As swine flu spreads globally, it's important to understand the short- and long-term causes and consequences.

Experts have been warning of a worldwide outbreak of a horrific influenza ever since 1997, when the first human cases of so-called H5N1 avian influenza were reported in Hong Kong. Two years ago the news was filled with a similar threat -- bird flu.

"We got lucky that time. That threat didn't ripen into a pandemic. But now we are watching and waiting to see what happens with another type of influenza -- swine flu," said Mark Jerome Walters, D.V.M., Associate Professor, University of South Florida St. Petersburg. Dr. Walters is a veterinarian and the author of "Six Modern Plagues and How We Are Causing Them" (Island Press, 2004).

"A spate of ominous mounting human cases has suddenly cast the threat of a pandemic into the headlines once again. If a severe pandemic does occur, nobody knows how many people will get sick or how many will die. The death toll could be in the millions," he cautioned.

Dr. Walters explained that nearly all infectious diseases are the result of the intersection of people and animals, with people disrupting natural processes and bringing on the trouble. He described the genesis of swine flu: "You have three different pools or families of influenza zooming around the globe," Dr. Walters told DOTmed News. "You have the birds migrating... carrying the virus from one pig farm to another. Then you have two billion people a year who fly. People migrate in their own way and so you now have these different pools colliding."

While people can contract a virus directly from livestock or birds, that is a contained or "dead end" jump because the virus spreads no further. This is what happened with the bird flu. The problem with today's swine flu is that it spreads directly from human to human.

"There have been a tremendous number of mild cases and one death in the U.S. and many more in Mexico but you cannot come up with a fatality rate. There are just not the numbers to do that. It may be extremely low. And it may stay that way. It may decrease or it could increase [in fatality]."

The time of year may come to our rescue here, at least for now. "It could be that -- because we are getting out of flu season--maybe this will just putter along until the next flu season when it will break out with a vengeance."

Because flu is transmitted from respiratory coughing and sneezing, it's associated with winter climates when people crowd together in confined places, increasing the likelihood of spreading.

"That doesn't mean that pandemic flus cannot spread outside of flu season. They can," Dr. Walters said.

What can you do right now to prepare yourself? Dr. Walters provided these recommendations:

Preparations to Take & Precautions to Implement

People can take basic steps to prepare themselves and their families for the worst. While these two simple actions may seem like a pittance in the face of a swine flu pandemic, they could help to decrease your chances of infection.

1. Take the time now to learn about swine flu. This will help you begin preparing emotionally for an event that may now be hard to comprehend. Those who have prepared themselves emotionally and intellectually will be able to act quickly and wisely while the unprepared are still struggling with denial and inaction.

2. Get in a habit of practicing the basic CDC-recommended hygiene techniques that you should have been practicing all along (but probably haven't):
-Cover your nose and mouth with a tissue when you cough or sneeze, and throw the tissue away after you use it.
-Try not to touch your eyes, nose, or mouth since germs can spread this way. Your children will learn this quickly if you teach them.
-Get in the habit of washing your hands often with soap and water, especially after you cough or sneeze. If you are not near water, use an alcohol-based hand cleaner. Although influenza spreads by respiratory droplets from coughing and sneezing, it can be carried on other surfaces.

3. Buy some face masks now. I have taken the modest step of buying (for a few dollars each) some face masks to have on hand in case the pandemic begins, although their effectiveness is limited in blocking transmission of the tiny influenza virus. (Masks with a rating of N95 or higher are apt to be more protective.) Such masks may be in short supply when the pandemic begins.

4. Plan ways to minimize your contact with others as you conduct essential business. To be sure, if a swine flu pandemic arrives, it will not be up to parents to send their children to school or not. Schools will be shut down. Large public gatherings, such as sporting events, will be prohibited. However, the small decisions you make every day will help to determine how many potentially infected people you come into contact with.

The Three Most Important Websites

Confirmed cases of swine flu in the U.S. can be tracked on CDC's website at http://www.cdc.gov/swineflu/ and recent swine flu news from the World Health Organization is posted at the follow site: http://www.who.int/csr/don/en/. If you are contemplating travel you can get the most recent traveler's health information at http://wwwn.cdc.gov/travel/.

Watch DOTmed News for ongoing coverage of the swine flu and for further excerpts from our interview with Dr. Walters.

Read an update on the swine flu at https://www.dotmed.com/news/story/8909.

Read DOTmed's exhaustive coverage of avian flu, with over 100 stories online, by entering "bird flu" in our news search box.