A killer flu could come at any time: Is the world prepared?

Ninety years after tens of millions died during the Spanish Flu, scientists say the world is due for another killer influenza pandemic and countries are not equipped to handle it.

It began with a cough. Then came the sniffles, and then a terrible fever.

No one thought it was anything more than the flu. And, indeed, that’s all it was. But the year was 1918, and this flu was one of the greatest killers mankind had ever known.

“I heard my father coughing, and I had never heard him the least bit sick before that,” said Lora Miller, a 96-year-old Los Angles resident whose father was killed by the epidemic. “He passed away pretty fast. It was a terrible shock. He was so young and strong. I never got over it.”

Ninety years after the deadliest flu swept through the world, scientists and health officials say that it could happen again. Not only is the planet overdue for another flu pandemic, scientists say, the United States is due for an influenza virus as bad or worse than the flu that killed more than 500,000 Americans in 1918 and 1919. Experts believe that if a similar pandemic struck again, with modern transportation moving unwittingly infected people quickly around the world, millions of Americans could die.

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A memorial stone at Maple Grove Cemetery, Queens, New York, dedicated to those who died in a 1918 flu pandemic. More than 300 victims are buried nearby in a mass grave. (Photo by Robert McDonald)

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A memorial stone at Maple Grove Cemetery, Queens, New York, dedicated to those who died in a 1918 flu pandemic. More than 300 victims are buried nearby in a mass grave. (Photo by Robert McDonald)

The federal government has made great strides in preparing for a pandemic - global virus surveillance has been beefed up, flu vaccine and anti-viral supplies expanded and detailed plans created to deal with a society in crisis. The problem is that no knows how much these efforts will actually help slow down a killer virus.

The pandemic of 1918 and 1919, known as the Spanish Flu because it was erroneously thought to have come from Spain, was an unusual killer. Unlike conventional flu viruses, it killed the strong and the healthy, but passed over the old and the very young.

It killed An estimated 20 million to 50 million people worldwide. The disease killed more U.S. soldiers in World War I than were killed in combat.

“The clock is ticking, and we don’t know if time's up,” said Dr. Bruce Gellin, director of the National Vaccine Program Office at the Department of Health and Human Services. “A flu pandemic could happen at any time.”

A flu pandemic is an outbreak of a new type of influenza A virus, a variant of the deadliest type of flu, that spreads throughout the world.

Historically, there have been flu pandemics every 30 to 35 years, according to the federal Centers for Disease Control and Prevention. The Asian Flu of 1957-58 killed 70,000 Americans and the Hong Kong Flu of 1968-69 killed 34,000.

The 1918 flu killed so many because it occurred at the end of the First World War when millions of soldiers were crammed together in battlefields and camps worldwide before returning home. Now, with airplanes bringing people from one side of the earth to the other in a matter of hours instead of weeks, officials worry that a pandemic could be far more deadly.

“With modern transportation, a flu pandemic could spread faster than any time in history,” said Richard Thompson, spokesman for the World Health Organization. “The death toll would be between 4 to 40 million deaths.”

Thompson said he is not sure it will ever be possible to stop a pandemic, but much can be done to slow one down and protect people from its worst ravages. Every government should prepare for such an outbreak, he said, by stocking up on massive amounts of antiviral medications and investing in a global surveillance network to detect a killer virus early.

The WHO encourages governments to create plans to deal with a pandemic. The U.S. Government published its plan in 2005.

Dr. Stephen Morse, a virus expert at the Mailman School of Public Health at Columbia University, said that the United States is better prepared for a pandemic but no one knows if its precautions will really do any good.

“We have all kinds of ways to fight a pandemic,” said Morse. “The problem is we don’t know if all our defenses will really put a dent in something that can kill like a 1918 flu virus.”

The current flu vaccine would be ineffective against a new flu virus because it was created to fight a conventional flu. It would take months to develop a vaccine to combat a new killer flu virus, experts said. A pandemic would be well under way before a vaccine would be ready.

Scientists are worried about Avian influenza, which has decimated bird populations in southeast Asia in the last 10 years and killed more than 100 people in Indonesia this year. Pandemic flu viruses are believed to originate from bird or swine viruses that mutate and transfer to humans. So far, the only way humans can catch bird flu is from birds. If the Avian virus mutates so that it can by human-to-human contact, it could easily become a pandemic flu virus, experts say.

Miller said she always knew that a pandemic flu could come back and she dreads to see the effect it would have on society. She believes that people in 1918 could handle a disaster like the Spanish Flu because they saw death far more often; infant mortality was still high and the war had killed and maimed millions in Europe. She is not sure that Americans could handle seeing hundreds of thousands or millions of people dying in just a few months.

“The world doesn’t know fear and fright anymore,” said Miller. “You won’t want to leave your house. I pray every day that it doesn’t come back. Every day.”