It starts with body aches, chills, exhaustion, headache and fever. Then come congestion, sore throat and cough. It is miserable. It is the flu.

In Ohio, where I picked up the bug that laid me low, despite a flu vaccine shot, the hospitals are full. But it is spreading across the country like a shadow. No state is immune.

I had just read several excellent books about the great flu pandemic of 1918, which started a century ago this month. It is a chilling medical mystery, with incredible death and suffering. More than 500 million people were infected. Many recovered only to die young of complications, including my grandfather whom I never knew.

Some American soldiers sent abroad to fight the Great War carried the virus with them. It spread throughout Europe, and healthy soldiers picked it up and came back ravished with illness, and the flu spread across the country and back again. People got up healthy in the morning and were dead by nightfall. Those most vulnerable were between the ages of 20 and 40.

There isn’t even a good estimate of how many died; it is believed to be at least 20 million and perhaps 50 million people worldwide, the most devastating epidemic in recorded world history, worse than the Bubonic Plague outbreak from 1347 to 1351 and more than all the deaths in World War I. In the United States one of every four people got sick.

With all our medical knowledge, vaccines and information campaigns and gleaming hospitals, that could not happen again, I thought.

I was wrong.

My sister has been involved with disaster preparedness drills in Ohio in the event of another flu epidemic; she tells me the state is not prepared. Apparently, this is true for every state.

I am writing about it because when I was a reporter I covered hearings in Washington about the politics of vaccines. It was infuriating that people were sick and died because of politics, infuriating how often it happened.

But it’s happening again. We are not remotely ready for the influenza pandemic which, scientists insist, will happen.

Only 40 percent of Americans get the flu vaccine every year. And while reports are that this year’s batch may be only about 10 percent effective, that is better than nothing. Getting the vaccine is likely to reduce the severity of your symptoms if you contract influenza. But many people allergic to eggs can’t tolerate the vaccine although egg-free vaccines are becoming available. Each year’s vaccines are a guess on which strains of flu will strike.

In this world people don’t always stay home when they get sick. They feel guilty if they don’t tough it out and report for duty. They get on planes and spread the virus from one state to another, from one country to another. They don’t cough into their elbows but send a prism of deadly droplets all around them.

Worse, hospitals do not have enough drugs on hand to handle an all-out epidemic, and getting more would be difficult if not impossible on short notice.

Washington, at the moment, is not particularly interested in science. Research budgets have been slashed, and more cuts are coming. The government spent only $75 million last year on flu vaccine research. The White House is not interested in developing a universal vaccine, the best solution if an animal flu virus infects humans and then goes viral.

But many are worried. Michael Osterholm, professor and director of the Center for Infectious Disease Research and Policy at the University of Minnesota, and Mark Okshaker, a documentary film maker who with Osterholm wrote “Deadliest Enemy: Our War Against Killer Germs,” sounded a full-throated alarm in The New York Times. “We are not prepared,” they said. “Our current vaccines are based on 1940s research. Deploying them against a severe global pandemic would be equivalent to trying to stop an advancing battle tank with a single rifle.”

They, too, insist a pandemic is not a question of “if” but “when.” They argue for a smallpox-vaccine-like effort, a “Manhattan Project-scale effort.”

That’s not likely with a tax cut adding $1.5 trillion to the national debt, meaning, by law, less medical research.

Stay healthy, my friends. Get plenty of rest, stay hydrated and keep your fingers crossed.

Ann McFeatters is a columnist for Tribune News Service.