It is commonly believed that the clinical and epidemiological characteristics of the next influenza pandemic will mimic those of the 1918 pandemic. Determinate beliefs regarding the 1918 pandemic include: that infections were expressed as primary viral pneumonias and/or acute respiratory distress syndromes; that pandemic-related deaths were the end states of the natural progression of disease caused by the pandemic strain; that bacterial superinfections caused relatively fewer deaths in 1918 than in subsequent pandemics. In turn, response plans are focused on developing and/or increasing inventories of a strain-specific vaccine, antivirals, intensive care beds, mechanical ventilators, and so on. Yet, there is strong and consistent evidence of epidemiologically and clinically important interactions between influenza and secondary bacterial respiratory pathogens (also during the 1918 pandemic). The majority of deaths in the 1918-1919 influenza pandemic likely resulted directly from secondary bacterial pneumonia caused by common upper respiratory tract bacteria. If severe pandemic influenza is largely a problem of viral-bacterial copathogenesis, pandemic planning needs to go beyond addressing the viral cause alone (e.g., influenza vaccines and antiviral drugs). Prevention, diagnosis, prophylaxis, and treatment of secondary bacterial pneumonia, as well as stockpiling of antibiotics and bacterial vaccines, should also be considerated as high priorities for pandemic planning.
|Translated title of the contribution||Influenza: Bacterial complications|
|Journal||GIMT - Giornale Italiano delle Malattie del Torace|
|Publication status||Published - 2009|
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine