Influenza is one of the leading causes of death. On average, the flu is responsible for more than 200,000 hospitalizations and 36,000 deaths a year in the United States, according to the Centers for Disease Control and Prevention (CDC). While these are tragic events, they do not compare to the morbidity and mortality that occur with a pandemic. Public health experts agree that the likelihood of another pandemic occurring is not a question of "if," but "when." There were three influenza pandemics in the last century:

The first in 1918 (Spanish flu) was responsible for the worst infectious epidemic in modern history. During this period, influenza circled the globe and killed over 20 million people worldwide. In the United States, 500,000 died;

The second epidemic in 1957 (Asian flu) left 70,000 U.S. residents dead ;

And the third in 1968 (Hong Kong flu) resulted in 34,000 U.S. deaths.

Planning has been underway for the next pandemic of influenza. The recent outbreak of Severe Acute Respiratory Syndrome (SARS) has also brought urgency to pandemic preparedness and taught our nation's health officials to continue to look for holes in testing and security measures and to devise a strategy to respond.

Last year's vaccine crisis pointed to the larger problem of the fragility of the nation's manufacturing and distribution of the vaccine. Hospitals, pharmacies and health officials were thrown into a scramble to obtain doses of the flu vaccine and were initially forced to deny thousands of citizens their annual shots because of the nation's dwindling supply. One hundred and eighty million Americans are considered high risk and are advised to get a flu shot; yet, even in our best year, the nation has only inoculated 87 million people. Now is the time for both governmental and non-governmental agencies to explore ways to prevent the vaccine shortage from happening again.

The World Health Organization (WHO) works through a network of collaborating national influenza centers to track the types of flu strains infecting humans and to measure the effectiveness of current vaccines. Twice a year, an international consultation is held to evaluate the various virus strains and make decisions concerning future vaccine composition. In the spring and fall of each year, a recommendation is made to vaccine manufacturers concerning the makeup of the vaccine to be used. Lawmakers have introduced legislation to address the threat of a flu pandemic, particularly in the wake of the current avian influenza outbreak. The Flu Protection Act of 2005, for example, offers important steps to protect the public, including educating individuals of the importance of the flu vaccine and the groups most at risk for serious influenza-related complications. Influenza season typically peaks in the United States between December and March, says the CDC.

Besides getting their flu shots, individuals can take practical steps to help prevent the spread of flu, such as avoiding close contact with people who are sick, or if an individual becomes sick, taking the initiative to keep their distance from others; when possible, staying home from work, school, and errands when they're sick; covering their mouths and noses when coughing and sneezing; and cleaning their hands often. Public education, coupled with the modernization of the vaccine production process and improved distribution, are essential to protecting the nation against future flu epidemics or pandemics.

The nation must have a dependable vaccine supply and adequately prepared public health system to effectively and efficiently respond to a pandemic situation. Thousands of lives depend on thwarting this potentially fatal, but mostly preventable, health risk.