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In 1510, an acute respiratory disease emerged in Asia before spreading through
North Africa North Africa, or Northern Africa is a region encompassing the northern portion of the African continent. There is no singularly accepted scope for the region, and it is sometimes defined as stretching from the Atlantic shores of Mauritania in ...
and
Europe Europe is a large peninsula conventionally considered a continent in its own right because of its great physical size and the weight of its history and traditions. Europe is also considered a subcontinent of Eurasia and it is located entirel ...
during the first chronicled, inter-regional flu pandemic generally recognized by medical historians and epidemiologists. Influenza-like illnesses had been documented in Europe since at least
Charlemagne Charlemagne ( , ) or Charles the Great ( la, Carolus Magnus; german: Karl der Große; 2 April 747 – 28 January 814), a member of the Carolingian dynasty, was King of the Franks from 768, King of the Lombards from 774, and the first ...
, with 1357's outbreak the first to be called ''influenza'', but the 1510 flu pandemic is the first to be pathologically described following communication advances brought about by the
printing press A printing press is a mechanical device for applying pressure to an inked surface resting upon a print medium (such as paper or cloth), thereby transferring the ink. It marked a dramatic improvement on earlier printing methods in which the ...
. Flu became more widely referred to as ''coqueluche'' and ''coccolucio'' in
France France (), officially the French Republic ( ), is a country primarily located in Western Europe. It also comprises of overseas regions and territories in the Americas and the Atlantic, Pacific and Indian Oceans. Its metropolitan area ...
and
Sicily (man) it, Siciliana (woman) , population_note = , population_blank1_title = , population_blank1 = , demographics_type1 = Ethnicity , demographics1_footnotes = , demographi ...
during this pandemic, variations of which became the most popular names for flu in early modern Europe. The pandemic caused significant disruption in government, church, and society with near-universal infection and a mortality rate of around 1%.


Asia

The 1510 flu is suspected of originating in East Asia, possibly China. Gregor Horst writes in ''Operum medicorum tombus primus'' (1661) that the disease came from Asia and spread along trade routes before attacking the Middle East and North Africa. German medical writer Justus Hecker suggested the 1510 influenza most likely came from Asia because of the historical nature of other influenzas to originate there in more recent pandemics.


Middle East

The flu spread along trade routes towards North Africa, traveling southwest through the Middle East. Frequently visited cities like
Jerusalem Jerusalem (; he, יְרוּשָׁלַיִם ; ar, القُدس ) (combining the Biblical and common usage Arabic names); grc, Ἱερουσαλήμ/Ἰεροσόλυμα, Hierousalḗm/Hierosóluma; hy, Երուսաղեմ, Erusałēm. i ...
and
Mecca Mecca (; officially Makkah al-Mukarramah, commonly shortened to Makkah ()) is a city and administrative center of the Mecca Province of Saudi Arabia, and the holiest city in Islam. It is inland from Jeddah on the Red Sea, in a narrow ...
would have almost certainly been reached by the flu, with large volumes of people destined to travel to
Egypt Egypt ( ar, مصر , ), officially the Arab Republic of Egypt, is a transcontinental country spanning the northeast corner of Africa and southwest corner of Asia via a land bridge formed by the Sinai Peninsula. It is bordered by the Medit ...
, North Africa, and the
Ottoman Empire The Ottoman Empire, * ; is an archaic version. The definite article forms and were synonymous * and el, Оθωμανική Αυτοκρατορία, Othōmanikē Avtokratoria, label=none * info page on book at Martin Luther University) ...
.


Africa

It is generally understood that the 1510 influenza had spread in Africa before Europe. Influenza was likely widespread in North Africa before crossing continents through the Mediterranean, arriving in
Malta Malta ( , , ), officially the Republic of Malta ( mt, Repubblika ta' Malta ), is an island country in the Mediterranean Sea. It consists of an archipelago, between Italy and Libya, and is often considered a part of Southern Europe. It lies ...
where British medical historian Thomas Short believed that the "island of ''Melite'' in ''Africa''" became the 1510 flu's springboard into Europe.


Europe

Europe's internationally traveled cities and flu's highly contagious nature enabled its spread through European populations. The 1510 flu disrupted royal courts, church services, and social life across Europe. Contemporary chroniclers and those who've read their accounts observed how entire populations were attacked at once, which is how the disease first received the name ''influenza'' (from the belief that such outbreaks were caused by influences like stars or cold).
Turin Turin ( , Piedmontese: ; it, Torino ) is a city and an important business and cultural centre in Northern Italy. It is the capital city of Piedmont and of the Metropolitan City of Turin, and was the first Italian capital from 1861 to 1865. The ...
professor Francisco Vallerioli (aka Valleriola) writes that the 1510 flu featured "Constriction of breathing, and beginning with a hoarseness of voice and... shivering. Not long after that there being a cooked humor which fills the lungs." Physicians like Valleriola described the 1510 flu as more fatal to children and those who were bled. Lawyer Francesco Muralto noted that "the disease killed 10 people out of a thousand in one day," supporting a fatality rate of around 1%.


