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It is very difficult to assess the risk that the virus may mutate so that it spreads easily from human to human. The risk may be high, because different kinds of flu viruses mix and exchange genes all the time -- this is why we get new outbreaks of flu every year.

To prevent further contagion to humans, more poultry must be destroyed. Viet Nam has even banned all duck and goose farming. This represents a great economic setback to farmers and to the entire local economy. If they don't get compensation, many will keep their poultry, to keep from starving, and the flu is more likely to spread to humans and mutate. Since this is important to everyone around the globe, and rich countries have far more resources than the affected countries, it seems reasonable that rich countries contribute significantly to these costs.

If the flu starts spreading as a pandemic, its deadly effects can be greatly diminished if people take a flu medication called oseltamivir, sold under the brand name Tamiflu. This medicine would have to be produced and stockpiled beforehand, because when the pandemic has started it's too late. Once you show symptoms you must start medication in two days.

Doctors recommend that people do not stockpile Tamiflu at home, because if it's used incorrectly, viruses may develop resistance, so that when the pandemic appears the medicine has very little effect. Then the death toll will be much greater. Therefore they recommend that the medicine be stockpiled by the health system.

Recently it was reported in Sweden that some Swedish doctors have stockpiled Tamiflu at home for themselves and their families. If doctors don't trust the health system, can others be expected to trust it?

Bird flu has now been in the news for a few days in Sweden, and now all the stocks of Tamiflu in Sweden's capital Stockholm have been sold, not a single package can be found in any of the pharmacies. This means that sensitive people who need the medicine to overcome ordinary flu, primarily the elderly, cannot get the medication they need.

Tamiflu is expensive. Stockpiling sufficient quantities so that every citizen can take them in a pandemic would be hugely expensive. Tamiflu can only be stored for a few years, so if there is no outbreak in that time the investment has been wasted, and new stockpiles must be bought. One solution may be to only stockpile quantities that are sufficient for key personnel who are essential to the continued functioning of society, such as medical personnel, garbage collectors and government officials. Burning questions arise. Is such selection ethical? Who is essential?

Because of the high costs, perhaps only rich countries can stockpile quantities that are sufficient to contain the pandemic. However, it might make more sense to stockpile the medicines in those Asian countries where the flu is widespread among birds, so that the spread can be contained at its source, and we don't get any pandemic at all. If this can indeed stop the pandemic, millions of lives could be spared. But of course we are only human, and therefore we will think first of ourselves.

That's assuming Tamiflu can limit the spread of the disease. It is not yet clear whether it can do that. It's quite possible that it will only alleviate the symptoms, without affecting its spread. If so, the only medicine that can limit the spread will be a vaccine. Unfortunately, production of a reliable vaccine can only be started after the outbreak, when the virus has been identified. Exploring this, and then developing, testing and producing large quantities of vaccine, may take many months.

A less reliable vaccine can probably be developed, produced and stockpiled beforehand. This would be a vaccine against the virus that exists today. Unfortunately, since the virus that produces the pandemic will be a mutated version, there is no guarantee that such a vaccine will be effective.

We should not panic. Health experts point out that so far only very few cases of people contracting the virus have been confirmed, even though millions of people in Asia are handling poultry all the time. WHO, the World Health Organization, has confirmed only 55 cases worldwide of humans infected with this flu in the period from January 28, 2004, to February 2, 2005. And in the very few confirmed cases of contagion from human to human, so far the experts have never seen the swift and easy contagion that could spell worldwide danger.