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's 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/periodKey developments
Prior to the 18th centuryThe outbreak of influenza reported in 1173 is not considered to be a pandemic, and other reports to 1500 generally lack reliability. The outbreak of 1510 is probably a pandemic reported with spreading from Africa to engulf Europe. The outbreak of 1557 is possibly a pandemic. The first influenza pandemic agreed by all authors occurs in 1580.[3]
18th centuryData from this century is more informative of pandemics that those of previous years. The first agreed influenza pandemic of the 18th century begins in 1729.[3]
19th centuryTwo influenza pandemics are recorded in the century.[3] Avian influenza is recorded for the first time.[4]
20th CenturyInfluenza pandemics are recorded four times, starting with the deadly Spanish flu. This is also the period of virus isolation and development of vaccines.[5] Prior to 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.[6][7]
1945 – 21st centuryInternational health organizations merge, and large scale vaccination campaigns begin.[8]
21st centuryWorldwide 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.[8]

Full timeline: Spanish flu
Reported cases of influenza in 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.[9]
Specific strains of influenza infection throughout the 20th century.[10]
Year/periodType of eventEventGeographical location
400 BCEMedical developmentThe symptoms of human influenza are described by Hippocrates.[11][5]
1173EpidemicFirst epidemic, where symptoms are probably influenza, is reported.[3]Europe
1357The term influenza is first used to describe a disease prevailing in 1357. It would be applied again to the epidemic in 1386−1387.[12]Italy
1386–1387EpidemicInfluenza-like illness epidemic develops 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.[12]Europe
1411EpidemicEpidemic of coughing disease associated with spontaneous abortions is noted in Paris.[12]France
1510EpidemicInfluenza pandemic develops in Africa in the summer of 1510 and proceedes northward to involve all of Europe and then the Baltic States. Attack rates are extremely high, but fatality is low and said to be restricted to young children.[12]Africa, Europe
1557–1558EpidemicThe first influenza pandemic in which global involvement and westward spread from Asia to Europe is documented. Unlike the previous pandemic from 1510, this one is highly fatal, with deaths recorded as being due to "pleurisy and fatal peripneumony". High mortality in pregnant women is also recorded.[12]Eurasia
1580EpidemicInfluenza pandemic originates in Asia during the summer, spreading to Africa, and then to Europe along two corridors from Asia Minor and North-West Africa. Illness rates are high. 8000 deaths are reported in Rome, and some Spanish cities are decimated.[3][12]Eurasia, Africa
1729EpidemicInfluenza pandemic originates in Russia, spreading westwards in expanding waves to embrace all Europe within six months. High death rates are reported.[7][3][12]Eurasia
1761–1762EpidemicInfluenza pandemic originates in the Americas in the spring of 1761 and spreads from there to Europe and around the globe in 1762. It is the first pandemic to be studied by multiple observers who communicate with each other in learned societies and through medical journals and books. Influenza is characterized clinically to a greater degree than it has been previously, as physicians carefully record observations on series of patients and attempt to understand what would later be called the pathophysiology of the disease.[12]Americas, Europe
1780–1782EpidemicInfluenza pandemic originates in Southeast Asia and spreads to Russia and eastward into Europe. It is remarkable for extremely high attack rates but negligible mortality. It appears that in this pandemic the concept of influenza as a distinct entity with characteristic epidemiological features is first appreciated.[12]Eurasia
1830–1833EpidemicInfluenza pandemic breaks out in the winter of 1830 in China, further spreading southwards by sea to reach the Philippines, India and Indonesia, and across Russia into Europe. By 1831, the epidemic reaches the Americas. Overall the attack rate is estimated at 20–25% of the population, but the mortality rate is not exceptionally high.[3]Eurasia, Americas
1878Scientific developmentAvian influenza is recorded for the first time. Originally known as Fowl Plague.[4]Italy
1889–1892Epidemic1889–90 flu pandemic. Dubbed the "Russian pandemic". Attack rates are reported in 408 geographic entities from 14 European countries and in the United States. Rapidly spreading, the pandemic would take only 4 months to circumnavigate the planet, reaching the United States 70 days after the original outbreak in Saint Petersburg.[13] Following this pandemic, interest is renewed in examining the recurrence patterns of influenza.[12]Eurasia, Americas
1901Scientific developmentThe causative organism of avian influenza is discovered to be a virus.[14]
1918-1920EpidemicThe Spanish flu (H1N1) pandemic is considered one of the deadliest natural disasters ever, infecting an estimated 500 million people across the globe and claiming between 50 and 100 million lives. This pandemic would be described as "the greatest medical holocaust in history" and is estimated to have killed in a single year more people than the Black Death bubonic plague killed in four years from 1347 to 1351.[15][16]Worldwide; originated in France (disputed)
1931Scientific developmentAmerican virologist Richard Shope discovers the etiological cause of influenza in pigs.[17]