Sicily and the Italian Kingdoms

The first cases of influenza began to appear in
Sicily (man) it, Siciliana (woman) , population_note = , population_blank1_title = , population_blank1 = , demographics_type1 = Ethnicity , demographics1_footnotes = , demographi ...
around July after the arrival of infected merchant ships from
Malta Malta ( , , ), officially the Republic of Malta ( mt, Repubblika ta' Malta ), is an island country in the Mediterranean Sea. It consists of an archipelago, between Italy and Libya, and is often considered a part of Southern Europe. It lies ...
. In Sicily it was commonly called ''coccolucio'' for the hood (resembling a coqueluchon - a kind of monk's cowl) the sick often wore over their heads. Influenza quickly spread out along the Mediterranean coasts of Italy and southern France via merchant ships leaving the island. In
Emilia-Romagna egl, Emigliàn (man) egl, Emiglièna (woman) rgn, Rumagnòl (man) rgn, Rumagnòla (woman) it, Emiliano (man) it, Emiliana (woman) or it, Romagnolo (man) it, Romagnola (woman) , population_note = , population_blank1_title ...
, Tommasino de' Bianchi recorded the recovery of Modena's first cases on 13 July 1510, writing that in the city "there appears 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 they recover." This data would indicate that the first cases of flu, which has an incubation period of one to four days, began to fall ill in the Emilia-Romagna region around late June or early July.
Pope Julius II Pope Julius II ( la, Iulius II; it, Giulio II; born Giuliano della Rovere; 5 December 144321 February 1513) was head of the Catholic Church and ruler of the Papal States from 1503 to his death in February 1513. Nicknamed the Warrior Pope or th ...
attributed the outbreaks in
Rome , established_title = Founded , established_date = 753 BC , founder = King Romulus (legendary) , image_map = Map of comune of Rome (metropolitan city of Capital Rome, region Lazio, Italy).svg , map_caption ...
and the
Holy See The Holy See ( lat, Sancta Sedes, ; it, Santa Sede ), also called the See of Rome, Petrine See or Apostolic See, is the jurisdiction of the Pope in his role as the bishop of Rome. It includes the apostolic episcopal see of the Diocese of R ...
to God's wrath.


Central Europe

Flu spread over the Alps into Switzerland and the
Holy Roman Empire The Holy Roman Empire was a political entity in Western, Central, and Southern Europe that developed during the Early Middle Ages and continued until its dissolution in 1806 during the Napoleonic Wars. From the accession of Otto I in 962 ...
. In Switzerland it is documented as being called ''das Gruppie'' by the
Mellingen Mellingen is a historic town and a municipality in the district of Baden in the canton of Aargau in Switzerland. The town is located on the Reuss. History Mellingen is first mentioned in 1045 as ''Mellingen'' though this comes from a 16th-cen ...
chronicler Anton Tegenfeld, the flu nickname then preferred by German-speaking Europeans. A respiratory illness seemed to have menaced the Canton of Aargua in June, with the population falling ill with sniffling, coughing, and fatigue. German physician Achilles Gasser recorded a deadly epidemic spreading over the Holy Roman Empire's upper kingdoms, branching into the cities and the "whole mankind:" ''Mira qua edam Epidemia mortales per urbes hanc totamque adeo superiorem Germaniam corripiebat, qua aegri IV vel V ad summum dies molestissimis destillationibus laborabant ac ration privati instar phrenicorum furebant, atque inde iterum convalescebant, paucissimis ad Gorcum demissis.'' André de Burgo's letters dated 24 August 1510 indicate Margaret of Austria had to intervene at a royal assembly between her father, Holy Roman Emperor Maximilian I, and Louis XII of France because the King of France was too sick with "coqueluche" to be spoken to. Influenza spread out from the Holy Roman Empire towards Northern Europe, the Baltic states, and west towards
France France (), officially the French Republic ( ), is a country primarily located in Western Europe. It also comprises of overseas regions and territories in the Americas and the Atlantic, Pacific and Indian Oceans. Its metropolitan area ...
and
England England is a country that is part of the United Kingdom. It shares land borders with Wales to its west and Scotland to its north. The Irish Sea lies northwest and the Celtic Sea to the southwest. It is separated from continental Europe b ...
.


