Timeline of influenza

This is a timeline of influenza, briefly describing major events such as outbreaks, epidemics, pandemics, discoveries and developments of vaccines. In addition to specific year/period-related events, there is the seasonal flu that kills between 250,000 and 500,000 people every year and has claimed between 340 million and 1 billion human lives throughout history.^[1][2]

Overview

Year/period	Key developments
Before the 16th century	The outbreak of influenza reported in 1173 is not considered to be a pandemic, and other reports to 1500 generally lack reliability.
16th century	The 1510 influenza pandemic spread from Asia to Africa, then engulfing Europe. It is the first documented case of intercontinental spread of an influenza virus, with less lethality than future pandemics. The 1557 influenza pandemic spread from Asia to the Ottoman Empire, then Europe, the Americas, and Africa. This flu pandemic is the first to be reliably recorded as spreading worldwide,[3][4][5][6] is when flu received its first English names.[7][8] It is also the first pandemic in which flu is linked to miscarriages.[9] The pandemic lasted for at least two years.[10]: 307–308 [11] The 1580 pandemic is well-documented, with high mortality recorded as influenza spreads across Europe.[12]
18th century	Data from this century is more informative of pandemics than those of previous years. The first influenza pandemic of the 18th century begins in 1733.[13]: 18 [14]: 28 [15]: 25
19th century	Two influenza pandemics are recorded in the century.[12] Avian influenza is recorded for the first time.[16]
20th century	Influenza pandemics are recorded four times, starting with the deadly Spanish flu. This is also the period of virus isolation and development of vaccines.[17] Prior to the 20th century, much information about influenza is generally not considered certain. Although the virus seems to have caused epidemics throughout human history, historical data on influenza are difficult to interpret, because the symptoms can be similar to those of other respiratory diseases.[18][19]
1945 – 21st century	International health organizations merge, and large scale vaccination campaigns begin.[20]
21st century	Worldwide accessible databases multiply in order to control outbreaks and prevent pandemics. New influenza strain outbreaks still occur. Efficacy of currently available vaccines is still insufficient to diminish the current annual health burden induced by the virus.[20] One influenza pandemic has occurred thus far in the 21st century, in 2009.

Full timeline: Hippocrates – 2017

Reported cases of influenza in North American and South American countries for the period 1949–1958, illustrating the severity of influenza A virus subtype H2N2 pandemic in 1957. Chile (not shown in the graph) was severely hit and reported 1,408,430 cases in 1957.^[21]

Specific strains of influenza infection throughout the 20th century.^[22]

Influenza has been studied by countless physicians, epidemiologists, and medical historians. Chroniclers distinguished its outbreaks from other diseases by the rapid, indiscriminate way it struck down entire populations. Flu has been called various names including tac,^[23] coqueluche,^[24][25][26] the new disease,^[27] gruppie,^[28] grippe, castrone,^{[29][30]: 17} influenza,^[31] and commonly just catarrh^[32][33][34] by many chroniclers and physicians throughout the ages.

