WASHINGTON - Children would likely be both prime spreaders and targets of a flu pandemic, but they're being overlooked in the nation's preparations for the next super-flu, pediatricians and public health advocates reported Wednesday.

The report urges the government to improve planned child protections, including how to care for youngsters if a pandemic closes schools.

"Right now, we are behind the curve in finding ways to limit the spread of a pandemic in children even though they are among the most at risk," said Dr. John Bradley of the American Academy of Pediatrics, which co-authored the report with the Trust for America's Health.

Concern is rising that the Asian bird flu known as H5N1 could trigger the next worldwide influenza epidemic if it mutates to become more easily spread person-to-person.

Children have long seemed particularly vulnerable to H5N1, possibly because they are more likely to touch or play with the diseased birds who spread it. Wednesday's report says nearly 46 percent of bird flu deaths since 2003 were among people 19 or younger.

Bird flu aside, germ-ridden youngsters already spur regular flu's spread through communities every winter, and experts have long called for better pediatric pandemic preparations.

Among gaps cited Wednesday:

  • A stockpile of anti-flu medications contains only enough pediatric doses for 100,000 children; child vaccine doses are still under study.
  • No protective face masks come in child sizes, although it's also not clear that children would tolerate wearing one.
  • There are no plans for how to feed the 30 million children who rely on the school lunch program, if schools close.