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{{Paper
|id=Vol-3834/paper29
|storemode=property
|title=Getting to grippe with influenza: an investigation of why the disease is called that
|pdfUrl=https://ceur-ws.org/Vol-3834/paper29.pdf
|volume=Vol-3834
|authors=Maria Bekker-Nielsen Dunbar,Manex Agirrezabal,Tønnes Bekker-Nielsen
|dblpUrl=https://dblp.org/rec/conf/chr/DunbarAB24
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==Getting to grippe with influenza: an investigation of why the disease is called that==
https://ceur-ws.org/Vol-3834/paper29.pdf
Getting to Grippe With Influenza: An Investigation
of Why the Disease Is Called That
Maria Bekker-Nielsen Dunbar1,2,∗,† , Manex Agirrezabal3,† and
Tønnes Bekker-Nielsen4
1
Department of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg,
Germany
2
Centre for Research on Pandemics & Society, OsloMet – Oslo Metropolitan University, Oslo, Norway
3
Department of Nordic Studies and Linguistics, University of Copenhagen, Copenhagen, Denmark
4
Department of Culture and Language, University of Southern Denmark, Odense, Denmark
Abstract
We investigate influenza-related terminology to gain a deeper understanding of what may have
driven the choice in disease name when competing options were available. It is unclear why
influenza in English should be called “influenza” and not “grippe” as the latter is seemingly
the most common term for influenza within Indo-European languages. We examined why
influenza is referred to as “influenza” in English using minimum edit distance to determine the
available space in a language for a new disease term. We included other European languages
for comparison. Available space may part of but not the full reason for why diseases are called
what they are called when competing options are available.
Keywords
influenza, grippe, digital humanities, onomasiology, nosography
1. Introduction
Influenza is a respiratory disease with pandemic potential which has existed alongside
humans for a long time. There are many influenza outbreaks, but there is certain
agreement that influenza pandemics occurred in 1830 (to 1833), 1889 (to 1890), 1918
(to 1920), 1957 (to 1958), 1968 (to 1969), 1977 (to 1979), and 2009 (to 2010) whereby
we need language to be able to discuss, record, and report on the disease. The term
“influenza” originates from Italy, where it is found as early as 1360 [19]. In English, the
disease was previously known as “influenza” and “grippe” (or “grippings”), both terms
first attested in 1743 [3].
CHR 2024: Computational Humanities Research Conference, December 46, 2024, Aarhus, Denmark
∗
Corresponding author
†
These authors contributed equally
£ bl328@uni-heidelberg.de (M. Bekker-Nielsen Dunbar); Manex.Aguirrezabal@hum.ku.dk
(M. Agirrezabal); tonnes@sdu.dk (T. Bekker-Nielsen)
ç https://manexagirrezabal.github.io (M. Agirrezabal)
ȉ 0000-0002-7249-3524 (M. Bekker-Nielsen Dunbar); 0000-0001-5909-2745 (M. Agirrezabal);
0000-0003-4628-5411 (T. Bekker-Nielsen)
© 2024 Copyright for this paper by its authors. Use permitted under Creative Commons License Attribution 4.0 Inter-
national (CC BY 4.0).
301
CEUR
ceur-ws.org
Workshop ISSN 1613-0073
Proceedings
With the advent of germ theory, the agent responsible for influenza was (incorrectly)
identified and named as Haemophilus influenzae in 1892 which contains “influenza” in
its name and could be considered a reason why “grippe” is not used to denote influenza
in contemporary English. We suggest a different reason as disease names need not
match their pathological agents: there was no lexical space for “grippe” to become the
dominant disease term in English while space existed for “influenza”. We illustrate this
with a comparison with Romance and Germanic languages to support our argument.
1.1. Related work
Menadue [11] did a descriptive analysis of outbreak-related terms in fiction. The
“plague.txt” project considered synonyms for the disease name for plague (called on-
tology terms, an example is the term bubo as a representation of plague) and suggest
descriptive analysis of text corpora may provide insights [6]. Textual investigation is a
common line of inquiry to understand infectious diseases: other researchers have also
examined plague alongside measles, [1] cholera [12, 1], typhus, malaria, and smallpox
[12] and sexually transferred infections [10].
