Hong Kong Influenza

Lindsay, Malcolm I.; Herrmann, Ernest C.; Morrow, George W.; Brown, Arnold L.

doi:10.1001/jama.1970.03180100019004

Cited by 86 publications

(5 citation statements)

References 10 publications

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“…Of 129 adults diagnosed with pandemic influenza, pneumonia was established in 16%, of which 40% of these cases (6% of all 129 influenza cases) were fatal. S. aureus or P. aeruginosa bacterial infection was present in 75% of all fatal cases, indicating bacterial co/secondary infection was a major determinant of severe disease and death (Lindsay et al, 1970). …”

Section: Historical Evidence Of Co/secondary Bacterial Infection Durimentioning

confidence: 99%

Secondary Bacterial Infections Associated with Influenza Pandemics

2017

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Lower and upper respiratory infections are the fourth highest cause of global mortality (Lozano et al., 2012). Epidemic and pandemic outbreaks of respiratory infection are a major medical concern, often causing considerable disease and a high death toll, typically over a relatively short period of time. Influenza is a major cause of epidemic and pandemic infection. Bacterial co/secondary infection further increases morbidity and mortality of influenza infection, with Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus reported as the most common causes. With increased antibiotic resistance and vaccine evasion it is important to monitor the epidemiology of pathogens in circulation to inform clinical treatment and development, particularly in the setting of an influenza epidemic/pandemic.

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Section: Historical Evidence Of Co/secondary Bacterial Infection Durimentioning

confidence: 99%

Secondary Bacterial Infections Associated with Influenza Pandemics

2017

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“…Histological examinations and autopsy reports of the 1918 influenza pandemic victims shows evidence of bacterial invasion in more than 90% of cases 26 , and, taken together with the accounts of bacterial pneumonia cases in army camps across the USA during the 1918 pandemic 27 , suggest high rates of bacterial co-infection in influenza patients, indicating an extremely strong interaction. Similarly, hospital admissions during the 1957 Asian 28 29 , the 1968 Hong Kong 30 31 , and the 2009 32 influenza pandemics also indicate a moderate to strong association. In contrast, studies that have tested for an association during non-pandemic periods have concluded the interaction is modest or non-existent 33 34 35 .…”

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confidence: 94%

The role of influenza in the epidemiology of pneumonia

Shrestha

Foxman

Berus

et al. 2015

Sci Rep

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Interactions arising from sequential viral and bacterial infections play important roles in the epidemiological outcome of many respiratory pathogens. Influenza virus has been implicated in the pathogenesis of several respiratory bacterial pathogens commonly associated with pneumonia. Though clinical evidence supporting this interaction is unambiguous, its population-level effects—magnitude, epidemiological impact and variation during pandemic and seasonal outbreaks—remain unclear. To address these unknowns, we used longitudinal influenza and pneumonia incidence data, at different spatial resolutions and across different epidemiological periods, to infer the nature, timing and the intensity of influenza-pneumonia interaction. We used a mechanistic transmission model within a likelihood-based inference framework to carry out formal hypothesis testing. Irrespective of the source of data examined, we found that influenza infection increases the risk of pneumonia by ~100-fold. We found no support for enhanced transmission or severity impact of the interaction. For model-validation, we challenged our fitted model to make out-of-sample pneumonia predictions during pandemic and non-pandemic periods. The consistency in our inference tests carried out on several distinct datasets, and the predictive skill of our model increase confidence in our overall conclusion that influenza infection substantially enhances the risk of pneumonia, though only for a short period.

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“…In fact, the majority of deaths during the 1918 H1N1 [1], 1957 H2N2 [2,3], and 1968 H3N2 [4] pandemics are believed to be due to a secondary bacterial pneumonia. During interpandemic influenza, secondary bacterial infections may account for ~25% of influenza-associated hospitalizations [5,6].…”

Section: Introductionmentioning

confidence: 99%

Potential role for alternatively activated macrophages in the secondary bacterial infection during recovery from influenza

et al. 2012

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Purpose Secondary bacterial infections are a common complication of influenza. Innate immune host defenses appear to be impaired following influenza, leading to susceptibility to subsequent bacterial infections. Alternatively activated macrophages (AAM) in the lungs may play a critical role in eliciting the hypersusceptibility to secondary bacterial pneumonia. Methods C57BL6 mice were challenged with sublethal doses of the mouse-adapted A/PR/8/34 (PR8) influenza virus or saline and allowed to recover. At complete recovery (day 14), mice were re-challenged with sublethal doses of Streptococcus pneumoniae serotype 3 (Sp3). Results PR8-recovered mice developed a rapidly fatal pulmonary infection to a 100-fold sublethal pneumococcal challenge, whereas PR8-naive mice demonstrated no mortality or illness. The cytokines which induce AAM (IL-4 and IL-13) and the expression of genes associated with AAM (Arginase-1, FIZZ1, and YM1) were elevated after PR8 infection. Flow cytometry suggests that alveolar macrophages demonstrate the AAM-phenotype, as indicated by MGL-1 and MHCII expression, in response to PR8 infection. Recovery from PR8 was associated with blunted cytokine responses to TLR ligands. Conclusions The mechanisms of immune regulation during recovery from influenza are being elucidated. We provide evidence that pulmonary AAM are induced during influenza infection and may contribute to the elicitation of hypersusceptibility to a secondary bacterial infection.

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Hong Kong Influenza

Cited by 86 publications

References 10 publications

Secondary Bacterial Infections Associated with Influenza Pandemics

Secondary Bacterial Infections Associated with Influenza Pandemics

The role of influenza in the epidemiology of pneumonia

Potential role for alternatively activated macrophages in the secondary bacterial infection during recovery from influenza

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