Flu Advice Would Vary Under U.S. Plan

Centers for Disease Control and Prevention Director Julie Gerberding, right, and Mitchell Cohen confer during a large-scale exercise to see how well the CDC would react to a pandemic flu outbreak, in Atlanta Wednesday, Jan. 31, 2007. (AP Photo/John Bazemore) (John Bazemore - AP)

For example, in a Category 1 pandemic, there's no need to dismiss schools. But in a 2 or 3, states should consider dismissing students for up to four weeks. In a 4 or 5, they should consider closing the schools for up to 12 weeks.

CDC officials said categories are important because until now many people have thought of pandemic flu in black and white terms: Either a deadly contagion is upon is, or it isn't.

"Not all pandemics are equally severe," Dr. Julie Gerberding, the CDC's director, said Thursday in unveiling the new guidelines.

The CDC copied the nation's hurricane ranking system to help people size up the situation and to help communities make what Gerberding called "real tough decisions" about when and how to cut back normal activities.

But not everything is covered in the new guidance. For example, it says little about whether sick people or healthy people should wear masks, and if they do, what kinds.

"It's not a simple matter," Gerberding said, adding that more detailed advice on masks should be coming out soon.

Flu pandemics can strike when a mutating flu virus shifts to a strain that people never have experienced. Scientists cannot predict when the next pandemic will arrive, although concern is rising that the Asian bird flu might trigger one if it starts spreading easily from person to person.

Most planning until now has focused on the worst-case scenario of an outbreak as severe as in 1918, when 50 million people worldwide died. But the 20th century's other two pandemics, in 1957 and 1968, were far less severe, claiming 2 million and 1 million lives, respectively.

The 1918 pandemic was a primary model for current pandemic flu planning. Dr. Howard Markel, a University of Michigan health historian, said he believes the government's new grading system might have made a difference back then.

Federal health officials put out guidance then, too, but cities varied on what steps they took, said Markel.

States still have leeway, of course, and neighboring states may institute different measures in a new pandemic. But if the government comes out with clear advice, it will probably be followed more closely than it was in 1918, when governmental power was more local, he said.

"The federal government telling a local or state health board to do something was not met with warmly," he said.

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AP Medical Writer Lauran Neergaard in Washington contributed to this report.

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On the Net:

Federal pandemic info: http://www.pandemicflu.gov