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A bird flu pandemic may have already been averted by large-scale chicken culls and containment of infection, Australia's chief medical officer John Horvath says.
But he warns the nation must be prepared, regardless, for the spread of a deadly influenza strain that has the potential to spread rapidly from human to human.
But while it has three of the four elements needed to cause a pandemic - it can infect humans, cause severe disease and there is little immunity to it - it apparently cannot transmit efficiently from human to human.
"It may be that the world has already averted an influenza pandemic by actions it has taken in response to H5N1, such as extensive culling of poultry and isolation of infected humans," Prof Horvath wrote in the Medical Journal of Australia.
"There's the quandary: the potential threat has horrific proportions but it is not clear whether anything will actually happen," he wrote.