Syphilis, which ravaged Europe beginning in the late 15th century, is a famous case of what Sontag calls “the need to make a dreaded disease foreign.” “It was the ‘French pox’ to the English, morbus Germanicus to the Parisians, the Naples sickness to the Florentines, the Chinese disease to the Japanese,” she wrote. (The name “syphilis” originated in an epic Latin poem written in 1530 by the Italian physician Girolamo Fracastoro, about a shepherd boy named Syphilis cursed with the disease by the god Apollo. The poem was called Syphilis sive morbus Gallicus, “Syphilis or the French Disease.”)

A similar pattern of blaming foreign powers emerged in naming influenza pandemics. Writing in 1922, the British epidemiologist Francis Graham Crookshank noted that “no epidemic disease has been ascribed so frequently, in respect of particular prevalences, to neighbouring, or antipathetic regions as influenza.” A pandemic that struck in 1889–90 earned the label “Russian flu” in English, German, Italian, and French. That geographic naming style set the template for the global outbreak of 1918, or the “Spanish flu” as it became commonly known.

As the science journalist Laura Spinney details in her 2017 book, Pale Rider: The Spanish Flu of 1918 and How It Changed the World, Spain ended up taking the blame not because the pandemic actually originated there, nor because its outbreak was any more severe. Rather, it happened because while Europe was at war, Spain remained neutral and did not censor its press. Spinney explains that the major combatants in World War I kept their outbreaks under wraps to avoid damaging morale, with French military doctors cryptically referring to maladie onze, or “disease eleven.” When influenza hit Spain hard in May 1918, it lit up the international news, and the French, British, and Americans began calling it “Spanish influenza.”

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With Spain serving as a convenient scapegoat, reports of the disease’s spread followed the old xenophobic tropes. For instance, in July 1918, the Fort Worth Record picked up a wire report about a Spanish passenger liner arriving at an unnamed Atlantic port and being “thoroughly fumigated and those on board thoroughly examined by federal and state health officers.” The article carried the headline “Spanish Influenza Is an Undesirable,” conflating the disease with the foreign “undesirables” blamed for spreading it. The irony, in retrospect, is that the leading theory for the origin of the so-called Spanish flu places it right here in the United States. In early 1918, the first wave of the pandemic started at Camp Funston, an Army training camp in Fort Riley, Kansas, before it spread to other military camps and traveled overseas.

Even when a geographic label for a disease is more accurate in pinpointing its origin, such names can be quickly outgrown. The Ebola virus was named for the Ebola River in the Democratic Republic of Congo in central Africa, where it was first identified, but the 2014 epidemic took place far away in western Africa. Similarly, the Zika virus was named for a forest in Uganda where it was first isolated in 1947, but the outbreak that began in 2015 started in Brazil and spread throughout the Americas.