Sir Liam Donaldson last week called together 30 public health leaders, including the heads of the royal colleges, to emphasise that the disease could kill between 50,000 and 750,000 people and should not be treated as a joke.

He is planning to issue a “protect and survive” leaflet to every household in England and Wales and has instructed all hospitals, doctors’ practices and National Health Service trusts to inform him of contingency plans for coping with mass casualties. Donaldson fears that the current level of precautions could lead to a lethal strain of flu arriving unnoticed.

“Many doctors think, ‘Flu is flu, we see it every winter’,” Donaldson said. “We have got to get the message through that this is going to be much more serious.

“I can’t give a likelihood of it starting this year, next year or in five years, but it will come. There is a biological inevitability and we’ve got to be prepared for it.”

Donaldson said he was dismayed after hearing that some hospitals were “full of dead parrot jokes and people (don’t) believe this is actually going to happen”. The first victim of bird flu in Britain was a parrot infected with the H5N1 strain that died in quarantine at Heathrow last month.

This strain has devastated poultry flocks in the Far East over the past eight years and killed 62 people, raising fears that the world may be on the brink of a lethal mutation of the virus capable of sparking a human pandemic.

Donaldson, who was appointed to his post in 1998 and knighted in 2002, believes that the predicted emergence of the killer strain will be the biggest test of his career and the worst epidemic to face the NHS.

Responsibility for minimising casualties falls ultimately on him. The disease could strike one in four people and kill more than one in 100.

“The fight will be an extended and protracted one,” he said. “We have to get local tenacity into the planning for this. We can’t be alarmist, but we have to take it seriously and we have to prepare.”

In addition to awarding a contract for 14.5m doses of the anti-viral drug Tamiflu — so far the only one available to combat the disease — Donaldson is supervising the protect and survive leaflets, similar to those produced when the nation believed itself to be under threat of nuclear attack.

The leaflets will put the population on the alert, while seeking to prevent hospitals and surgeries being swamped with anxious patients. They will advise the public on what symptoms to look out for and under what circumstances they should seek medical treatment. They will also give information on the effectiveness of anti-viral drugs and indicate when vaccines will become available.

He said there were no plans at present to impose “stay at home” orders: “On the whole, people are sensible and the majority of people with flu, even pandemic flu, are going to be at home in their own beds taking a whole heap of fluids.”

Donaldson is supervising public information bulletins to be televised in the event of a pandemic. The campaign can be drawn up in detail only in the interval between an outbreak in Asia and its arrival in Britain.

Corbett McDonald, emeritus professor of epidemiology at the Royal Brompton Hospital, London, was among experts invited to Donaldson’s meeting to give accounts of previous crises. McDonald, who helped manage the 1957 Asian flu, described it as “like a bonfire”.

He said the first wave had killed 15,000 people, while a second a month later killed up to twice as many, although official estimates were lower.

It will not be possible to predict who is most at risk until the virus strikes. While the Spanish flu of 1918 mainly attacked fit adults aged 20-40, killing an unprecedented 40m worldwide, the pandemic of 1957 hit the British population aged over 50. There was an outbreak of so-called Hong Kong flu in 1968 which also affected mainly older people.

Last week’s medical summit, held over dinner, was addressed by specialists in geriatrics and emergency medicine, and was attended by Colin Blakemore, chief executive of the Medical Research Council.

Every unit of the NHS is now being told to give Donaldson precise details of its planned response: “They’ve got the data in the contingency plan to give them some idea of the numbers involved. We’re asking, ‘If this number happened in your area, what would you do?’ ” A number of hospitals have also been told to track their flu admissions this winter. “We want them to ask themselves: if it was twice, three times or four times that number, what would they do?” said Donaldson.

Additional reporting: Mo Khan

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