Year/period	Type of event	Event	Geographical location
400 BCE	Medical development	The symptoms of human influenza were described by Hippocrates.[35][17]
1173	Epidemic	This is the first epidemic reported where the symptoms were probably influenza.[12]	Europe
1357		The term influenza was first used to describe a disease prevailing in 1357.[31][36] It would be applied again to the epidemic in 1386−1387.[37]	Italy
1386–1387	Epidemic	An epidemic of influenza-like illness developed in Europe, preferentially killing elderly and debilitating persons. This is probably the first documentation of a key epidemiological feature of both pandemic and seasonal influenza.[37]	Europe
1411	Epidemic	An epidemic of coughing disease associated with spontaneous miscarriages was noted in Paris.[37] The illness was referred to as le tac by some contemporaries.[23]	France
1414	Epidemic	Another outbreak of flu was recorded in Paris; possibly the first time the disease was referred to as coqueluche.
1510	Pandemic	An influenza pandemic developed in Asia and proceeded northward to involve North Africa, then all of Europe. Attack rates were extremely high, but fatality was low and said to be restricted to weaker individuals like children and those who were bled.[37]	Africa, Eurasia
1557–1558	Pandemic	An influenza pandemic spread westward from Asia to Africa and Europe, then traveled aboard European ships across the Atlantic Ocean. Another wave in 1558-59 spread worldwide with devastating effects.[38][3][4][5][6][37]	Eurasia
1580	Pandemic	[12][37]	Eurasia, Africa
1729–1730	Epidemic[10]: 343 [39]: 50 [15]: 25	Influenza broke out suddenly in Moscow in April, 1729, apparently causing the imperial household to flee the city.[30]: 22  The disease was not reported again, however, until the fall, in Sweden in September;[13]: 9  it spread throughout Germany in October and November, England in October and December, and Switzerland in December and January the following year. Paris was hit that month, and Rome in February.[13]: 9  The outbreak continued its spread in Germany in February, and in Italy in March, when it was also reported in Spain.[13]: 9  This was the first "well-authenticated" outbreak of influenza to occur in Iceland, in March 1730.[13]: 9	Eurasia
1732–1733	Pandemic	This has generally been considered the first pandemic of influenza in the 18th century.[13]: 18 [14]: 28 [15]: 25  However, it is not entirely clear whether this was a totally distinct outbreak from the first or rather a "long-delayed recurrence".[37][15]: 25  Some authors have historically considered the two as related epidemics during a single period of influenza,[40][41] while others have considered them separately, suggesting no connection between them beyond both being incidences of influenza.[39]: 50–55 [10]: 341–348  The disease seems to have been present in the northeast United States as early as October 1732, after which reports of it came out of Newfoundland, Barbados, Jamaica, Mexico, Peru, and Chile.[13]: 9 [30]: 23  The following month it appeared in Germany, reportedly coming from Russia through Poland.[30]: 23  It spread throughout Germany in November and into December, when it caused outbreaks in Switzerland and Holland through the end of the year.[30]: 23  Notably, it was reported on the Isle of Bourbon, off of Madagascar, in December as well.[13]: 9  It prevailed in London and Paris in January 1733, as well as the Netherlands; that same month, it was reported in Italy, where it continued into March.[13]: 9  Madrid was visited in February.[13]: 9	Americas, Eurasia
1742–1743	Epidemic	An outbreak of "catarrhal fever" prevailed in several countries in the winter of 1741–1742, in particular Germany, before the disease reappeared the following October of 1742 in Switzerland.[41]: 110 [13]: 9  From there it spread throughout much of Italy through February 1743, when it was first reported in Paris and other parts of France.[13]: 9–10  The Netherlands and Belgium were affected in March, and England in April.[13]: 10  Although not a pandemic, this outbreak was characterized by "enormous morbidity"[30]: 25  and came amidst a period, from 1742 to 1744, "when European deaths associated with influenza-like illnesses reached extraordinary peaks."[37] In January 1743 alone, over 8,000 in Rome and 5,000 in Mainz reported died from the disease. However, some of the mortality was also attributed at the time to the use of venesection as a treatment.[30]: 25  Though the name had been used in English before, this was the first time "influenza" was broadly used to refer to the disease. While it prevailed extensively in Italy, the rumor of a "great epidemic" of "influenza" in that country spread faster than the disease itself, and the name came to be used in England, at least for the duration of the outbreak. Once it had passed, the name fell out of common use.[10]: 304	Europe
