Emerging Problems in Infectious Diseases Influenza pandemics: a historical retrospect

The recent global outbreak of human cases of swine origin influenza A (H1N1) has spread fear that this virus will be of pandemic proportions causing high morbidity and mortality. While it is too early to determine the pandemic nature of swine origin influenza A (H1N1), it may be useful to look at the history of influenza pandemics described since recorded history. The first well-documented outbreak that fits a description of a pandemic occurred in 1580, originating in Asia and sweeping through Europe, Africa, and the Americas along trade routes [1]. In Asia the local people gave it the name of ―wind illness‖ to indicate the speed of propagation. Then, at intervals of roughly one to four decades, thirty-one influenza pandemics have occurred [2,3]: three over the past century in 1918-19, 1957, and 1968 (Fig.1); and six in the 19th century in 18001801, 1837, 1843, 1857, 1874, and in 1889-92. The latter was known as the ―Russian flu‖ in Western Europe. Beginning in May 1889 in Bokara, Central Asia, the Russian flu travelled quickly through Russia and Germany and then into Western Europe along the new rail networks [4]. While not having the severity of the so-called ―Spanish flu‖ outbreak of 1918-19, the 1889-92 pandemic caused extensive morbidity and high general mortality with approximately 250,000 deaths in Europe [5] (Table1).