"We have already seen cases of human-to-human transmission (of avian flu). We’re one step from a pandemic," Dr. Sureyya Hornston told the Gainesville Rotary Club Monday. "I hate to sound pessimistic, but I have to tell you the truth."

Hornston has worked for many years in the field of disease prevention, both in the United States and abroad. After completing a doctorate in clinical microbiology, parasitology and tropical diseases in her native Turkey, she earned a master’s degree in public health at Emory University in Atlanta.

She recently spent four months working at the World Health Organization’s regional office in the Philippines, targeting an area of the world where pandemic flu is most likely to emerge.

"Thank goodness, at the moment there is no pandemic flu," she told the Rotary Club.

But that situation could change quickly. "Most people say this can’t happen. This won’t happen," she said. "But trust me, it can happen."

To illustrate how, Hornston explained the differences between types of flu epidemics. The garden-
variety viruses that pop up every winter are known as seasonal influenza and are spread from one person to another.

Avian influenza is a virus that originates in birds, and may or may not infect humans, depending on the strain.

Pandemic influenza is a highly virulent illness that spreads easily from one human to another in a global outbreak.

What troubles scientists about avian flu is that it has the potential to morph into a pandemic. Hornston said researchers are monitoring flu viruses to detect "shift," a radical mutation into a strain to which humans have no immunity.

That’s why world health officials have been so aggressive in trying to contain outbreaks of avian flu before that shift can occur. Hornston has visited a number of countries where governments responded to avian flu outbreaks by ordering the slaughter of millions of chickens, ducks, and other domestic birds.

"It’s very heart-breaking to see, in countries where people are very poor and their livelihood depends on the birds," she said.

But the alternative — waiting for the virus to jump to humans — would be far worse.

"If avian flu evolves to a form easily transmissible to humans, we don’t know how effective antiviral medicines will be," Hornston said. "And we cannot be prepared in advance. It takes six to nine months to develop a flu vaccine."

The CDC estimates that 90 million people in the U.S. could be sickened during a pandemic, with up to 300,000 deaths. Millions of people would be absent from work, due to their own illness or that of a family member, or to fear of catching the disease. This could wreak havoc on the transportation system, resulting in shortages of essential supplies.

The Georgia Division of Public Health has taken the lead on trying to get communities prepared for this possibility. In Hall County, local government agencies have been formulating a plan of action. But Hornston said businesses also need to become involved.

"Having a written plan (for your business) is very important," she said. "And you need to do dry runs or tabletop exercises to make sure the plan works."

William Wright, emergency management coordinator for Hall, said he is still trying to get the business community to take the threat of flu seriously.

"I think about 60 percent of preparedness is awareness," he said.

Wright has scheduled a "pandemic summit" March 5 at the Georgia Mountains Center for the county’s largest employers.

"We will have state health officials there, and also a physician from Southern Company (owner of Georgia Power), who will talk about the preparedness plan they have already developed," Wright said.