Custom text corpora have been constructed for the purpose of examining influenza
specifically [20, 16]. We note that Solovejute and Gatherer [16] stated “we conclude
that there is little or no corpus linguistic signal in the UK national press for large-scale
outbreaks of unidentified respiratory disease for the period 1785 to 1890” but there seems
to be an increase for the Northern Echo and Ipswitch Journal in that period of time (red
and green in the upper panel of Figure 1, respectively). We suspect the increase in
occurrences of “flu” around the mid 2000s is an artefact of reporting on a large outbreak
of avian influenza (H5N1) in and around the time of 2004 to 2007 which is likely being
referred to colloquially as “bird flu”. We also consider the results of the work by Taylor
and Kidgell [18] noting that it is not immediately comparable as it combines our terms
of interest (grippe and influenza (plus flu)) as well as severe acute respiratory syndrome
(SARS) disease. While the mentions of influenza by itself follows the timings of known
pandemics well as could be expected (Figure 1, lower panel where shaded areas and large
counts match from 1900 onwards with the exception of the early 2000s), there seems to
be less of an obvious pattern when SARS is included. The two approaches (Solovejute
and Gatherer [16] and Taylor and Kidgell [18]) seem to match well for the later part of
their study periods but there are discrepancies before 1950.
These plots of time series of word frequencies over time reflect trends of use as captured
in the sources investigated. News media is aimed at the general public and is unlikely to
contain vast amounts of medical jargon and thus is a weak proxy for general language use.
We do not consider it a full proxy as journalists writing about medical subjects will want
to avoid colloquialisms to bolster the authority and legitimacy of their reporting which
will of course provide noise to the signal if it is supposed to be a reflection of everyday
language. Medical journals have also been used to construct custom text corpora and
this approach has been used to examine changes in medical language [2] though not for
our terms of interest. Descriptive analysis of our terms can provide an indication of
when “grippe” is used less comparative to “influenza” but not why which is what we wish
302
Figure 1: Data from Solovejute and Gatherer [16] on occurrence of influenza in British news media
(top), scraped from Taylor and Kidgell [18] (middle), and a comparison of occurrences in the Times; a
source used by both research groups (bottom)
to investigate.
2. Methods
We examined the dominant term for influenza in European languages (Figure 2) using
the term in use in Wikipedia (as a reflection of most common use) or as is translated
from English in dictionaries for translation. We found that “grippe” is the term used in
most European languages with the exceptions being English, Nordic languages, Uralic
languages, and Italian from whence the term “influenza” originates. English and Italian
are outliers on their language branches (Figure 2) and a belt of “grippe” is found between
them when plotted on a map. We sought to determine why influenza is not called “grippe”
in English. We postulate that is due to a minor form of synonymy avoidance by arguing
that there was not space in English for “grippe”.
303
Euphonics explains how a word fits into a language. Rather than investigating ease of
pronunciation, we examine which word can be said to have the least amount of ambiguity.
In this work we consider that for a word to have “space” in a language and thus fit, it
needs to not be taking up space already occupied by a similar word. A contemporary
example is that COVID-19 (full name: coronavirus disease 2019) was often abbreviated
as “corona” in Scandinavian countries but not in Spanish as the word corona (meaning
crown) already existed.
Table 1
Influenza-related terms (above) and control words (below)
English Spanish German French Italian Danish
influenza influenza influenza influenza influenza influenza
grippe gripa grippe grippe grippa grippe
catarrh catarro Katarrh catarrhe catarro katar
cough toser husten tousser tossire hoste
In this research we consider influenza-related terms used in English, Italian, French,
German, Spanish, and Danish (Table 2). We include “catarrh” and “cough” as control
words, the former is in use in the 1700s [5, and Samuel Johnson’s dictionary] and 1800s
[17, 4] and the latter is a common respiratory disease symptom. We then investigate
whether “grippe” and “influenza” could take up space in the target language, though
certain words are already in use and suspected to “block” the incoming influenza-related
term (some examples are given in Table 1).
We determined the space available for the words of interest (Table 2) through calcu-
lating the minimum edit distance of our influenza-related terms. We expect, under this
hypothesis, that whether “grippe” or “influenza” is preferred in a language depends on
whether there is space in the language for that term. We do not pass judgement on
these words, i.e. we make no further assertions about their role besides potentially being
present.
We examine dictionaries to determine the available space for words starting from
“grippe” and “influenza”. By changing a letter we investigate how many similar words we
find in the dictionary. If many similar words exist, we can conclude there is little space
for the word. We construct our own dictionaries based on the latest raw exports1 from
Google Books Ngram Viewer.2 These exports allow us to construct dictionaries covering
a specific time period, where we wished to focus on the nineteenth century. This is
because the closer our cut-off is to the present day, the greater the risk of language bias
towards English in medical communication.
