The recent cluster of human H5N1 infections on the Indonesian island of Sumatra resulted in a noticeable spike in concern that the risk of efficient human-to-human transmission was increasing. Fortunately, there is still no evidence of sustained, efficient, human-to- human transmission of the H5N1 virus, but as fears surrounding the Karo cluster have subsided, we are left to ponder several critical questions:

• Is the risk of pandemic changing?
• If so, how does one assess the changing profile of pandemic risk?
• And, how do you communicate the meaning of any change in risk profile?

In an effort to grapple with these and other vexing issues, bio-era convened a web teleconference on June 22, 2006 featuring commentary from a distinguished panel of experts, including Dr. David Nabarro, Senior United Nations (U.N.) System Coordinator for Human and Avian Influenza, Dr. William Karesh, Director of Field Veterinary Services, Wildlife Conservation Society, Dr. Peter Sandman, a noted authority on risk communication, and Mr. James Newcomb, Managing Director for Research at bio-era. Participating with them on the call was an equally distinguished collection of bio-era clients and invited guests. What follows is an illustrated and edited transcript of what was said.