Eyewitness accounts of the 1510 influenza pandemic in Europe

Eyewitness accounts of the 1510 influenza pandemic in Europe

By David M Morens, Michael North and Jeffery K Taubenberger

Lancet, Volume 376, No. 9756 (2010)

Sick man in bed - Royal 6 E.VII, f.70

Introduction: “On this day [July 13, 1510]…in Modena there appeared an illness that lasts three days with a great fever, and headache and then they rise…but there remains a terrible cough that lasts maybe eight days, and then little by little they recover and do not perish.”

So wrote Tommasino de’ Bianchi in a rare first-hand account of perhaps the first recognised pandemic of the disease we now call influenza. As we wonder about new epidemics today, the accounts by de’ Bianchi and six other men who documented the 1510 pandemic offer insights into how this disease was understood at the time. These chroniclers of events in 1510 wrote about what they thought this disease was, where it came from, who was susceptible to it, what its complications were, how fatal it was, and how it could be treated. Their accounts illuminate our understanding of the history of influenza in 16th-century Europe.

In 1510, there was little appreciation that a specific respiratory disease might have been recurring over centuries, but historians now believe that influenza had probably been circulating as an epidemic disease since as early as the 9th century AD, if not earlier. The respiratory disease known as febris Italica (Italian fever) followed Charlemagne’s army around Europe in 876–77 AD. Later, similar European-wide epidemics appeared between 1173 and 1387, two of them even called “influenza”, a popular Italian term that did not, however, become permanently attached to a respiratory disease until centuries later. A disease referred to as “sweate” (English sweat, Sudor Anglicus) was repeatedly epidemic between 1485 and 1551, but was considered by the physician Jean Fernel and others to be distinct from influenza. Only in the 19th century was sweate plausibly attributed to influenza by the sifting of centuries-old evidence. Had observers recognised these major European epidemics as one distinctive disease they might have also recognised, in 1510, the return of an explosive respiratory epidemic, known as horion or le taq, that had struck 100 years earlier in 1410 with accounts of violent coughing and miscarriages among pregnant women.

While contagion had been understood and linked to a short list of diseases over the preceding 300 years, the notion of infection was almost non-existent in 1510. Humoralist ideas from the Greco-Roman era often influenced treatment decisions, leading to attempts to remove the humors believed to be causing disease. In 1546, Girolamo Fracastoro would propose that some epidemic diseases were caused by, and transmitted to others by, what he called living seminaria, but this idea was at best only percolating in 1510. Unable to identify microbial agents or understand aetiopathological entities, observers like de’ Bianchi probably did not suspect that periodic epidemic fevers with cough might represent a single continually re-emerging disease.

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