100 Years Ago: Deadliest Flu in History Killed Tens of Millions: Could it Happen Again?

The U.S. Centers for Disese Control says the current flu seaon is the most severe in nine years and getting worse.  30 children have died from the virus and most states are reporting sharp increases in hospitalizations each week.  Concern over the current flu outbreak has some wondering how bad it could get,-even questioning the likelihood of what occurred in 1918.

This year marks the 100th anniversary of the Spanish Flu.  It was the deadliest flu pandemic in human history and the third deadliest disease outbreak ever.

Within just one year, Spanish Flu swept the entire globe, killing 50 million people, about four percent of the world's population at that time, including 675,000 Americans.  By comparison, smallpox killed an estimated 300 million people in the 20th century, The Plague killed 20 million people in a four-year period during the 1300s.  The AIDS virus has reportedly killed a total of 35 million people worldwide since the 1970s.   

The catastrophic Spanish Flu killed its victims suddenly.  People who contracted the aggressive virus often appeared fine in the morning and were dead that night.  Unlike most influenza viruses which prove fatal mostly to the very old or very young, Spanish Flu morbidity centered on healthy people in their twenties and thirties.

One of the first known outbreaks of Spanish Flu occurred in Kansas in 1918.  However, it wasn't named "Spanish Flu" until later after a reported outbreak in Spain.  It's believed U.S. servicemen deployed to Europe during World World I greatly contributed to the rapid spread of the virus. 

This season's virulent flu outbreak, combined with marking the 100th anniversary of the Spanish Flu has many wondering whether another pandemic like it could occur today.

Unlike today, before and during the Spanish Flu pandemic, there were no effective vaccines.  According to the U.S. Department of Health and Human Services, it wasn't until the 1950s that vaccine manufacturers could routinely produce vaccines that would help control and prevent future pandemics.

However, even though we have flu vaccines, they are far from effective, only as much as 60% at best.  This year's vaccine is estimated to be only about 30% effective, some estimates have it as low as 10%.  The actual efficacy won't be determined until after the flu season has ended.  

The reason vaccines are less than perfect is that the four strains of flu included in the vaccine must be chosen six months before the shots are given to allow time to cultivate and distribute the vaccines. In that time, the strains often mutate or new strains, not in the vaccine, suddenly emerge.

"We've just got to get away from the necessity of growing the virus," said Dr. Anthony Fauci of the National Institutes of Health to AP, "That's the thing that takes so many months to get to where we need to be."

There are other problems with the vaccine, such as imperfect manufacturing techniques and simply predicting the wrong strain that will dominate the upcoming flu season.

With that in mind, health experts say, yes, another flu pandemic of the magnitude of the 1918 pandemic is indeed possible.  And they are doing everything possible to prevent such a catastrophe. 

"We have to do better and by better, we mean a universal flu vaccine. A vaccine that is going to protect you against essentially all, or most, strains of flu,"  Fauci said.

A "universal" flu vaccine has been the subject of fascination within the health industry for years.  The idea is that a single vaccine would protect a person from all forms of the flu for years, even life.  Ideally, children would receive a universal flu vaccine and never need one again.  

A universal flu vaccine is in developmental stages and is expected to be available to the general public relatively soon.

"If everything works out well, we should be having a universal influenza vaccine within years, not decades or a century," said flu microbiologist Peter Palese at Mount Sinai's Icahn School of Medicine in New York City.

"The ultimate preparation would be a universal flu vaccine, something you could stockpile, and you don't have to be chasing a pandemic," Facui said.