A scientist with the Chinese Academy of Agricultural Science is concerned about a bird flu pandemic. Hualan Chen rushes to work everyday to check the number of new H7N9 cases that were recorded overnight.

There was a bit of a scare in 2013, but then it quieted down, only to rear its ugly head with a vengeance again in December.

Chen can hardly keep up with the new cases, stating, “I think this virus is a bigger problem than people realize. There is a high chance of a pandemic if it continues to spread because no one has immunity to this virus,” she told attendees at a recent conference. “If there is sustained human-to-human transmission, it won’t just be a problem for China, it will be a disaster for the world.”

She’s not alone, health officials worry that the H7N9 cases in China are the beginnings of yet another pandemic, one for which the world is disturbingly unprepared. Although the public health community has been readying for The Next Big One, recent history shows that even smaller pandemics can cause serious problems.

The 2009 mini-pandemic with H1N1 came from nowhere, and proved to the medical industry that the distribution of vaccines and antiviral medication was nowhere near effective.

“Even just this little pipsqueak of an epidemic showed that we couldn’t get vaccines to the people who needed it in time, even in the US — the country with one of the most advanced health systems in the world,” says David Fedson, a retired infectious disease and vaccine expert from the University of Virginia. “The vaccine prevented maybe 2 to 4 percent of swine flu deaths.”

So far, the World Health Organization (WHO) reports that 246 people primarily in China have been infected with H7N9, and nearly a quarter of them have died.

What concerns health experts is that H7N9 meets two of the three conditions for becoming a pandemic—it is widespread among birds, and it can pass from birds to people.

Hong Kong ordered the killing of 20,000 chickens from a primary poultry market, as one bird tested positive for H7N9. They have since banned live poultry imports. Shanghai is closing its live poultry markets for three months beginning in February.

“Flu reminds us that we are all connected by the air we breathe,” says Dr. Thomas Frieden, director of the U.S. Centers for Disease Control.

“There is no way for us to know if a pandemic will happen tomorrow or 10 years from now or never. But what we can do is be even better prepared than we have in the past if it happens.”

A vaccine has been developed, but Frieden says it’s not very effective and may require more than one dose, which could complicate distribution if there were an urgent need to immunize the population.

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