Patterson K D
Soc Sci Med. 1985;21(5):571-80. doi: 10.1016/0277-9536(85)90042-5.
Four major influenza epidemics were recorded between 1830 and 1848. The 1830-1831 epidemic may have originated in China; then and in 1833 influenza advanced westward out of Russia into Europe. In 1836-1837, influenza diffusion was largely north to south, and in 1847-1848 the disease swept through the Mediterranean to southern France and thence elsewhere in Western Europe. Each of the four epidemics spread rapidly and caused very high morbidity rates. Although case-mortality rates were always low, each epidemic killed thousands of people, with most deaths being among the elderly. Many previous writers have described all four outbreaks as pandemics, but true pandemics, presumably caused by major new viral types, are clearly identifiable only in 1830-1831 and 1833. The status of the 1836-1837 outbreak is unclear, but there was no pandemic in 1847-1848.
1830年至1848年间记录了四次重大流感疫情。1830 - 1831年的疫情可能起源于中国；当时以及1833年，流感从俄罗斯向西蔓延至欧洲。1836 - 1837年，流感传播主要是从北向南，而在1847 - 1848年，该疾病席卷地中海地区至法国南部，进而蔓延至西欧其他地区。这四次疫情均迅速传播，导致了极高的发病率。尽管病死率一直很低，但每次疫情都造成了数千人死亡，其中大多数死亡发生在老年人中。许多以前的作者将这四次疫情都描述为大流行，但真正的大流行，大概是由主要的新型病毒类型引起的，仅在1830 - 1831年和1833年清晰可辨。1836 - 1837年疫情的情况尚不清楚，但1847 - 1848年并未发生大流行。