To determine the available space for the disease term, we use Levenshtein distance
wherein we count the minimum number of operations required to match another word
contained in the dictionary. The possible operations to change a letter in the word
1
https://storage.googleapis.com/books/ngrams/books/datasetsv3.html
2
https://books.google.com/ngrams/
304
Table 2
Potential terms already taking up space for influenza-related terms. Adjectives related to influenza
such as “grip(p)al” are not included in the table, nor the contemporary occupation of “influencer”.
English Spanish German French Italian Danish
influence (V) influenciar (V) Influenz (N) influencer (V) influenzare (V) influere (V)
influence (N) influencia (N) influenzieren (V) influence (N) influsso (N) influens (N)
influir (V) influer (V) influent (N)
influjo (N) influent (N)
influyente (A) influençable (A)
influenciable (A)
grip (V) gripar (V) Grip (N) agripper (V) grippare (V) gribe (V)
gripe (V) gripaje (N) Grips (N) grib (N)
grip (N) grip (N)
gripe (N)
are: deletion, substitution, and insertion. Using the distance metric, we determine the
number of words that can be found in a language following the operations. The intuition
is that given two words that have the same length, if we change the same number of
letters (perform the same number of operations on the word), the word that has more
alternatives in a dictionary will have less space in the target language as that space is
already in use by a greater number of words.
As different words may have different lengths, instead of considering the total number
of operations we consider the proportion of a word that has been changed. If we make
two operations on a 4 letter word, half a word is changed, while if we make two operations
in a 10 letter word, one fifth of it will be changed. This allows us to plot the number of
possible matching words in a dictionary against the amount changed.
Regarding pre-processing of the data, we removed digits, punctuation, and made all
words lowercase. We considered only without any Part-Of-Speech attached (meaning no
words with something after an underscore). We added the word counts for different years
(previous 10 years to the moment of interest) and after summing everything, we made
sure that each word appeared at least 10 times. We did this to avoid considering nonce
words (these words may appear from optical character recognition errors or misspellings).
The code will be made available at: xxxx.
3. Results
As the Google Books Ngram source does not contain Scandinavian languages, we were
are unable to do the entire analysis (including Danish) but continued the investigation
with five target languages (English, Spanish, German, French, and Italian). Figure 3
shows a plot for each language, where we can observe how many words were found in
each dictionary (vertical axis) after altering a certain proportion of the words (horizontal
axis). We only show the proportions where no more than the 60% of words were altered.
305
If a larger proportion of the words is altered, we could observe that longer words would
have more matching words in the dictionary regardless of whether the word was a true
word. In the future, we should further analyse the effect of word length in these plots.
This plot is constructed using the dictionaries obtained from the words that were used
between 1820 and 1830. We show the plot for four words of interest, namely: “gripe”,
“grippe”, “influenza” and “ ‘catarrh” as a control. We include in the background of each
plot 50 randomly sampled words from each target language. This is intended as an aid
that provides a sense of the amount of space in the language in general and sets the
infectious disease terms in a wider non-epidemiological context.
If we take a closer look at each target language, the plot with English words (Figure 3a)
has the word “influenza” as the word with the fewest matching words, by a very small
margin. This is identified as the curve that is closest to the lower right corner of the
plot. In the case of the plot for the words in Spanish (Figure 3b) the words “grippe”
and “gripe” seem to have the least number of matches in the language. The results for
English and Spanish thus coincide with the actual word preference as shown in Figure 2
and support our postulation that available space can determine which term becomes
used.
The plot that represents French words (Figure 3c seems rather similar to the English
one, but in this case, the plot lines are closer to each other, making it harder to draw
conclusions. In the case of German (Figure 3d), “influenza” seems to be the term that
would be preferred, which does not coincide with the use of “grippe” according to Figure 2.
The last plot (Figure 3e) shows the results for Italian, and it seems as the preferred word
in this case would be the same as in Spanish, as both the words “gripe” and “grippe” seem
lower than both “catarrh” and “influenza”. Italian and Spanish are similar in structure
so the results being similar for these languages is not surprising.
We also considered the years 2014 to 2024 to reflect the use of language further removed
from the origin of the two terms (results not shown). The results are more homogenous
for all languages which makes it difficult to conclude in favour of either term with recent
data.
