Deaths from bacterial pneumonia during 1918-19 influenza pandemic.

Deaths from bacterial pneumonia during 1918-19 influenza pandemic.
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DOI:
10.3201/eid1408.071313
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发表时间:
2008-08
影响因子:
11.8
通讯作者:
Shanks GD
Shanks GD
中科院分区:
医学2区
文献类型:
--
作者:
Brundage JF;Shanks GD

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一个连续感染的假设是符合本次大流行的特点。1918-19年流感大流行期间的死亡归因于高毒力流感毒株。因此,下一次大流行的准备工作几乎完全集中在疫苗预防和针对新型流感病毒株感染的抗病毒治疗上。然而,我们假设大流行菌株的感染通常会引起自限性(很少致命)疾病,使细菌的定殖菌株能够产生高致命性肺炎。这种连续感染假说与1918- 1919年流感大流行的特征、当时的专家意见以及目前关于流感病毒的病理生理学效应及其与呼吸道细菌相互作用的知识一致。这一假设表明在下一次大流行期间预防和治疗的机会(例如,使用细菌疫苗和抗菌药物),特别是如果隔离、拥挤或医疗服务不足的人群无法获得或无法获得大流行毒株特异性疫苗。
A sequential-infection hypothesis is consistent with characteristics of this pandemic. Deaths during the 1918–19 influenza pandemic have been attributed to a hypervirulent influenza strain. Hence, preparations for the next pandemic focus almost exclusively on vaccine prevention and antiviral treatment for infections with a novel influenza strain. However, we hypothesize that infections with the pandemic strain generally caused self-limited (rarely fatal) illnesses that enabled colonizing strains of bacteria to produce highly lethal pneumonias. This sequential-infection hypothesis is consistent with characteristics of the 1918–19 pandemic, contemporaneous expert opinion, and current knowledge regarding the pathophysiologic effects of influenza viruses and their interactions with respiratory bacteria. This hypothesis suggests opportunities for prevention and treatment during the next pandemic (e.g., with bacterial vaccines and antimicrobial drugs), particularly if a pandemic strain–specific vaccine is unavailable or inaccessible to isolated, crowded, or medically underserved populations.
DOI: 10.1016/s1473-3099(06)70466-2
发表时间: 2006-05
期刊: The Lancet. Infectious diseases
影响因子: --
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1918年大流行性流感的传播性。
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