1761–1762	Pandemic	A "severe influenza" broke out in the northern United States in the winter and spring of 1761. It reportedly spread across the entire country as well as the West Indies.[42]: 250  The disease did not appear in Europe, however, until the following February of 1762, when it caused outbreaks in Germany that lasted through April.[13]: 10  In March, it was reported in Hungary and Denmark; in April, it was in England (London) and Scotland (Edinburgh), as well as Italy.[13]: 10  In May, it appeared in Ireland, and between June and September it caused outbreaks in France, where it persisted in some parts into October.[13]: 10 [30]: 27  On the whole, the epidemic was notable for seeming to follow no clear path, "being reported now here, now there,"[30]: 27  and for missing certain locales altogether, such as Paris.[10]: 358  Morbidity was "great" where the disease did strike.[30]: 27  Mortality was relatively low, though it did vary, with some cities seeing more severe epidemics than others even within the same country.[30]: 27 [10]: 358  Spontaneous abortions and premature births were reported as new complications during this pandemic, which can be taken as a piece of supporting evidence that this was indeed a pandemic of influenza, in addition to its high attack rate and broad distribution across at least two continents.[30]: 27 [37]	Americas, Europe
1781–1782	Pandemic	Some accounts place the earliest outbreaks of this pandemic in the fall of 1780 in Southeast Asia,[37] more specifically the coasts of modern-day Guangzhou and the Bengal and Coromandel regions.[40]: 114 [41]: 110  Influenza was later reported in St. Petersburg in December and in Vilnius in February 1781.[13]: 11  It then prevailed in North America in the spring of that year.[42]: 268  Other authors, however, consider only the 1781–1782 experience to be a true pandemic.[13]: 18 [30]: 30 [15]: 27  If anything, the outbreaks in Russia and North America in 1780–1781 were possible "herald waves" of the later, greater epidemic.[15]: 27  During this true pandemic period, influenza is said to have first broken out in China and British India in the fall of 1781.[13]: 11  By the winter, it was sweeping through Siberia and Russia, visiting St. Petersburg again in January 1782.[13]: 11  It moved through Germany between February and June.[13]: 11  It struck Finland in February and Denmark, Sweden, and Hungary in April. After reaching England as early as April, influenza broke out in London and other parts in May and was general in England and Scotland in June.[13]: 11  After hitting the Netherlands in May, it spread to France and then to Italy, where it broke out in June.[30]: 30  Finally, it reached Spain by August, prevailing in Madrid and other parts.[13]: 11  This epidemic solidified "influenza" as the name of the disease in English. Although first used generally in 1743 to refer to the affliction epidemic in Italy at the time, it was not until an epidemic in 1775 that the term began to be used again more generally, and by 1782, it was the typical name applied. In the summer of that year, when the disease hit England, the Royal College of Physicians formally adopted the Italian word as the official name.[10]: 362	Eurasia
1788–1790	Epidemic	Another epidemic, or series of epidemics, of influenza occurred at the end of this decade. This period has more recently been described as a pandemic,[37] though historically it has not been considered as such;[13]: 11–12  at most, it may "possibly" have been a pandemic.[14]: 29  This lack of definition is reflected in how the epidemics are divided and described. In general, the initial period spanned from spring to fall 1788, when it spread across Europe; after a year-long absence, influenza reappeared in North America in the fall of 1789, initiating a second period that spanned at least into the spring of 1790. While these have often been treated separately,[13]: 11–12 [39]: 73–74 [42]: 283–291  connecting them as part of a single period that lasted from 1788 to 1790 (perhaps even into 1791, at least in the United States)[43] is by no means a novel interpretation of the data.