By Maggie Fox, Health and Science Editor

WASHINGTON, July 17 (Reuters) - The United States has helped many countries watch and prepare for a bird flu pandemic, but lacks the rapid tests and hospital capacity to cope with one at home, the White House said on Tuesday.

The federal government issued a report card one year after it released a pandemic influenza plan, and said agencies had finished many of the hundreds of tasks assigned.

But some of the most difficult tasks remain, including the ability to quickly detect the spread of disease, capacity to make vaccines quickly and in large-enough amounts, and detailed plans on who gets drugs and vaccines if a pandemic hits.

"We have limited surveillance capability here in the United States," said Dr. Rajeev Venkayya, assistant to President George W. Bush for biodefense.

Hospitals are already overwhelmed with day-to-day patients. "We are almost certainly not going to have sufficient health and medical capacity to take care of the large number of individuals that would be presented by a large pandemic," Venkayya told a briefing.

The report noted that a billion dollars has been invested in upgrading vaccine manufacturing. It said U.S. antiviral drug production capacity was at 80 million regimens per year.

Experts agree that a pandemic of some sort is inevitable. No one can predict when, or what disease, although the H5N1 virus that has infected birds in 50 countries is the main suspect.

It has killed 192 out of the 318 people infected since 2003 and a few mutations could make it flash around the world, infecting tens of millions and killing many of them.

The flu plan, published on the Internet at http://pandemicflu.gov, called for the federal government to do whatever is possible to get ready, while noting that most of the response to any outbreak of disease will be the responsibility of individuals, states and local authorities.

PROGRESS ABROAD

The plan also called for U.S. agencies to help other countries cope. Much of the progress reported in the one-year update is in other countries.

"Over the past year, the U.S. government has supported the training of more than 129,000 animal health workers and 17,000 human health workers in H5N1 surveillance and outbreak response," the report said.

"In Cambodia and Laos, for instance, the time between onset of outbreaks and reporting has shortened from up to five weeks to 48 hours, significantly improving the opportunity for an effective outbreak response and containment," it adds.

The report said the United States was close to an agreement with Canada and Mexico that would arrange for the three nations to jointly watch for the virus and, if necessary, respond to it. The highly pathogenic strain of H5N1 that has devastated flocks from China to Africa and parts of Europe has not yet crossed to the Americas.

The U.S. Department of Agriculture's Dr. John Clifford said 84,000 wild birds had been tested on both coasts for signs of H5N1, and the virus had not been found, although a relatively harmless low-pathogenic strain had turned up several times.

Jeff Levi, executive director of the nonprofit Trust for America's Health, which has been examining pandemic preparations, praised the report card system as a way of making sure the government was accountable.

"Major work remains to be done," Levi said. "There are critical elements of preparedness that the strategy does not fully address."

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