FEARS of an influenza pandemic like that which killed more than 20 million people in 1918 prompted the US Government yesterday to reveal plans to close schools, ban travel, impose quarantine and ration vaccines.

Tommy Thompson, the Health Secretary, released a document that estimated that a bad outbreak could kill 207,000 people in the US alone.

Experts say it is only a matter of time until a new and deadly strain of flu erupts. Recent species-hopping of bird flu to pigs in Asia has heightened concerns.

“We’re all holding our breath,” Julie Gerberding, head of the Centres for Disease Control and Prevention, said. In any pandemic, Americans would be advised to wear masks in public, work from home, stop shaking hands and avoid contact with large groups of people. Travellers from affected regions would be tested at airports and quarantined if sick.

Antiviral drugs could be used to reduce the risk of death, but it takes six to eight months to produce a vaccine for any new strain, so authorities would have to hand-pick its recipients at the beginning of a pandemic.

The plan did not predict a pandemic but was intended to serve, Mr Thompson said, as a road map for such an event “whenever that may be”.

The Department of Health said yesterday that it is working on a similar plan to deal with a new pandemic of flu. When complete the plan will be published, a spokeswoman said, but it is not yet clear when that will be.

Doctors in Britain say today that British plans to deal with flu-like illnesses in nursing and residential homes by giving preventive doses of an anti-flu drug are impracticable and hugely expensive.

Last year the Government’s drug watchdog, the National Institute for Clinical Excellence, said that every time a case of flu-like illness was found in a home, other residents should be given oseltamivir (Tamiflu) to prevent them catching it.

Three experts in epidemics studied the number of such cases in 48 homes last winter, to assess how practical that advice was. They report in the British Medical Journal online that, given the volume of cases, it wouldn’t be very practical at all. Almost three-quarters of the homes had at least one new case in a four-week period. If applied to all 500,000 residents of care homes in England, this would mean at least 360,000 courses of oseltamivir would have been given last winter, at a cost of more than £4.5 million.

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