France

Arriving aboard infected sailors from Sicily, influenza struck the
Kingdom of France The Kingdom of France ( fro, Reaume de France; frm, Royaulme de France; french: link=yes, Royaume de France) is the historiographical name or umbrella term given to various political entities of France in the medieval and early modern period ...
through the ports of
Marseille Marseille ( , , ; also spelled in English as Marseilles; oc, Marselha ) is the prefecture of the French department of Bouches-du-Rhône and capital of the Provence-Alpes-Côte d'Azur region. Situated in the camargue region of southern Fra ...
and
Nice Nice ( , ; Niçard dialect, Niçard: , classical norm, or , nonstandard, ; it, Nizza ; lij, Nissa; grc, Νίκαια; la, Nicaea) is the prefecture of the Alpes-Maritimes departments of France, department in France. The Nice urban unit, agg ...
and spread through the international crowds of the shipyards. Merchants, pilgrims, and other travelers from the south and east spread the virus throughout the western Mediterranean in July. It was referred to as "" among French physicians, but more commonly just called coqueluche. Historian
François Eudes de Mézeray François Eudes de Mézeray (1610 – 10 July 1683) was a French historian A historian is a person who studies and writes about the past and is regarded as an authority on it. Historians are concerned with the continuous, methodical narrat ...
traced the etymology of "coqueluche" to an outbreak 1410s during which sufferers wore hoods resembling coqueluchons, a kind of monk's cowl. French surgeon Ambroise Paré described the outbreak as having been a "rheumatic affliction of the head...with constriction of the heart and lungs." By August it had appeared in
Tours Tours ( , ) is one of the largest cities in the region of Centre-Val de Loire, France. It is the prefecture of the department of Indre-et-Loire. The commune of Tours had 136,463 inhabitants as of 2018 while the population of the whole metro ...
and after it had propagated itself throughout France over summer, sickening the entire country by September. French poet and historian Jean Bouchet, employed by King Louis XII's Royal Court, wrote that the epidemic "appeared in the entire Kingdom of France, as much in the towns as in the countryside." Coqueluche filled up the hospitals in France. King Louis XII's National Assembly of
Bishop A bishop is an ordained clergy member who is entrusted with a position of authority and oversight in a religious institution. In Christianity, bishops are normally responsible for the governance of dioceses. The role or office of bishop is c ...
s,
Prelate A prelate () is a high-ranking member of the Christian clergy who is an ordinary or who ranks in precedence with ordinaries. The word derives from the Latin , the past participle of , which means 'carry before', 'be set above or over' or 'pre ...
s, and university
professor Professor (commonly abbreviated as Prof.) is an academic rank at universities and other post-secondary education and research institutions in most countries. Literally, ''professor'' derives from Latin as a "person who professes". Professors ...
s scheduled for September 1510 was delayed because of the intensity of the flu in
Paris Paris () is the Capital city, capital and List of communes in France with over 20,000 inhabitants, most populous city of France, with an estimated population of 2,165,423 residents in 2019 in an area of more than 105 km² (41 sq mi), ma ...
.
Jean Fernel Jean François Fernel ( Latinized as Ioannes Fernelius; 1497 – 26 April 1558) was a French physician who introduced the term "physiology" to describe the study of the body's function. He was the first person to describe the spinal canal. The l ...
(aka Fernelius), physician to Henry III of France, compares the 1557 influenza to the 1510 epidemic which attacked everyone with fever, a heaviness in their head, and profound coughing. Up to 1000 Parisians per day were dying at the height of the "1510 peste." Mézeray mentions that it disrupted judicial proceedings and colleges, and that the 1510 flu was more widespread and deadly in France than in other countries. Cardinal Georges d'Amboise, a close friend and advisor to the King of France, is sometimes believed to have died of influenza since his health sharply declined after arriving in Lyons in May 1510. The cardinal, also known as Monseigneur le Ledat, made his final testimony and recited Sacraments around 22 May before he died on the 25th. His sudden decline in health and flu's arrival in Europe around early summer have created uncertainty as to whether he died of gout or influenza, but "coqueluche" is not mentioned in French royal correspondence that year until August.


England and Ireland

British medical historian Charles Creighton claimed there is one foreign account of the 1510 flu in England, but did not elaborate. Fernel and Paré suggested that the 1510 influenza "spread to almost all countries of the world" (not concerning Spain's territories in the New World). An epidemiological study of past influenza pandemics reviewing previous medical historians' data has found England was affected in 1510 and there were reports of symptoms like "gastrodynia" and noteworthy murrain among cattle. The 1510 flu is also recorded to have reached
Ireland Ireland ( ; ga, Éire ; Ulster Scots dialect, Ulster-Scots: ) is an island in the Atlantic Ocean, North Atlantic Ocean, in Northwestern Europe, north-western Europe. It is separated from Great Britain to its east by the North Channel (Grea ...
.