1933Scientific developmentBritish researchers Wilson Smith, Christopher Andrews, and Patrick Laidlaw are the first to identify the human flu virus by experimenting with ferrets.[18][19][20]United Kingdom
1936Medical developmentSoviet scientist A. Smorodintseff first attempts vaccination with a live influenza vaccine that has been passed about 30-times in eggs. Smorodintseff would later report that the modified virus causes only a barely perceptible, slight fever and that subjects are protected against reinfection.[21]Russia
1942Medical developmentBivalent vaccine is produced after the discovery of influenza B.[20]
1945Medical developmentThe first license to produce an influenza vaccine for civilian use is granted in the United States.[22]United States
1946OrganizationThe Centers for Disease Control and Prevention (CDC) is established by the U.S. Department of Health and Human Services in order to protect public health and safety through the control and prevention of diseases. The CDC would launch campaigns targeting the transmission of influenza.[23][24]United States (Atlanta)
1947OrganizationThe World Medical Association (WMA) is formed as an international confederation of free professional medical associations. Like CDC, the WMA would launch Influenza Immunization Campaigns.[25]France (serves worldwide)
1948OrganizationThe World Health Organization (WHO) is established.[26]
1952Organization (Research institute)The Global Influenza Surveillance and Response System (GISRS) is established by the WHO with the purpose of conducting global influenza virological surveillance. GISRS monitors the evolution of influenza viruses and provides recommendations in areas including laboratory diagnostics, vaccines, antiviral susceptibility and risk assessment. It also serves as a global alert mechanism for the emergence of influenza viruses with pandemic potential.[27]
1957EpidemicNew, virulent influenza A virus subtype H2N2 breaks out in Guizhou (China). It would turn into pandemic (category 2) and kill 1 to 4 million people.[28] It is considered the second major influenza pandemic to occur in the 20th century, after the Spanish flu.[29][12]China
1959Non–human infectionInfluenza A virus subtype H5N1 breaks out in Scotland and affects domestic chicken.[30]United Kingdom
1961Non–human infectionAvian Influenza A virus subtype H5N1 strain is found in birds.[31][32]South Africa
1963Non–human infectionInfluenza A virus subtype H7N3 breaks out in England and affects domestic turkeys.[30]United Kingdom
1966Non–human infectionInfluenza A virus subtype H5N9 breaks out in Ontario and affects domestic turkeys.[30]Canada
1968-1969EpidemicHong Kong flu (H3N2) pandemic breaks out, caused by a virus that has been “updated” from the previously circulating virus by reassortment of avian genes.[12][33]Eurasia, North America
1973Program launchThe World Health Organization starts issuing annual recommendations for the composition of the influenza vaccine based on results from surveillance systems that would identify currently circulating strains.[20]
1976EpidemicSwine flu outbreak is identified at U.S. army base in Fort Dix, New Jersey. Four soldiers infected resulting in one death. To prevent a major pandemic, the United States launches a vaccination campaign.[34][35]United States (New Jersey)
1976Non–human infectionInfluenza A virus subtype H7N7 breaks out in Victoria (Australia) and affects domestic chicken.[30]Australia
1977EpidemicRussian flu (H1N1) epidemic. New influenza strain in humans. Isolated in northern China. A similar strain prevalent in 1947–57 causes most adults to have substantial immunity. This outbreak is not considered a pandemic because most patients are children.[35]Russia, China, worldwide
1978Medical developmentThe first trivalent influenza vaccine is introduced. It includes two influenza A strains and one influenza B strain.[20]
1980Medical developmentUnited States FDA approves influenza vaccine Fluzone (Sanofi Pasteur), developed for A subtype viruses and type B virus contained in the vaccine.[36]United States
1983Non–human infectionAvian Influenza A virus subtype H5N8 breaks out. 8,000 turkeys, 28,020 chickens, and 270,000 ducks are slaughtered.[37][32]Ireland
1988InfectionInfluenza A virus subtype H1N2 is isolated from humans in six cities in China, but the virus does not spread further.[38]China
1990-1996Medical developmentOseltamivir (often referenced by its trademark name Tamiflu) is developed by Gilead Sciences, using shikimic acid for synthesis. It would be widely used in further antiviral campaigns targeting influenza A and B. Included on the World Health Organization's List of Essential Medicines.[39]United States
1997InfectionHighly pathogenic avian influenza (HPAI) H5N1 (also known as bird flu) is discovered in humans. The first time an influenza virus is found to be transmitted directly from birds to people. Eighteen people hospitalized, six of whom die. Hong Kong kills its entire poultry population of about 1.5 million birds. No pandemic develops.[40]China (Hong Kong)
1997InfectionHighly pathogenic Influenza A virus subtype H7N4 strain causes a minor flu outbreak in chicken.Australia
1999InfectionNew Influenza A virus subtype H9N2 strain is detected in humans. It causes illness in two children in Hong Kong, with poultry being the probable source. No pandemic develops.[35][32]China (Hong Kong)
2002InfectionNew avian influenza A virus subtype H7N2 strain affects 197 farms in Virginia and results in the killing of over 4.7 million birds. One person is infected, fully recovered.[41][32]United States