4. Discussion
An additional dimension not fully explored yet is geography. We postulate it may be
the case that there are a few languages influencing neighbouring languages: Welsh vs
Breton (Figure 2) suggests there is a neighbouring language trendsetter effect rather
than the choice of term being driven by euphonics or space available in a language. This
might explain why Estonian and Hungarian use different terms (Figure 2) though they
are linguistically similar.
We were not able to investigate regional language differences, only national languages.
This may have an impact as Florentine, Castilian, and High German became Italian,
Spanish and German, respectively, whereby the usage is a reflection of a specific sub-
national dialect rather than the entire country. This may explain why the results for
Italian and German are not as obviously interpreted in favour of our argument as for
306
English.
We have not considered the socio-linguistic dimension of language in this work. If
“grippe” was a colloquial word (which is not unthinkable since “influenza” is related to
the name of the infectious agent), we would need to determine where it is used. Collo-
quialisms rise up through society (which is well-documented in Latin) and so popularity
flows from the people to “high society”. We have treated all texts considered in the data
as effectively having equal weight which is to say we have not distinguished them upon
inclusion.
A strength of our work is that we considered multiple languages. This comparison
allows us to examine the words not just in their English context but also the surrounding
contexts, which strengthens our argument. The inclusion of more languages and more
data could strengthen the results further. Showing that there was space for “influenza”
but not “grippe” in English and “grippe” but not “influenza” in Romance languages (bar
Italian where it originates) suggests our instincts have merit or at least that this could
be part of the explanation for why influenza is called “influenza” in English. There are
differences in how the word is used as an adjective related to disease, as regards the
virus we speak of “virus grippeaux” in French, “Grippevirus” in German and “influenza-
like virus” in English.
Currently diseases are named by the World Health Organization who follow specific
guidelines to avoid the unnecessary stigmatisation of peoples [21] and viruses and bac-
teria are named by International Committee on Taxonomy of Viruses and International
Committee on Systematics of Prokaryotes, respectively. The naming is sometimes re-
vised [22, 9] but we believe historical investigations will provide greater insight than ones
for present-time.
5. Conclusion
We introduced names used for influenza as well as its historical context. We placed our
work in relation to work by others to provide an overview of investigations done by others
using similar data sources. We investigated which term is used in Europe by country
and suggested the use of minimum edit distance to determine whether this could explain
why one term is used over the other in specific languages, focusing on the words “grippe”
and “influenza” as terms to denote influenza. We examined English, Spanish, German,
French, and Italian.
Based on character-level Levenshtein distance, we calculated and visualised the num-
ber of matching words in a dictionary against the proportion changed. Building on this,
we found that a possible explanation for which of the terms is preferred in a language
could be affected by the number of words with similar spellings. More words with similar
spellings would lead to increased ambiguity whereby a less ambiguous term would be
favoured. This simple method can be used for other comparisons of words and languages
that have an associated dictionary. We outlined limitations of our work–that this is but
one dimension of how language is determined–as well as strengths such as using control
vocabulary and multiple languages.
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5.1. Future directions for work
In this project we considered the birth and berth of influenza-related terms. We did
not consider the death of a word, i.e. when a word ceases to be used and so ceases
to be included in a dictionary, which would be the other end of the chronology. The
lexicology of epidemiologic terms has to our knowledge not been examined and could be
a line of future inquiry. In future investigation to strengthen the work, we will investi-
gate other terms to evaluate whether the method works for other diseases. Infectious
diseases of a certain age (meaning having been with humans a long time) are the ones
likely to experience changes, so terminology for smallpox and typhus may also be worth
investigating.
The shortened form “flu” is not solely used to refer to influenza and may also be
used for gastro-intestinal infections “stomach flu and intestinal flu” [8]. This is a similar
problem to that encountered by McEnery and Baker [10] in their investigation of “pox”
as it pertains to sexually-transferred infections. Further confusion arises from hand, foot,
and mouth disease being referred to as “tomato flu” [15, 14]. Researchers will need to
determine whether “flu” is related to influenza or other terms.
Similarly to the chai/tea divide, with one term arriving via land routes (chai) and one
via sea routes (tea), one possible line of investigation for further research are the records
of physicians on ships. Epidemic diseases were a major concern on ships and in 1782, a
squadron of the British Royal Navy was forced to abandon its mission and return to base
after an outbreak of influenza on board [13]. The vessels transporting enslaved African
people to the Americas were accompanied by ships physicians whose observations made
important contributions to epidemiology [7].
