By Maggie Fox, Health and Science Editor

WASHINGTON, Oct 17 (Reuters) - U.S. plans for an influenza pandemic have failed to take into account children, who will likely be among the biggest spreaders of the disease and its most vulnerable victims, health experts said on Wednesday.

Federal and state governments have not stockpiled nearly enough flu-fighting drugs, and no one has laid out a coherent plan for what to do with tens of millions of schoolchildren if schools and day-care centers are closed, the experts said.

And no federal policies have addressed the issue of parents who would have to choose between losing pay or caring for their children, according to the report from the American Academy of Pediatrics and the Trust for America's Health.

"We at this point are not adequately prepared to insure the health and well-being of our nation's children if and when a pandemic strikes," Dr. Henry Bernstein, chief of pediatrics at Children's Hospital at Dartmouth College in New Hampshire, told reporters in a telephone briefing.

"How will children be able to miss school for extended periods of time? Who will care for them when they are out of school?" Bernstein asked.

"How do we expect kids to stop congregating outside of school? ... We need to think now while there is still time to prepare."

Health experts almost universally agree that the world is overdue for a pandemic of influenza. Such global epidemics strike three times in a century, on average, when a new strain of influenza emerges that humans have no immunity against.

No one can say when or what strain will cause the next one, but the main suspect now is the H5N1 avian flu virus that has killed 203 people in 12 countries since 2003. It has infected 331, giving it a 60 percent fatality rate. Nearly half, or 46 percent, of the victims have been children.

LACKING DETAILS

Governments have been planning for such a pandemic for at least two years but experts complain the U.S. federal plan, available on the Internet at http://www.pandemicflu.gov, lacks needed details.

The report, published at the non-profit Trust's Web site at http://www.healthyamericans.org, notes that while there are 73.6 million children in the United States, there are only 100,000 courses of flu drugs for children in the Strategic National Stockpile.

"Neither of the two antiviral drugs that have been shown effective against H5N1 are licensed for children younger than 1 year of age," the report added.

And how would children who rely on school meals get fed if schools closed -- one of the recommended measures to help slow the spread of influenza, they asked?

"All schools should educate students in infection control," the report recommends -- a measure that would help right away in reducing seasonal colds and flu, too.

The Trust's Jeff Levi said that 50 percent of Americans have no sick leave. They may send their children to unlicensed care givers if schools and licensed day-care centers close.

"There is little realization that there are unlicensed day-care centers that can't be closed officially that operate under the radar screen, which is where all these kids would be going," said Dr. John Bradley of Children's Hospital San Diego, another member of the American Academy of Pediatrics Committee on Infectious Disease.

They will almost certainly spread influenza among themselves and then bring it home to their parents, he said.

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