A French study of the 1918-1919 influenza pandemic, which analyzed mortality rates in approximately three-quarters of the European population, has concluded that it is unlikely that the virus, often described as Spanish flu, originated in Europe.
Published in the May issue of Influenza and Other Respiratory Viruses, the research shows a high degree of synchronicity in the 14 countries studied, including Spain, with the flu peaking in October to November 1918.
The study was carried out by a team from INSERM, the French National Institute for Health and Medical Research.
Key facts highlighted by the research include:
-- Overall deaths increased by 86 percent in the 14 European countries studied during the 1918-1919 pandemic, with 1.98 million excess deaths recorded. When these figures were extrapolated to cover the 25 percent of Europe not covered by the study, the figure reached 2.64 million.
-- Excess mortality rates for the individual countries covered by the INSERM analysis were: Bulgaria (102 percent), England and Wales (55 percent), Finland (33 percent), Sweden (74 percent), France (66 percent), Germany (73 percent), Italy (172 percent), Norway (65 percent), Denmark (58 percent), Portugal (102 percent), Scotland (57 percent), Spain (87 percent), Switzerland (69 percent) and The Netherlands (84 percent).
-- Figures for the worldwide death toll remain very imprecise. A first American report in 1927 suggested that the main 1918-1919 wave was responsible for 21 million deaths worldwide. A revised estimate in 1991 put the figure between 24.7 and 39.3 million and another in 2002 set the death toll at up to 100 million to take into account the lack of data in a large part of the world.
The authors point out that the source of the 1918 pandemic remains unclear. A recent analysis of the 1918 H1N1 genome failed to single out a particular location. Theories put forward by various researchers include Asia, a British army post in France in 1916, the U.S. and Spain.
The first reported pandemic was in 412 BC and the first attributed to influenza was in 1580. Since then 31 influenza pandemics have been reported, with the five most recent being in 1889, 1900, 1918, 1957 and 1968. The 1918 pandemic was the most deadly in modern history.
Reference: Ansart et al. Mortality burden of the 1918-1919 influenza pandemic in Europe. Influenza and Other Respiratory Viruses 3(3), 99-106. (May 2009).
Stay prepared and protected with Infection Control Today's newsletter, delivering essential updates, best practices, and expert insights for infection preventionists.
Reducing Hidden Risks: Why Sharps Injuries Still Go Unreported
July 18th 2025Despite being a well-known occupational hazard, sharps injuries continue to occur in health care facilities and are often underreported, underestimated, and inadequately addressed. A recent interview with sharps safety advocate Amanda Heitman, BSN, RN, CNOR, a perioperative educational consultant, reveals why change is overdue and what new tools and guidance can help.
New Study Explores Oral Vancomycin to Prevent C difficile Recurrence, But Questions Remain
July 17th 2025A new clinical trial explores the use of low-dose oral vancomycin to prevent Clostridioides difficile recurrence in high-risk patients taking antibiotics. While the data suggest a possible benefit, the findings stop short of statistical significance and raise red flags about vancomycin-resistant Enterococcus (VRE), underscoring the delicate balance between prevention and antimicrobial stewardship.
What Lies Beneath: Why Borescopes Are Essential for Verifying Surgical Instrument Cleanliness
July 16th 2025Despite their smooth, polished exteriors, surgical instruments often harbor dangerous contaminants deep inside their lumens. At the HSPA25 and APIC25 conferences, Cori L. Ofstead, MSPH, and her colleagues revealed why borescopes are an indispensable tool for sterile processing teams, offering the only reliable way to verify internal cleanliness and improve sterile processing effectiveness to prevent patient harm.
The Next Frontier in Infection Control: AI-Driven Operating Rooms
Published: July 15th 2025 | Updated: July 15th 2025Discover how AI-powered sensors, smart surveillance, and advanced analytics are revolutionizing infection prevention in the OR. Herman DeBoard, PhD, discusses how these technologies safeguard sterile fields, reduce SSIs, and help hospitals balance operational efficiency with patient safety.
Targeting Uncertainty: Why Pregnancy May Be the Best Time to Build Vaccine Confidence
July 15th 2025New national survey data reveal high uncertainty among pregnant individuals—especially first-time parents—about vaccinating their future children, underscoring the value of proactive engagement to strengthen infection prevention.