The 1918-19 pandemic of "Spanish flu" killed around 2.64 million Europeans, according to a French study, which says that despite its name, the pathogen probably originated outside Europe. Writing in the latest issue of the journal Influenza and Other Respiratory Viruses, the investigators believe the virus killed 1.1 percent of the European population at the time.
Overall deaths increased by 86 percent when the virus went on the rampage, says the study, which is based on mortality figures in 14 countries amounting to roughly three-quarters of the European population in 1918-19. But the toll varied enormously from country to country, according to the team from the National Institute for Health and Medical Research (Inserm).
Excess mortality rates in the 14 countries were highest in Italy, where they were 172 percent above the norm, followed by Bulgaria and Portugal (102 percent), Spain (87 percent), the Netherlands (84 percent), Sweden (74 percent) and Germany (73 percent). This was followed by Switzerland (69 percent), France (66 percent), Norway (65 percent), Denmark (58 percent) Scotland (57 percent), England and Wales (55 percent) and finally Finland, which had the lowest increase in mortality, of 33 percent above normal rates.
Spanish flu, a novel strain of influenza against which there was no immunity, has been described as the biggest plague of the 20th century. It is so named because of the belief that it originated in Spain before spreading into northern Europe. It was transmitted like wildfire among troops in trenches and camps on the Western Front of World War I, and returning US and Canadian soldiers brought it back to North America, where hundreds of thousands more people were killed.
How many people died has been hugely debated, as have the origins of the virus. A US estimate in 1927 put the world-wide death toll at 21 million. Another published estimate in 1991 put it at between 24.7-39.3 million, while a paper in 2002 ventured a count of up to 100 million. As for the source of the virus, various investigations have pointed at a huge British army base in northern France and the United States, as well as Spain.
Another theory is that the virus came from Asia, which would explain why the pandemic started in the European summer, which is usually the low point of the flu season. The new study, though, says the virus is unlikely to have originated in Europe. When a lethal pandemic erupts, mortality shows up in waves that radiate out from the geographical source.
But the data suggests that "all the European countries reached simultaneously their epidemic peaks," in October to November 1918, according to the authors, led by Severine Ansart of the Universite Pierre et Marie Curie in Paris. "Our findings can provide clues to the origin of the pandemic and do not make plausible a European origin," they say.
The study found 1.98 million excess deaths recorded in the 14 studied countries during the 1918-19 pandemic. When these figures are extrapolated for all of the European population, the figure reaches 2.64 million.