Did the 1918–19 Influenza Pandemic Originate in China?

This article seeks to establish whether China, like most other countries, experienced an influenza outbreak in 1918–19 and to gauge its extent and severity. It evaluates the suggestion that the 1918–19 influenza virus originated in China and was carried to France by Chinese migrant workers during World War I. The investigation covers statistical and other materials for Hong Kong and Shanghai, nonstatistical materials for elsewhere in China, and British archival records relating to the recruitment and transportation to France of Chinese workers. Influenza was widespread in China in 1918–19, but, although severe in some parts, it was mild in many places compared with elsewhere in the world. The most plausible explanation is that the 1918–19 influenza virus, or a closely related precursor, had originated in China, so that many Chinese had prior exposure and hence some immunity. It is thus conceivable that Chinese workers en route to France would have carried the virus with them, leading to the pandemic.