Disease & Vaccine Information

What is the History of Influenza in America and Other Countries?

Updated October 07, 2022


The name Influenza originated in 15th century Italy from the belief that the epidemic of respiratory illness was “influenced” by the stars. While the first documented global influenza pandemic appears to have occurred in 1580, ancient Greek literature traces reports of possible influenza as far back as 412 BC.1 2

It is likely that seasonal influenza outbreaks and epidemics have occurred yearly in different parts of the world throughout recorded history. However, because influenza rarely caused significant mortality and morbidity on a global scale, influenza reports in the historical literature likely focused on influenza pandemics and not seasonal outbreaks.

Influenza pandemics occur when a new strain of influenza emerges and has a global impact on human populations because most people - or certain age groups within a population - do not have natural immunity to the new influenza strain. While influenza outbreaks or epidemics typically affect the elderly and those with chronic health issues, influenza pandemics tend to also impact younger people, both healthy individuals and those with chronic illness.3

Between 1700 and the 1918-19 influenza pandemic, historical literature documented at least four influenza pandemics, each occurring between 40 and 60 years apart.4

The 1918-19 influenza pandemic is thought to have originated in the U.S., even though it is often referred to as the “Spanish Flu,” and it was the first flu pandemic of the 20th century. Caused by a type A influenza strain, the 1918-19 pandemic is estimated to have resulted in 20 to 50 million deaths worldwide, including more than 600,000 deaths in the U.S.5 6

The 1957-58 Asian flu pandemic began in February of 1957 in Singapore and continued to Hong Kong before spreading globally. It is estimated that approximately 1.1 million excess deaths occurred worldwide during this pandemic and there was a noticeable increase in the influenza-related respiratory mortality rate among school aged children and young adults.7 Ten years later, in comparison, the 1968-69 Hong Kong flu pandemic was fairly mild, with 33,800 U.S. deaths being attributed to it.8

In 1976, a type A influenza virus (H1N1/swine flu) was isolated from two soldiers at Fort Dix, New Jersey and approximately 200 more soldiers were subsequently infected. The fear of a repeat of the influenza pandemic of 1918-19 prompted the pre-emptive development of a flu vaccine. The projected swine flu epidemic did not occur, and the outbreak was limited to New Jersey, with no additional cases detected after February 1976.9

In April 2009, a new influenza type A H1N1 (swine flu) strain that was first identified and has been confirmed to have originated in Mexico near a pig farm was detected in the United States.10 By April 26, 2009, public health officials from the Centers for Disease Control (CDC) and the U.S. Secretary of Homeland Security declared a national public health emergency.11 The quick declaration of a public health emergency put the production of experimental pandemic H1N1 influenza vaccines on a fast track and vaccine manufacturers were given liability protection, while there was a nationwide promotion for everyone to get vaccinated.12 13 Eventually the CDC recommended that Americans get two flu shots in the 2009-2010 flu season: a seasonal flu shot and a pandemic H1N1 flu shot.14

The 2009 influenza pandemic was mild compared to previous pandemics like the one in 1918-19. The CDC estimated there were more than 60 million cases in the U.S. and 12,469 deaths directly attributable to the 2009 H1N1 “swine flu” virus.15

IMPORTANT NOTE: NVIC encourages you to become fully informed about Influenza and the Influenza vaccine by reading all sections in the Table of Contents, which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.




[1] Communication and Education Branch, National Center for Immunization and Respiratory Diseases (NCIRD) and the Centers for Disease Control (CDC). In: Influenza. Epidemiology and Prevention of Vaccine-Preventable Diseases. 13th ed. Centers for Disease Control (CDC) 2015; p. 179. Updated Aug. 18, 2021.

[2] Potter CW. A History of Influenza. J. Appl. Microbiol July 7, 2001; 91(4): 572-579.

[3] U.S. Centers for Disease Control and Prevention. How Is Pandemic Flu Different from Seasonal Flu? May 7, 2019.

[4] Potter CW. A History of Influenza. J. Appl. Microbiol July 7, 2001; 91(4): 572-579.

[5] Short KR, Kedzierska K, van de Sandt CE. Back to the Future: Lessons Learned From the 1918 Influenza Pandemic. Front Cell Infect Microbiol. Oct 8, 2018;8:343.

[6] U.S. Centers for Disease Control and Prevention. 1918 Pandemic (H1N1 virus). In: Influenza (Flu). Mar. 20, 2019.

[7] Viboud C, Simonsen L, Fuentes R. et al. Global Mortality Impact of the 1957-1959 Influenza Pandemic. J Infect Dis Mar 1, 2016;213(5):738-45.

[8] U.S. Department of Health & Human Services. Pandemic Flu History. Oct. 22, 2016.

[9] Gaydos JC, Top FH, Hodder RA. et al. Swine influenza A outbreak, Fort Dix, New Jersey, 1976. Emerg Infect Dis Jan. 2006; 12(1).

[10] Mt. Sinai School of Medicine. 2009 swine flu pandemic originated in Mexico, researchers discover. Science Daily June 27, 2016.

[11] U.S. Centers for Disease Control and Prevention. How CDC Estimates the Burden of Seasonal Influenza in the U.S. In: Influenza (Flu). Nov. 22, 2019.

[12] Roos R. HHS extends liability shield to antivirals used for H1N1. CIDRAP June 26, 2009.

[13] National Vaccine Information Center. Pandemic H1N1 Swine Flu: What About You and Your Family. July 2009.

[14] U.S. Centers for Disease Control and Prevention. Summary of the 2009-2010 Influenza Season. In: Influenza (Flu). Sept. 8, 2010.

[15] U.S. Centers for Disease Control and Prevention. 2009 H1N1 Pandemic (H1N1pdm09 virus). In: Influenza (Flu). Jun 11, 2019.

Opens in new tab, window
Opens an external site
Opens an external site in new tab, window