Limits on Social Contact Helped Fight Flu Pandemic

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The findings are published in the Aug. 8 issue of the Journal of the American Medical Association.

"Here is something we could apply," Markel said. "These old-fashioned methods hopefully could buy us time until a vaccine could be created and put in the arms of people who need it."

But what worked in the United States of 1918-19 might not work today, said Philip Alcabes, associate professor in the School of Public Health at Hunter College in New York City.

"The world is a dramatically different place," Alcabes said. "We don't have people working in big factories where there are a lot of people under one roof. We commonly use private transportation. We have smaller families. We live in suburbs, where the pathogen is not as likely to be transmitted as quickly as it was then."

The new study is "a very, very good piece of historical epidemiology," Alcabes said. But, he added, "It's not clear that the interventions that were effective against the flu in 1918 are relevant to the preparations we are making today."

Markel countered that the world is not that different in basic ways. Children still have runny noses and poor respiratory habits, people still pass the virus from one to another in the same way. The study provides evidence that basic public health measures can slow that passage of germs, he said.

"No one has even gotten any evidence that it works in the past," Markel said. "You don't want to do a multibillion dollar policy unless you're sure it works."

Guidelines on such measures would be recommended by the federal government and carried out by the states, Markel said. The states are working with the federal government to cover implementation, he said.

More information

A vivid history of the Spanish flu pandemic is supplied by Stanford University.