The 1918–1920 flu pandemic, commonly known as the Spanish flu, caused millions of deaths worldwide, infecting approximately 500 million people. Despite its widespread impact, the name "Spanish flu" is a misnomer, stemming from wartime censorship during World War I. While belligerent nations like Germany, the United Kingdom, France, and the United States minimized reports of illness and mortality to maintain morale, neutral Spain openly reported the epidemic's
effects. This created a false impression that Spain was particularly hard-hit, leading to the enduring, yet inaccurate, nickname.
The Misleading Name: A Consequence of War
The nickname "Spanish flu" did not reflect the pandemic's actual origin but rather the differing media environments during World War I. To maintain public morale, wartime censors in countries involved in the conflict suppressed negative news, including early reports of illness and mortality. This meant that the true extent of the flu's spread and severity in these nations was not widely publicized. In contrast, neutral Spain had no such censorship restrictions, allowing its newspapers to freely report on the epidemic, even detailing the grave illness of King Alfonso XIII. This open reporting gave the false impression that Spain was the epicenter or was suffering disproportionately, thus leading to the pandemic being labeled the "Spanish flu" by the international community.
This practice of assigning foreign-sounding names to diseases was not new. Even before the 1889–1890 pandemic, also known as the "Russian flu," similar epithets were used. For instance, Russians called epidemic influenza the "Chinese catarrh," Germans referred to it as the "Russian pest," and Italians called it the "German disease." During the 1918 pandemic, this pattern continued, with various regions attributing the disease to others. For example, in Poland, it was the "Bolshevik disease," while in Russia, it was the "Kirghiz disease." Some Africans called it a "white man's sickness," and in South Africa, it was sometimes referred to as "kaffersiekte." Japan blamed sumo wrestlers for bringing the disease from Taiwan, calling it "sumo flu." The French press initially used "American flu" but later adopted "Spanish flu" to avoid antagonizing an ally. British soldiers called it "Flanders flu," and German soldiers used "Flandern-Fieber," both after a battlefield in Belgium. In Senegal, it was named "Brazilian flu," and in Brazil, "German flu." In Spain itself, it was also known as the "French flu" or the "Naples Soldier," after a popular song.
Debates Over the Pandemic's True Origin
Despite its common name, the geographical origin of the Spanish flu remains indeterminate, with several competing hypotheses. Historical and epidemiological data do not definitively pinpoint a starting location. One theory, supported by historian Alfred W. Crosby and author John M. Barry, suggests an origin in Kansas, United States, specifically an outbreak in Haskell County in January 1918. The first conventionally marked case was Albert Gitchell, an army cook at Camp Funston in Kansas, on March 4, 1918, though cases had been observed earlier in Haskell County.
However, other theories propose different origins. Some researchers, including virologist John Oxford, have theorized that the major UK troop staging and hospital camp in Étaples, France, was at the center of the flu's emergence. His study found that a new disease with high mortality and flu-like symptoms struck the Étaples camp in late 1916, with a similar outbreak occurring in March 1917 at army barracks in Aldershot, England. Military pathologists later recognized these early outbreaks as the same disease as the Spanish flu. A 2016 study in the Journal of the Chinese Medical Association found evidence that the 1918 virus had been circulating in European armies for months, possibly years, before the 1918 pandemic. Political scientist Andrew Price-Smith also published data suggesting the influenza began in Austria in early 1917.
Another hypothesis points to China. In 2014, historian Mark Humphries argued that the mobilization of 96,000 Chinese laborers to work behind British and French lines might have been the source. He found archival evidence that a respiratory illness in northern China in November 1917 was later identified by Chinese health officials as identical to the Spanish flu. Claude Hannoun, a leading expert on the Spanish flu at the Pasteur Institute, asserted in 1993 that the precursor virus likely came from China, then mutated in the United States near Boston, and spread to Brest, France, Europe's battlefields, and the rest of the world via Allied forces. A 2009 study in Influenza and Other Respiratory Viruses, based on data from fourteen European countries, found that Spanish flu mortality simultaneously peaked in October and November 1918, which is inconsistent with a gradual spread from a single European origin. This suggests a more widespread, possibly non-European, initial emergence.
