In which country did Spanish Flu emerge? If you said Spain, you'd be mistaken. Following the first observations of the disease in a military base in Kansas in 1918, the H1N1 influenza A virus first spread to France, Germany and the United Kingdom as part of the First World War effort. To maintain morale, censors in most countries minimised reports of the disease - but neutral Spain faced no such pressure, creating the impression that the country was at the epicentre. They called it French Flu.

From Guinea to Germany

Although 'Spanish' Flu was the most deadly and well-known viral outbreak, it was also part of a longstanding pattern of naming diseases or parasites after places: Middle East Respiratory Syndrome and the guinea worm take their official names from the regions of their discovery, while informal titles such as German Measles for rubella have been common historically. When H1N1 influenza A made a comeback in 2009, it was alternatingly dubbed 'Swine Flu' or 'Mexican Flu'. 

The trend persists into the current pandemic, in which COVID-19 has repeatedly been dubbed the 'Wuhan Flu' or 'Chinese Virus' by certain public figures. As Jérôme Viala-Gaudefroy and Dana Lindaman have argued for The Conversation, these two terms "personify the threat ... [the] purpose is to help understand something unfamiliar and abstract (i.e. the virus) by using terms that are familiar and embodied (i.e. a location, a nationality or a person)."

Muddying the waters

The most notable purveyor of these terms, Donald Trump, is quoted in the article making the case for such personification: "It comes from China. I want to be accurate." Bear in mind that this statement comes from someone who once expressed scepticism of vaccines because he didn't like the idea of "injecting bad stuff in your body" but later went on to advocate ingesting bleach. Discounting accuracy as one of his strong points, a likelier explanation is simply that Trump is overcompensating for domestic failures in disease management by associating it with a country which he has repeatedly named as an 'enemy' of the United States.

Further support for the argument that disease names are used to deliberately convey messages comes from the rarer cases of countries choosing a location-based title to avoid a bigger backlash in another area. In 2009, both South Korea and Israel considered formalising H1N1 influenza A's name as 'Mexican Flu' to try and prevent 'Swine Flu' from catching on. In South Korea, this was due to the economic importance of the pork industry; in Israel, it was thought that Jewish and Muslim restrictions on eating pork may undermine the pandemic's significance.

The measles of mankind

Given the long tradition, some argue that place-based nicknames are of little consequence. But as National Geographic notes, the rise of COVID-19 has gone hand in hand with increased discrimination and abuse against Asians, often fitting into a pattern of scapegoating them for negative events in US history. Informal names also create misunderstandings around the disease itself, such the idea that COVID-19 only infects Chinese people. Returning to Kansas, the chairman of the Riley County Commissioners underplayed the initial spread to Europe because "Italy has a lot of Chinese people, and we don't have that problem here." This is nothing new either: Egypt culled hundreds of thousands of pigs in response to 'Swine' Flu, despite it being spread by humans instead of hogs.

At the end of a decade of increased nationalism, it's hardly surprising that something as important as pandemic management has been used for cross-border point scoring and name calling. As we (hopefully) round the corner on COVID-19, however, it's clearer than ever that international issues like pandemics require international solutions, such as combined efforts on supply distribution, contact tracing and vaccine research. In many ways, the outbreak has highlighted successes in these areas, yet our insistence on attaching preconceived stereotypes to diseases continues to cloud our understanding of them. As Albert Einstein put it, "nationalism is an infantile disease. It is the measles of mankind."

- Josh