[40]: 121–124  The influenza was first reported in Russia in March 1788, in St. Petersburg and Kherson and in Poland.[13]: 11  It then spread westward, invading Germany, Hungary, Denmark, England, Scotland, France, and Italy successively throughout the year and being reported finally in Switzerland in October.[13]: 11  Observed influenza activity then remained low for nearly a year before the disease appeared in the Western Hemisphere, breaking out in the US states of Georgia and New York in September 1789.[13]: 11  The epidemic crossed the entire United States in six to eight weeks.[42]: 290  It was reported in Jamaica in October[13]: 11  and Grenada in November,[43]: 256–257  and by the end of the year it was prevalent in Nova Scotia and South America.[13]: 11  After a short reprieve, the influenza resumed epidemic proportions in the spring of 1790 in the northeast United States and perhaps some other parts,[13]: 12  declining about the first week of June.[43]: 259  There is some evidence of increased severity during the spring wave as compared to the fall one.[42]: 291  The disease was prevalent again in Philadelphia and neighboring counties in Pennsylvania, and was observed as well in Virginia and Rhode Island, in the winter of 1790–1791, but it was not nearly as widespread as its first two appearances.[43]: 260	Americas, Eurasia
1830–1833	Pandemic	[12]	Eurasia, Americas
1878	Scientific development	First descriptions of avian influenza, termed "fowl plague," was recorded by Perroncito in Italy.[44][45][16]	Italy
1889–1892	Pandemic	[46][37]	Worldwide
1901	Scientific development	[45]
1918–1920	Pandemic	In March 1918, 48 soldiers died of "pneumonia" during a, outbreak at Fort Riley, Kansas. The flu traveled unchecked eastward[47] to New England military bases before traveling across the Atlantic Ocean on crowded military ships to Europe amid World War I. It spread rapidly through European cities and was nicknamed "Spanish flu" for the uncensored reporting in Spain, as moving armies spread flu around the world. The flu returned in waves for the next 2 years.[48][49]	Worldwide; originated in the US, some theories suggest France or other countries
1931	Scientific development	Richard Shope isolates the Influenza A virus from pigs.[50]
1933	Scientific development	Shope and his team discover the Influenza A virus.[51][52][53][54]	United Kingdom
1936	Medical development	[55]	Russia
1942	Medical development	[54]
1945	Medical development	[56]	United States
1946	Organization	[57][58]	United States (Atlanta)
1947	Organization	[59]	France (serves worldwide)
1948	Organization	[60]
1952	Organization (Research institute)	[61]
1957	Pandemic	[62][63][64][65][37]	Worldwide
1959	Non–human infection	[66]	United Kingdom
1961	Non–human infection	[67]	South Africa
1963	Non–human infection	[66]	United Kingdom
1966	Non–human infection	[66]	Canada
1968–1970	Pandemic	[37][68]	Worldwide
1973	Program launch	[54]
1976	Epidemic	[69][70]	United States (New Jersey)
1976	Non–human infection	[66]	Australia
1977	Epidemic	[70]	Russia, China, worldwide
1978	Medical development	[54]
1980	Medical development	[71]	United States
1983	Non–human infection	[72]	Ireland
1988	Infection	[73]	China
1990–1996	Medical development	[74]	United States
1997	Infection	[75]	China (Hong Kong)
1997	Infection		Australia
1999	Infection	[70]	China (Hong Kong)
2002	Infection	[76]	United States
2003–2007	Infection	[77] See also: Global spread of H5N1	East Asia, Southeast Asia
2003	Infection	[78]	Netherlands
2004	Organization	[79]
2004	Infection	[80]	Canada
2004	Infection	[81]	Egypt
2004	Non–human infection	[82]	United States
2005	Organization	[83][84]	United States
2005	Organization	[85][86]	United States (New York City)
2005	Infection	[87]	Cambodia, Romania
2006	Organization	[88]	China (Beijing)
2007	Non-human infection	[89]	Australia
2008	Scientific development	[90]	Worldwide
2008	Service launch	[91]	United States
2009–10	Pandemic	[92][93][70]	Worldwide
2011	Non–human infection	[94]	United States
2012	Scientific development	[95]
2012	Scientific project/controversy	[96][97]	Netherlands (Erasmus Medical Center), United States (University of Wisconsin–Madison)
2012	Medical development	[98]	United States
2013	Epidemic	[99][100]	China, Vietnam
2013	Medical development	[101]	United States
2013	Infection	[102]	China
2015	Program	[103][104][105]	United States
2017	Medical development	[106]	United States
2017	Scientific development	[107]	Finland

See also

• Influenza
• Timeline of global health