Influenza Pandemics and Tuberculosis Mortality in 1889 and 1918: Analysis of Historical Data from Switzerland

Abstract

BackgroundTuberculosis (TB) mortality declined in the northern hemisphere over the last 200 years, but peaked during the Russian (1889) and the Spanish (1918) influenza pandemics. We studied the impact of these two pandemics on TB mortality.MethodsWe retrieved historic data from mortality registers for the city of Bern and countrywide for Switzerland. We used Poisson regression models to quantify the excess pulmonary TB (PTB) mortality attributable to influenza.ResultsYearly PTB mortality rates increased during both influenza pandemics. Monthly influenza and PTB mortality rates peaked during winter and early spring. In Bern, for an increase of 100 influenza deaths (per 100,000 population) monthly PTB mortality rates increased by a factor of 1.5 (95%Cl 1.4–1.6, p<0.001) during the Russian, and 3.6 (95%Cl 0.7–18.0, p = 0.13) during the Spanish pandemic. Nationally, the factor was 2.0 (95%Cl 1.8–2.2, p<0.001) and 1.5 (95%Cl 1.1–1.9, p = 0.004), respectively. We did not observe any excess cancer or extrapulmonary TB mortality (as a negative control) during the influenza pandemics.ConclusionsWe demonstrate excess PTB mortality during historic influenza pandemics in Switzerland, which supports a role for influenza vaccination in PTB patients in high TB incidence countries.

Post tuberculosis treatment infectious complications

“…Mathematical modelling of epidemiological data suggests that there is an increase in frequency and severity of influenzaassociated disease during pandemics and seasonal epidemics in individuals with pulmonary TB compared to healthy individuals (Oei and Nishiura, 2012;Noymer, 2009;Zürcher et al, 2016). Influenza and TB co-infection can impair host immune responses leading to increased susceptibility to secondary bacterial infections (Ballinger and Standiford, 2010;Small et al, 2010).…”

The convergent epidemiology of tuberculosis and human cytomegalovirus infection

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Assessment of Mental Health Factors among Health Professionals Depending on Their Contact with COVID-19 Patients

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