WASHINGTON – One hundred years after the “Spanish flu” killed more than 50 million people worldwide, another influenza pandemic still is the biggest threat to global health, public health experts told lawmakers Friday. 

“Influenza, or something like influenza, is what keeps me up at night,” said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. “When you have a respiratory virus that can be spread by droplets and aerosol, you can have a catastrophe.” 

Fauci has long advocated for creating a “universal” flu vaccine that could block several strains of the virus. An early version is being tested at the National Institutes of Health with the goal of eradicating a single subtype.  

Since the deadly pandemic of Spanish flu, the U.S. has battled outbreaks like Ebola, Zika and SARS, and the flu remains a major threat, killing thousands of Americans every year, according to the Centers for Disease Control and Prevention. 

The country’s preparedness for pandemics and outbreaks is improving, but predicting, identifying and treating infectious diseases remains a challenge, leading scientists and doctors told the House Subcommittee on Oversight and Investigations. 

About 85 percent of all Americans live within a two-hour drive of one of the CDC’s 125 medical testing labs, allowing sick people to be tested and treated quickly for rare diseases and chemical poisoning. 

“Rapid identification of disease is critical to addressing public health threats before they become a crisis,” said Anne Schuchat, the CDC’s principal deputy director, who agreed that influenza is the greatest threat to public health. The CDC also runs the nation’s emergency stockpile of drugs and medical supplies. 

Rep. Gregg Harper, a Mississippi Republican whose subcommittee heard from the experts, said that Congress should reauthorize the Pandemic and All Hazards Preparedness Act, set to expire in September. The bill authorizes the federal government to create and organize multiple public health programs around emergency preparedness. 

Colorado Rep. Diana Degette, the top Democrat on the subcommittee, said hospitals were not adequately prepared for recent H1N1 flu, Ebola and Zika cases, and said the country should prioritize the next health emergency, “because there will be one,” she said. 

Fauci agreed.  

“We always have had (infectious diseases), we have them now, and we always will have them,” said Fauci. “They are a perpetual challenge and a perpetual risk, and we must meet them with perpetual readiness.”