On a wing and a prayer

What will determine whether I get it? Is it anything to do with my genetic make-up? We’re all vulnerable but especially those who are sick, elderly or whose immune system has been weakened (for example, people who are HIV-positive or receiving chemotherapy). The more people you meet daily during a pandemic, the more likely you are to pick up the virus.

As for genetic make-up, the answer is yes. Humans vary greatly in their response to a disease for a good reason; it makes it highly unlikely that the human race will be wiped out by a single bug. But being resistant to the H5N1 virus doesn’t mean that your immune system is better than someone else’s; it’s just different.

Are people in urban areas more at risk? If there is pandemic flu, people in built-up areas may be more vulnerable simply because they meet more people during their daily lives.

Are some groups more vulnerable to getting it; or dying from it ?People whose jobs bring them into contact with lots of people all the time are vulnerable, along with the sick and those in front-line health services. Traditionally, children, the elderly and those who are already sick (especially those with respiratory disease) are most likely to die from flu. People think that scientists already know who will be most at risk. But they don’t and won’t until the pandemic virus appears and its characteristics are apparent. It’s possible that the virus could be much milder than we fear.

How near is a threat? Everyone agrees that a pandemic will happen but most think it unlikely this year. Neil Ferguson, a professor of mathematical biology at Imperial College, one of the world’s best-known flu modellers, thinks that it will come within five years. Other people, such as the renowned virologist Professor Albert Osterhaus, at the University of Rotterdam, think that it will be sooner than this.

Can I catch it from eating chicken and does eating organic make a difference? The normal food hygiene measures you use to prevent getting other bugs. such as salmonella — proper cooking and washing your hands and surfaces after exposure to raw meat — will prevent you being infected if you happen to handle or eat an infected bird. The risk of infection via the food chain is thought to be very low. The EU has banned poultry meat from affected areas such as Turkey, but this is to reduce the risk of avian flu virus infecting other birds, not because of direct risk to human health. There is no difference between eating organic or ordinary chicken in terms of infection risk.

Can I catch it from garden birds or ducks, and should I stop feeding them? People have caught bird flu from being in close contact with sick or dead domestic poultry. There is no case of a human being infected by contact with a wild bird. However, you should leave birds that appear to be sick well alone.

Is it possible that bird flu will hit people on top of other kinds of flu? Bird flu, pandemic flu and seasonal flu are caused by different variants of the flu virus, so in theory, yes, but you’d be horribly unlucky.

Will masks help? If we have pandemic flu, probably only if you are in a front-line service caring for people who are sick. Even then, they need to fit properly and to be US standard N95 respirators to be effective. Handwashing is likely to be a more important preventive.

If I can get Tamiflu, will it help? In theory you could take Tamiflu to prevent infection, but you’d have to take it for months, if not years, as successive flu waves swept the country. The minute you stopped, you’d be vulnerable again. Britain’s stockpile is for treatment, not for prevention. If you take Tamiflu when you have pandemic flu it may mean the difference between life and death, so don’t waste any personal stockpile you have unless you know you definitely have flu, rather than just a cold. The catch is that you have to take it within 48 hours of onset for it to be effective.

Does Tamiflu have any side-effects? All medicines can have side-effects, but Tamiflu seems to be safe and has been licensed by both the FDA and British authorities.

Are there any alternatives to Tamiflu that might be more easily available? Relenza is the other appropriate anti-viral but it is no easier to obtain. A paper published this week in The Lancet showed that neither Tamiflu nor Relenza had an effect on avian flu, and should be reserved only for use with pandemic flu. Many businesses are already offering highly dubious quack remedies on the internet, along with fake Tamiflu. Don’t go there. Will good hygiene and handwashing help?Yes. Use tissues and flush them away to avoid them infecting others. If you’re out and about, wash your hands frequently as the flu virus is spread mainly by contact with surfaces touched by those with the virus, and then touching your face. The H5N1 virus can live for six days on a surface.

Will taking supplements help me to avoid it or fight it off? There are many claims, such as those for zinc and high doses of vitamin C, but little hard evidence. A variety of nutrients are essential for a healthy immune system. Some studies suggest that supplements might be helpful for some illnesses, but the evidence is weak. There is no published research specifically into the effects of supplements on H5N1 avian flu. The advice from doctors and nutritionists is that a healthy, varied diet with plenty of fresh vegetables, fruit and oily fish will provide all the nutrients required for a robust immune system.

Will any complementary medicines help? As with supplements, there are many claims but no real proof. Chinese medicine uses a number of herbal flu preparations. A review from the research body, The Cochrane Collaboration, concluded that some of these seemed equally effective or more effective than drugs but could not recommend any particular preparation owing to lack of evidence. Another review, on the homoeopathic remedy oscillococcinum, said it was promising but that there was not sufficient data to draw a conclusion. There are no studies on how these preparations might work on pandemic flu.

Additional information from Dr Toby Murcott, a Body&Soul columnist and the author of The Whole Story: Alternative Medicine on Trial?