If thing thing gets loose in some areas of India or Africa it could be devastating.
My biggest concern vis a vis the U.S. would be in the illegal immigrant communities in cities like LA. Someone gets infected but is afraid to seek help for fear of deportation, so they suffer through their "flu" at home. They cough and give it to friends/family. They begin to cough, and so on. Before you know it you have it spreading unchecked in areas populated by poor, in some cases illiterate folks who refuse to go to the hospital. Not good.