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.

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