The budget cuts that eliminated nearly 40 percent of the county Health Department staff, including many nurses, make the job more difficult, Billittier said.

Erie County is in the Western New York Public Health Alliance, which has been gearing up for a bird flu pandemic and other disasters since 9/11.

Christopher Szwagiel, Genesee County's health director, said the big question is whether medicines will be available.

While the slow process of developing and then producing a vaccine cannot begin until the virus strain has been identified in a laboratory, the antiviral Tamiflu - which is in short supply - makes symptoms less severe and shortens the duration of the illness.

"Our biggest concerns are if we are going to get enough vaccine or doses of the antiviral drugs to dispense," said Szwagiel, who oversaw a recent bird flu immunization test clinic in Batavia.

Paulette Kline, Niagara County's public health director, said her department has been working on a pandemic plan for two years and is in a pilot project with the U.S. Department of Agriculture to track potential effects on animals.

"We have ramped up our efforts and have a highly integrated model for an emergency response plan for the county," Kline said.

The most controversial part of the regional response will be removing people from the general population, a familiar response to disease-spreading calamities, Billittier said.

"For the most part, the people who are really sick would have to go into hospitals, and the people who are less sick would have to go home to their families, and hopefully their families could take care of them," he said.

"If your family member had pandemic flu, what we might say is that for two weeks you can't go to work because you could come down with it, and you have to stay home until the incubation period is over. That's a very old-fashioned public health practice that could be very effective."

Plans have been developed with officials from law enforcement and the judiciary, which Billittier said no one is taking lightly. "We'd be essentially depriving people of their civil liberties to protect the public at large," he said.

The state Health Department is planning a pandemic bird flu exercise for Western New York in the spring. That's unless the virus hasn't mutated into a human pandemic by then.

Avian flu was discovered in 1997 in Hong Kong. Later, a more lethal strain, identified as H5N1, resulted in about 60 deaths in Asia through physical contact with infected birds. A pandemic could occur if the virus found in poultry and migratory birds mutates so it can be transferred between humans.

Eating meat from birds infected with the virus is not dangerous because it is not a food-borne illness and dies with cooking. Touching infected birds, though, can infect humans.

Harshad Thacore, an associate professor in the University at Buffalo's department of microbiology and immunology in the School of Medicine and Biomedical Sciences, said there is no certainty of a flu pandemic. "It may or may not happen. It could happen next year, five years from now, 10 years from now. Or not at all," he said.

The bird flu has prompted comparisons to the 1918 Spanish Flu, which killed a minimum of 20 million people worldwide.

In the past week, scientists have held their breath as migratory birds have spread the disease from Asia to Romania, Turkey, Greece and parts of Russia en route next, they believe, to the Middle East and Africa.

If the evolving virus does acquire the gene or protein mutation it needs to allow human-to-human infection, global doomsday scenarios posit an outbreak that could kill millions.

An examination by the staff of Sen. Charles E. Schumer, D-N.Y., found Western New York would require more than 524,000 doses of Tamiflu - about one-quarter of the national supply of 2.3 million.

Recently, the Senate added $3 million to boost stockpiles, which would cover about 50 percent of the population. And Schumer helped prod Roche, the Swiss pharmaceutical company that holds the patent to Tamiflu, to announce Thursday that it would begin an effort to license it to U.S. drug manufacturers. The drug is currently produced in a single factory in Switzerland.

The prescription-only Tamiflu is sold locally for combating the common flu, but some insurers don't cover it, according to Wing Mak, pharmacy manager at Rite Aid's Elmwood store in Buffalo.

Sen. Hillary Rodham Clinton, D-N.Y., introduced legislation this month with Sen. Pat Roberts, R-Kan., to address the vaccine shortages of recent years. The bill would create a stable vaccine market for manufacturers,increase research into safer, faster and more reliable methods of vaccination production and set up a national tracking system to monitor where vaccines are most needed.

Each year, there are an estimated 36,000 deaths and 110,000 hospitalizations from the flu.

"Just last year, we watched people lining up for hours to obtain a flu shot, only to be turned away because the place they were waiting had run out of vaccine," Clinton said. "How can we possibly be prepared for a pandemic outbreak when we are not prepared to handle the routine and predictable occurrence of flu season?"

Billittier is also dissatisfied with the federal government's readiness so far.

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