Pandemic "Influenza" and Secondary Pneumonia at Camp Fremont, Calif.

Abstract

Laboratory Diagnosis.-Blood culture was taken, October 10. The same procedure was followed as in the previous case, with practically identical results except that the mouse had not died up to the date of my departure. COMMENT These two blood cultures were not taken with any hope of finding the influenza bacillus, but were secured from severely ill patients with the probability of finding the more ordinary bacteria usually associated with respiratory infections. Reasoning on that basis, the logical assumption would be that it is possible to isolate the influenza bacillus from the blood in a sufficient number of clinically influenza cases to prove undoubtedly the etiology of the prevailing epidemic of so-called "Spanish influenza."Owing to my transfer from Camp Jackson,-1 am unable to undertake this, but the foregoing short and incomplete report may be interesting to others.On approximately 100 throat cultures taken for meningitis, the number of plates showing the presence (macroscopically) of influenza colonies has been striking, especially to me after having examined thousands of plates last winter, when its presence did not seem common.

Pneumonia Complicating Asian Influenza

“…Cardiovascular Complications Acute myocarditis may have been the precipitating cause of death in a few cases of fulminating influenza, probably resulting more from the general toxaemia than from any specific effect of the virus upon the myocardium. Giles and Shuttleworth (1957) (Guthrie, Forsyth, and Montgomery, 1957;Lim, Smith, Hale, and Glass, 1957;Rowland, 1958 (Brem, Boiling and Casper, 1918 ;Opie, Freeman, Blake, Small, and Rivers, 1919;Chickering and Park, 1919;French, 1920), with no improvement in later epidemics (Collins, 1931 ;Scadding, 1937 …”

“…Death rates from pneumonic influenza before antibiotics were discovered were 27.5-40% in the pandemic of 1918-19 (Brem, Boiling and Casper, 1918 ;Opie, Freeman, Blake, Small, and Rivers, 1919;Chickering and Park, 1919;French, 1920), with no improvement in later epidemics (Collins, 1931 ;Scadding, 1937). Direct comparisons between Asian influenza and pre-antibiotic epidemics are naturally hazardous, owing to differences in virulence of the viruses concerned and of associated bacteria, and the variable times of onset and duration; but if they are limited to cases with pneumonia, these difficulties are to some extent overcome.…”

Проблема Бактериальных Осложнений При Респираторных Вирусных Инфекциях

“…Следует отметить, что во время «испан-ки», в начале XX века, этиологический агент заболе-вания еще не был известен: вирус гриппа открыли только в 1933 году. Микробиологи того времени пы-тались связать испанский грипп с различными бак-териальными агентами и, в частности, с Haemophilus influenzae (H. influenzae) [5]. В настоящее время, благо-даря технологии ПЦР, оказалось возможным иденти-фицировать гены вируса гриппа в патологоанатоми-ческих и гистологических препаратах того времени и реконструировать вирус гриппа 1918 года подтипа H1N1 с помощью методов обратной генетики.…”

“…При доминировании S. pneumoniae в образцах легких идентифицированы также Staphylococcus aureus (S. aureus), H. influenzae и другие представители Streptococcus spp. [5,7]. Таким образом, катастрофические последствия пандемии 1918 г. могли определяться отсутствием вакцины и специфических препаратов против вируса гриппа, а также антибиотиков, способных подавить вторич-ные бактериальные осложнения.…”

Insights from unusual aspects of the 1918 influenza pandemic

“…The 1918 influenza virus was extra-ordinarily destructive to the respiratory epithelium throughout with cellular necrosis being commonly observed microscopically [6,23]. Although some additional bleeding phenomenon were reported such as menometrorrhagia in women, other bleeding diatheses were only rarely seen [28]. It is most likely that both the increased bacterial pneumonia rate and epistaxis are explained by the 1918 virus having an increased pathogenic effect specifically in the destruction of the respiratory epithelium [6,23].…”