LAWRENCEVILLE - The Spanish flu of 1918 spread to nearly every corner of the world and killed somewhere between 50 and 100 million people, according to estimates. More than any single war in history.
In contrast to most influenza outbreaks, many of its victims were young, healthy adults.
Another pandemic of this magnitude is not out of the question, according to Martin Meltzer, senior health economist with the Centers for Disease Control and Prevention.
"We are always at risk ... always worried about the next pandemic," Meltzer said. "It is not a question of if, but when."
Meltzer addressed Georgia Gwinnett College students Thursday, speaking about various pandemics throughout history as well as the biology of the influenza virus itself.
The main topic, though, was the pandemic of 1918. Studying and understanding that outbreak, he said, can show us what might happen with the next one.
Normally, flu deaths are much higher among the very young and the elderly, and those with pre-existing conditions and weakened immune systems. The 1918 pandemic, however, was responsible for the sickness and death of many young, healthy adults, attacking strong immune systems and causing overreactions more severe than those in weaker systems. For a "short, sharp, brief period," Meltzer said, life expectancy dipped below 40 years.
"Why was this strain so lethal?" Meltzer asked. "You identify that, you're on your way to a Nobel Prize."
Hospitals overflowed. Patients lay on hospital cots receiving warm meals and rest, but little treatment. There were no vaccines back then, only home remedies. But moonshine mixed with honey or garlic salves ultimately proved ineffective.
It is anyone's guess what the effects of another flu pandemic would be. Meltzer pointed to studies that suggest if it were moderate, like the 1958 and 1968 pandemics that began in China, it could kill more than 200,000. If it were severe, like the Spanish Flu, the death toll could reach nearly 2 million. He added, though, that these numbers may be ballpark, or not even close.
Every year researchers develop new vaccines for an ever-evolving virus, and billions of dollars are being spent researching the largest pandemic threat today, the H5N1 virus.
"Never underestimate the flu's ability to change," Meltzer said.