Spain and Portugal

Influenza reached the
Iberian Peninsula The Iberian Peninsula (), ** * Aragonese and Occitan: ''Peninsula Iberica'' ** ** * french: Péninsule Ibérique * mwl, Península Eibérica * eu, Iberiar penintsula also known as Iberia, is a peninsula in southwestern Europe, def ...
early after Italy, due to the highly interconnected trade and pilgrimage routes between Spain, Portugal, and the Italian kingdoms. Cases began to appear in Portugal around the same time the disease entered the Holy Roman Empire. Spanish cities were reportedly "dispopulated" by the 1510 flu.


The Americas

There are no records of influenza affecting the
New World The term ''New World'' is often used to mean the majority of Earth's Western Hemisphere, specifically the Americas."America." ''The Oxford Companion to the English Language'' (). McArthur, Tom, ed., 1992. New York: Oxford University Press, p. ...
in 1510, even though Spain was sending fleets of ships across the Atlantic. The first recorded flu outbreak in the New World had afflicted the Isle of Santo Domingo (Now Haiti and the
Dominican Republic The Dominican Republic ( ; es, República Dominicana, ) is a country located on the island of Hispaniola in the Greater Antilles archipelago of the Caribbean region. It occupies the eastern five-eighths of the island, which it shares with ...
) in
1493 Year 1493 ( MCDXCIII) was a common year starting on Tuesday (link will display the full calendar) of the Julian calendar. Events January–December * January 19 – Treaty of Barcelona: Charles VIII of France returns Cerdagne a ...
. Amerindian populations sharp decline due to Spanish-imported diseases in these 1490s and early 1500s is however documented, most notably due to
smallpox Smallpox was an infectious disease caused by variola virus (often called smallpox virus) which belongs to the genus Orthopoxvirus. The last naturally occurring case was diagnosed in October 1977, and the World Health Organization (WHO) c ...
.


Medicine and Treatment

Blistering on the back of the head and shoulders was one form of treatment prescribed in Europe for the flu. Paré regarded the common treatments of
bloodletting Bloodletting (or blood-letting) is the withdrawal of blood from a patient to prevent or cure illness and disease. Bloodletting, whether by a physician or by leeches, was based on an ancient system of medicine in which blood and other bodily flu ...
and purgation to be especially dangerous to 1510's flu patients. Supraorbital pain and vision problems were symptoms of ''coqueluche'', so sufferers may have felt tempted to wear hoods due to light sensitivity. Short describes some medicinal treatments for the 1510 flu including "Bole Armoniac, oily lintus, pectoral troches, and decoctions."


Origin of 1510 Influenza

Justus Hecker and John Parkin presumed the 1510 influenza originated from East Asia because of the historical nature of other influenza pandemics to originate there, while in 1661 Gregor Horst wrote that the 1510 flu spread along trade routes from East Asia to Africa before reaching Europe. Influenza viruses sometimes leap from Asia's migratory water fowl after massive migrations congregate near water sources for humans and domesticated animals, in which cross-species infections trigger antigenic shift and create new strains of flu human beings have little immunity to. European chroniclers noticed that the 1510 influenza did appear in North Africa before Europe, which has led some medical historians to suggest it may have developed there(parts of
North Africa North Africa, or Northern Africa is a region encompassing the northern portion of the African continent. There is no singularly accepted scope for the region, and it is sometimes defined as stretching from the Atlantic shores of Mauritania in ...
also lie along migratory bird ways, specifically the east Africa-West Asia and Black Sea-Mediterranean routes, that make it vulnerable to spontaneous reassortment of pandemic flu viruses). There remains no chronicled or biological evidence to suggest the 1510 flu originated from, as opposed to just spread in, Africa before reaching Europe.


Debunking suggestions of whooping cough

The 1510 "coqueluche" has been recognized as influenza by modern epidemiologists and medical historians. Suggestions that the 1510 ''coqueluche'' was
whooping cough Whooping cough, also known as pertussis or the 100-day cough, is a highly contagious bacterial disease. Initial symptoms are usually similar to those of the common cold with a runny nose, fever, and mild cough, but these are followed by two or t ...
have been doubted because adult sufferers often experienced "precipitous" symptoms described by contemporaries like Tommasino de Bianchi or Valleriola as high fever for 3 days, headache, prostration, loss of sleep and appetite, delirium, a cough most severe on the 5th to 10th days, lung congestion, and slow recovery beginning on the second week. Adults with pertussis will usually cough for weeks before becoming gradually more ill then recovering over a period of months. The ''coqueluche'' of 1510 is considered to be influenza by experts because of its sudden symptoms, explosive spread, and timelines of sickness to recovery. The first outbreak of whooping cough to be agreed on by most medical historians is Guillaume de Baillou's description of an outbreak in Paris in 1578.


References

{{Epidemics 1510 in Europe Influenza pandemics 16th-century epidemics