Additionally, the biology of the disease has largely been neglected in this work. The
north/south divide in terms with “influenza” mostly in the north and “grippe” in the
south (Figure 2) could be due to where the disease is historically endemic which may be
different between northern Europe and central and southern Europe and an investigation
of historical terms taking into account disease endemicity could be warranted. This may
become evident after examining the medical records.
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Basque (eus) Gripe
Kartvelian Georgian Georgian (kat) gri¨i (Grip’i)
Canaanite Hebrew (heb) !( שפעתShp’et)
Afro-Asiatic Semitic Central South
Maltese (mlt) Influwenza
Arabic
Arabic InfluunzÁÁ
(Inflūnzā)
Western Aralo-Caspian Kazakh (kaz) Tұmau (Tūmau)
Turkic Turkmenian Turkmen (tuk) Dümew
Southern Turkish Turkish Grip
Azerbaijani Azerbaijani (azj) fuulaanzÁÁ
(Anfūlānzā)
Finnish (fin) Influenssa abbrv. lenssu and flunssa
Finnic
Uralic Estonian (ekk) Gripp
Hungarian (hun) Influenza
Southwestern Persian (fas) flwÁanzÁÁ
(Anflwānzā)
Indo-Iranian Iranian Western
Northwestern Kurdish Kurdish (ckb) EflzÁ (Enflonza)
Portuguese-Galician Portuguese (por) Gripe
West Iberian
Castillian Spanish (spa) La gripe
Ibero-Romance
Western Gallo-Iberian East Iberian Catalan (cat) La grip
Italo-Western Gallo-Romance Gallo-Rhaetian Oïl French French (fra) La grippe
Romance Italo-Dalmatian Italian (ita) Influenza
Italic Eastern Romanian (rom) Gripă
Latino-Faliscan Latin (lat) Influentia
Greek Attic Greek (ell) Γριπη (Gripe)
West Flemish (vls) Griep
Low Saxon-Low Franconian Low Franconian
Dutch (nld) Griep
Yiddish Yiddish (ydd) !( גריפעGryp)
West High German West Middle German Moselle Franconian Luxembourgish (ltz) Gripp
German Middle German
East Middle German German (deu) die Grippe
Germanic English English (eng) Influenza abbrv. flu
West Scandinavian Icelandic (isl) Inflúensa abbrv. flensa
North Swedish Swedish (swe) Influensa abbrv. flunsa
East Scandinavian Danish-Swedish Danish-Riksmal Danish Danish (dan) Influenza abbrv. flue (uncommon)
Danish-Bokmal Norwegian(nor) Influensa
Gàidhlig (gla) Cnatan mòr
Goidelic
Indo-European Gaeilge (gle) Fliú
Celtic Insular
Welsh (cym) Ffliw
Brythonic
Breton (cym) Grip
Lechitic Polish (pol) Grypa
West
Slovak (slk) Chrípka
Czech-Slovak
Czech (ces) Chr̆ipka
Slovene (slv) Gripa
Serbian (srp) Grip (Grip)
Western Montenegrin (cnr)
Slavic Croatian (hrv) Gripa
South
Bosnian (bos) Gripa
Macedonian (mkd) Gripot (Gripot)
Eastern
Bulgarian (bul) Grip (Grip)
Balto-Slavic
Ukranian (ukr) Grip (Grip)
East Russian (rus) Gripp (Gripp)
Belarusian (bel) Gryp (Gryp)
Lithuanian (lit) Gripas
Baltic Eastern
Latvian (lvs) Gripa
Armenian Armenian (hye) (Grip)
Albanian Tosk Albanian (als) Gripi
Figure 2: European languages distinguished by the term used for influenza by location (above) and
language tree branch (below). Green denotes “influenza” and orange denotes “grippe”. Light green
denotes “flu”. Grey is neither term or undetermined. Figure source: 10.6084/m9.figshare.27210597
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(a) English words (b) Spanish words
(c) French words (d) German words
(e) Italian words
Figure 3: The number of words found in each dictionary when a given percentage of the word was
altered through insertion, deletion or substitution. Green denotes “influenza”, orange denotes “grippe”,
blue denotes “gripe”, and red denotes “catarrh” (the control) using the words outlined in Table 2. Grey
curves denote randomly selected words. In these plots we use the words that appeared between 1820
and 1830.
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