BIRD FLU PLANS IN WORKS L.A. FINE-TUNES RESPONSE IN CASE OF VIRAL PANDEMIC.

Byline: Harrison Sheppard Sacramento Bureau

As 75 officials were trained Thursday at Los Angeles International Airport for a possible avian flu outbreak, worried state regulators moved rapidly to develop an updated response plan for dealing with a statewide pandemic.

State Department of Health Services officials said they expect to release their updated pandemic influenza response plan soon after the federal government issues its own plan later this month.

``One of the questions is, 'Are we prepared?''' said Dr. Howard Backer, the state's interim public health officer. ``There is no yes or no. It's a continual state of increasing and improving our preparedness.

``Even when we have a draft plan, we'll continue to work on that to expand details.''

Avian influenza - which has jumped this year from Southeast Asia to China, Russia, Turkey, Romania and Macedonia - has yet to reach the United States.

Officials say it remains a greater danger to animals than humans because it is transmitted primarily among birds and has resulted in only about 60 human deaths worldwide.

But health officials remain worried about the potential for it to mutate and be transmitted among people - and to land ultimately in California.

A state plan crafted shortly after the terrorist attacks of Sept. 11, 2001, estimated that an influenza pandemic could kill at least 21,000 people in California, compared with about 200 deaths in a normal flu season.

Overall, it could make about 9 million Californians ill, with 97,000 hospitalizations, compared with 3,000 hospitalizations in a normal year.

``If it was truly a pandemic like they're talking about, the hospitals would be totally overwhelmed,'' said Dorel Harms, vice president of the California Hospital Association. ``The hospitals are already somewhat overwhelmed during a regular flu season. If we had a pandemic, it would not be a good thing.''

In the past 10 years, about 70 hospitals have closed in California, including six in the San Fernando Valley, reducing the total number to 430, according to the association. During that time, the state's population grew by 5 million people.

Part of the state's 2001 plan calls for ways to deal with potential shortages in medicine and personnel by, for example, recruiting volunteers with medical training or health care workers from other states or the federal government.

It also calls for setting up temporary medical locations similar to military MASH units, asking the governor to call the National Guard for help with law enforcement, and increasing the number of public messages asking sick people to stay at home to avoid spreading the virus.

Meanwhile, at LAX on Thursday, airline personnel and officials from the U.S. Centers for Disease Control and Prevention, the county health department, and the city of Los Angeles' police and fire departments tested responses to different scenarios of a potential bird flu outbreak.

``With each tabletop exercise, emergency operation plans get better and better,'' airport spokeswoman Nancy Castles said after the closed-door session.

The CDC has for years maintained a quarantine station at LAX and other major international airports across the country. CDC officials also have already trained airport and airline employees to spot symptoms of infectious diseases in passengers.

When such symptoms are observed in a passenger during a flight, the pilot is expected to notify airport personnel in advance, who in turn notify health and customs officials. CDC officials then treat the passenger and try to determine whether they have an infectious disease, according to CDC spokeswoman Jennifer Morcone.

If they do, medical personnel work to provide treatment and contact other passengers and employees who may have come in contact with the infected person. They also may have to quarantine those other passengers.

There is currently no vaccine available for the bird flu, although one is in clinical trials. Tamiflu is the most effective medication to treat the virus. The federal government has stockpiled about 2 million doses, and has plans to adds million more.

Other health officials say, however, that amount would be far short of what is needed if a pandemic occurs.

The worst flu crisis of modern times was the ``Spanish flu'' pandemic of 1918-19, in which an estimated 50 million people died worldwide, including 500,000 in the United States, according to the CDC.

Later pandemics, which initiated in Asia in 1957-58 and 1968-69, killed a combined 100,000 people in the United States. The flu virus strains in all three cases had an avian origin.

``Many scientists believe it is only a matter of time until the next influenza pandemic occurs,'' the CDC states on its Web site.

California's poultry industry is also concerned about the possibility of an outbreak, and state agriculture officials say they have a regular program of testing about 60,000 birds a year for various illnesses, including avian flu.

State Department of Food and Agriculture spokesman Jay Van Rein said agency officials remain confident they can detect the virus and contain it fairly quickly, given their experience containing an outbreak of exotic Newcastle disease in poultry farms in Riverside County in 2002.

``It's hard to overstate how important early detection is in a case like this,'' Van Rein said. ``The solution in itself is fairly straightforward, once you detect it. The detecting it in the smallest possible area and smallest bird population is the key, in terms of saving as many birds as possible and also in terms of minimizing exposure to humans.''

Harrison Sheppard, [phone]

harrison.sheppard(at)dailynews.com