Dr John Campbell
@campbellteaching·3.3M subscribers·3.1K videos
Historic Pandemic
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November 4, 2020
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as posted by the channelPredominant Role of Bacterial Pneumonia as a Cause of Death in Pandemic Influenza: Implications for Pandemic Influenza Preparedness
The Journal of Infectious Diseases, Volume 198, Issue 7, 1 October 2008, Pages 962–970
David M. Morens, Jeffery K. Taubenberger, and Anthony S. Fauci
Methods
Prior to the use of antibiotics
1918 –1919 “Spanish flu” (H1N1) pandemic, 675,000 excess US deaths
(1.9 million on current population figures)
Examined lung tissue sections
Obtained during 58 autopsies
Reviewed pathologic and bacteriologic data from 109 published autopsy series
that described 8,398 individual autopsy investigations.
Results
Uniformly exhibited severe changes indicative of bacterial pneumonia
Bacteria, neutrophils, blood
Bacteriologic and histopathologic results clearly and consistently implicated secondary bacterial pneumonia
Caused by common upper respiratory tract bacteria in most influenza fatalities
Many different bacterial strains
Blood cultures, 1,887 subjects (table 2)
Positive results in 70.3% of cases, typically contained either pneumococci or streptococci
Conclusions
The majority of deaths in the 1918–1919 influenza pandemic likely resulted directly from secondary bacterial pneumonia…
caused by common upper respiratory–tract bacteria
Viral-bacterial copathogenesis
Prevention, diagnosis, prophylaxis, and treatment of secondary bacterial pneumonia
Stockpiling of antibiotics and bacterial vaccines
Less substantial data from subsequent pandemics
1957 H2N2 Asian flu, 86,000 excess US deaths
1968 H3N2 Hong Kong flu, 56,300 excess US deaths
The extraordinary severity of the 1918 pandemic remains un- explained
Guests & Subjects Covered
Predominant RoleBacterial PneumoniaPandemic Influenza ImplicationsInfectious Diseases VolumeResults UniformlyConclusions TheHN AsianHN Hong Kong
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