2003–2007InfectionAvian (Influenza A virus subtype H5N1) strain is reported in humans. In February 2003, two people are infected in Hong Kong, one dies. In December 2003, H5N1 breaks out among chicken in South Korea. By January 2004, Japan has its first outbreak of avian flu since 1925 and Vietnam reports human cases. In Thailand, nine million chickens are slaughtered to stop the spread of the disease.[32] By December 2006, over 240 million poultry would die or be culled due to H5N1.[42] East Asia, Southeast Asia
2003InfectionFirst reported case of avian influenza A virus subtype H7N7 strain in humans. 88 people are infected, one dies. 30 million birds are slaughtered.[43][32]Netherlands
2004OrganizationThe Influenza Genome Sequencing Project is launched to investigate influenza evolution by providing a public data set of complete influenza genome sequences from collections of isolates representing diverse species distributions. Funded by the NIAID.[44]
2004InfectionNew avian Influenza A virus subtype H7N3 strain is detected in humans. Two poultry workers become infected, eventually fully recovered.[45][32]Canada
2004InfectionNew avian influenza A virus subtype H10N7 strain is detected in humans. Two children become infected.[46][32]Egypt
2004Non–human infectionAvian influenza A virus subtype H5N2 infects birds in Texas. 6,600 infected broiler chickens are slaughtered.[47][32]United States
2005OrganizationUnited States President George W. Bush unveils the National Strategy to Safeguard Against the Danger of Pandemic Influenza. US$1 billion for the production and stockpile of oseltamivir are requested after Congress approves $1.8 billion for military use of the drug.[48][49]United States
2005OrganizationAmerican president George W. Bush announces the International Partnership on Avian and Pandemic Influenza. The purpose of the partnership is protecting human and animal health as well as mitigating the global socioeconomic and security consequences of an influenza pandemic.[50][51]United States (New York City)
2005InfectionAvian influenza A virus subtype H1N1 strain kills one person in Cambodia. In Romania, a village is quarantined after three dead ducks test positive for H1N1.[52][32]Cambodia, Romania
2006OrganizationThe International Pledging Conference on Avian and Human Pandemic Influenza is held Beijing. Co-hosted by the Chinese Government, the European Commission and the World Bank. The purpose is to raise funds for international cooperation in the prevention and control of avian and human influenza.[53]China (Beijing)
2007Non-human infectionEquine influenza outbreak is diagnosed in Australia's horse population following the failure to contain infection in quarantine after the importation of one or more infected horses. The outbreak would also have a major impact on individual horse owners, the horse industry and associated sectors in both infected and uninfected states.[54]Australia
2008Scientific developmentOpenFluDB is launched as a database for human and animal influenza virus. It's used to collect, manage, store and distribute worldwide data on influenza.[55]Worldwide
2008Service launchGoogle launches Google Flu Trends, a web service with aims at providing estimates of influenza activity by aggregating Google Search queries. The system would provide data to 29 countries worldwide, extending service to include surveillance for dengue.[56]United States
2009EpidemicNew flu virus (H1N1) pandemic, first recognized in the state of Veracruz, Mexico, spreads quickly across the United States and the world, prompting a strong global public reaction. Overseas flights are discouraged from government health bodies.[57] Worldwide, nearly 1 billion doses of H1N1 vaccine are ordered.[58] A total of 74 countries are affected. 18,500 deaths.[35]Worldwide
2011Non–human infectionInfluenza A virus subtype H3N8 causes death of more than 160 baby seals in New England.[59]United States
2012Scientific developmentA 2012 meta-analysis finds that flu shots are efficacious 67 percent of the time.[60]
2012Scientific project/controversyAmerican virologists Ron Fouchier and Yoshihiro Kawaoka intentionally develop a strain based on H5N1 for which no vaccine exists, causing outrage in both the media and scientific community.[61][62][63]Netherlands (Erasmus Medical Center), United States (University of Wisconsin–Madison)
2012Medical developmentUnited States FDA approves first seasonal influenza vaccine manufactured using cell culture technology.[64]United States
2013EpidemicAvian Influenza A virus subtype H7N9 strain, a low pathogenic AI virus, breaks out in China. As of April 11, 2014, the outbreak's overall total would reach 419 people, including 7 in Hong Kong, with the unofficial death toll at 127.[65][66]China, Vietnam
2013Medical developmentUnited States FDA approves influenza vaccine Flublok (Protein Sciences), developed through recombinant DNA technology.[67]United States
2013InfectionAvian Influenza A virus subtype H10N8 strain infects for the first time and kills one person.[68][32]China
2015ProgramGoogle Flu Trends shuts down in August 2015 after successive inaccuracies in the big data analysis.[69] After performing well for two to three years since the service launch in 2008, GFT would start to fail significantly and require substantial revision.[70] However, Google Flu Trends would also inspire several other similar projects that use social media data to predict disease trends.[71]United States
2017Medical developmentResearchers from the University of Texas at Arlington build influenza detector that can diagnose at a breath, without the intervention of a doctor.[72]United States
2017Scientific developmentResearchers from the University of Helsinki demonstrate that three anti-influenza compounds effectively inhibit zika virus infection in human cells.[73]Finland

See also

References
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