After several years of educating myself so that I could answer anxious questions from my patients about nerve gas, anthrax, swine flu, mad cow disease, West Nile virus, SARS, and now bird flu, I find myself thinking wistfully back to 1963 when, as a 10-year-old, all I had to worry about was total nuclear annihilation.

Pandemic bird ("avian") flu is the latest in a series of health problems that have kept us in a heightened state of alert lately. This cannot be good for anybody's sanity. We are wired evolutionarily for brief surges of adrenaline, "fight or flight" responses that briefly put us in overdrive. But what engine can remain in overdrive for years at a time without becoming seriously fried?

I try to provide logical advice about fears that might just prove real. At the same time, I like to point out that bird flu at present is mainly a problem for birds. It is a contagious disease caused by influenza A viruses --- so far passed easily among birds, but not humans. To date, health experts know of fewer than 200 cases of human infection worldwide, and these are almost entirely in patients who had close contact with sick birds. The few cases of human-to-human transmission have required very close contact with an ill patient.

The truth is, health experts don't know what will happen if bird flu is able to spread easily from human to human. Previous flu pandemics (1918, 1957, 1968, and 1977) may be of little value in predicting a pandemic today. On the one hand, airplanes will help spread the virus more quickly than in the past. But on the other, we have far more sophisticated tools for early detection and treatment than we've ever had before.

Meanwhile, what can you do for yourself and your family?

Skip antivirals. Resist the temptation to stockpile antivirals such as Tamiflu. Shortages created by hoarding would hamper the ability to treat patients with regular flu, which affects millions of people and kills about 36,000 annually in the United States. In addition, bird flu virus will likely become resistant to antivirals if people overuse them.

Practice good hygiene. Since human bird flu would be spread in a similar way as regular flu --- that is, by respiratory droplets produced by sneezing or coughing --- take the same steps you would for avoiding regular flu: Wash your hands, cover your mouth when you sneeze, stay home when you're ill, and so on.

Consider a mask. The jury's still out on the benefit of using a mask in public. However, infected people could wear a mask to protect others, and their caretakers can wear one as well.

Stay informed. Check out the Centers for Disease Control's Pandemic Flu Planning Checklist for Individuals and Families on the CDC's web site, www.PandemicFlu.gov. Go to the home page and click on "Individual Planning."