The 1510 Influenza Pandemic: A Historical Perspective
In 1510, an acute respiratory disease emerged in Asia, subsequently spreading through North Africa and Europe. This pandemic is recognized as the first inter-regional flu pandemic recorded by medical historians and epidemiologists. Although influenza-like illnesses had been documented in Europe since the time of Charlemagne, the 1510 outbreak was the first to be pathologically described, thanks to advances in communication facilitated by the printing press. During this pandemic, flu was commonly referred to as coqueluche in France and coccolucio in Sicily, evolving into popular names across early modern Europe. This outbreak caused significant disruption in government, church, and society, resulting in near-universal infection with a mortality rate of around 1%.
Asia
The 1510 flu is suspected to have originated in East Asia, possibly China. Gregor Horst, in his work Operum medicorum tombus primus (1661), posited that the disease spread from Asia along trade routes before affecting the Middle East and North Africa. German medical writer Justus Hecker suggested that it was most likely of Asian origin, consistent with the historical patterns of previous influenza pandemics.
Africa
It is generally accepted that the 1510 influenza spread in Africa before making its way to Europe. The disease was likely widespread in North Africa before crossing the Mediterranean Sea, arriving in Malta, which British medical historian Thomas Short believed served as a key entry point into Europe.
Europe
The interconnected nature of Europe’s cities and the highly contagious nature of the flu facilitated its rapid spread. The outbreak disrupted royal courts, church services, and daily life across the continent. Chroniclers noted that entire populations fell ill simultaneously, leading to the term influenza, derived from the belief that such outbreaks were influenced by celestial bodies or weather conditions. Turin professor Francisco Vallerioli described the 1510 flu as featuring “Constriction of breathing, beginning with a hoarseness of voice and… shivering, followed by a “cooked humor” filling the lungs.” Physicians noted that the flu was particularly deadly to children and those who underwent bloodletting. Notably, lawyer Francesco Muralto recorded that “the disease killed 10 people out of a thousand in one day,” corroborating the estimated fatality rate of around 1%.
Sicily and the Italian Kingdoms
The first cases of influenza were reported in Sicily around July, following the arrival of merchant ships from Malta. The illness was commonly referred to as coccolucio in Sicily, named after the hoods worn by the sick. The flu quickly spread along the coastlines of Italy and southern France, facilitated by merchant ships.
In Emilia-Romagna, Tommasino de’ Bianchi documented the recovery of Modena’s first cases on July 13, 1510. He described an illness lasting three days, characterized by a high fever and headache, followed by a persistent cough lasting several days. This suggests that the initial illnesses began around late June or early July. Pope Julius II attributed the outbreaks in Rome to divine retribution.
Central Europe
The flu traveled over the Alps into Switzerland and the Holy Roman Empire. In Switzerland, it was known as das Gruppie according to chronicler Anton Tegenfeld. Residents of Canton of Aargua reported symptoms such as sniffling, coughing, and fatigue in June. German physician Achilles Gasser recorded a deadly epidemic affecting the entire Holy Roman Empire, noting the overwhelming impact on the populace.
Letters from André de Burgo dated August 24, 1510, indicate that Margaret of Austria had to intervene in a royal assembly due to King Louis XII of France being too ill with coqueluche to attend. The flu continued to expand towards Northern Europe, the Baltic states, and westwards into France and England.
France
Arriving via infected sailors from Sicily, influenza struck the Kingdom of France through ports such as Marseille and Nice. The disease spread among the international crowds in shipyards by July. French physicians referred to the illness as cephalie catarrhal but commonly used the term coqueluche. Historian François Eudes de Mézeray traced the etymology of “coqueluche” back to earlier outbreaks where patients wore hoods that resembled a monk’s cowl.
By August, cases had been reported in Tours, and the flu subsequently spread throughout France, affecting the entire nation by September. French poet and historian Jean Bouchet noted that the epidemic permeated towns and rural areas alike.
Hospitals in France became overwhelmed. A planned National Assembly of Bishops scheduled for September was postponed due to the severity of the flu in Paris. Physician Jean Fernel compared the 1557 influenza to the 1510 outbreak, highlighting its broad impact on health and daily life. Reports indicated that as many as 1000 Parisians per day were succumbing to the disease at the height of the outbreak.
Cardinal Georges d’Amboise, a close advisor to King Louis XII, is believed to have died from influenza after his health deteriorated upon arriving in Lyons in May 1510. His decline and the flu’s emergence have led to speculation about the cause of his death, but details remain ambiguous.
England and Ireland
British medical historian Charles Creighton mentioned a solitary foreign account of the 1510 flu in England but did not expand on it. Physicians Fernel and Paré suggested that the influenza spread to nearly every country globally, except for Spain’s territories in the New World. An epidemiological review confirmed that England experienced the pandemic in 1510, with symptoms reported, including gastrodynia, alongside murrain among cattle. The flu also reportedly reached Ireland.
Spain and Portugal
Influenza reached the Iberian Peninsula shortly after its arrival in Italy, facilitated by trade and pilgrimage routes. Reports indicated that cases began appearing in Portugal around the same time it entered the Holy Roman Empire, leading to significant depopulation in various Spanish cities.
The Americas
There are no records of the influenza impacting the New World in 1510, despite Spain’s active shipping routes across the Atlantic. The first documented flu outbreak in the Americas occurred in the Isle of Santo Domingo in 1493.
Medicine and Treatment
Common treatments prescribed in Europe included blistering on the back of the head and shoulders. Paré criticized standard practices such as bloodletting and purgation, deeming them dangerous for flu patients. Symptoms included supraorbital pain and vision problems, prompting many sufferers to wear hoods to combat light sensitivity. Medical treatments mentioned included Bole Armoniac, oily lintus, pectoral troches, and decoctions.
Origin of the 1510 Influenza
Medical historians Justus Hecker and John Parkin theorized that the 1510 influenza originated in East Asia, given the historical trends of pandemics originating in that region. Gregor Horst indicated that the flu spread along trade routes from Asia to Africa before reaching Europe. European chroniclers noted the presence of influenza in North Africa prior to its appearance in Europe, leading some to suggest it may have developed locally.
Debunking Suggestions of Whooping Cough
Modern epidemiologists and medical historians have recognized the 1510 coqueluche as influenza. Claims that it was actually whooping cough have been challenged due to the rapid onset of symptoms, which included high fever, headaches, and severe coughing, leading to recovery after a week. In contrast, whooping cough typically involves a prolonged coughing phase followed by a gradual decline. The first agreed-upon outbreak of whooping cough is thought to have occurred in Paris in 1578.