Learning from History: Swine Flu & Antibiotics

With so much emphasis now on not using antibiotics it may be time to look at the evidence in the current pandemic of Influenza A H1N1 (WHO) or Swine flu (U.K.). News of death from Streptococcal septicaemia of a girl is reported in the Times. Bacteria are very crafty indeed and they wait for the right moment to strike. (See Quorum Sensing )

Predominant Role of Bacterial Pneumonia as a Cause of Death in Pandemic Influenza: Implications for Pandemic Influenza Preparedness

1 Oct., 2008 David M. Morens, Jeffery K. Taubenberger, and Anthony S. Fauci

National Institute of Allergy and Infectious Diseases, N

ational Institutes of Health, Bethesda, Maryland

Background. Despite the availability of published data on 4 pandemics that have occurred over the past 120 years, there is little modern information on the causes of death associated with influenza pandemics.

Methods. We examined relevant inform

ation from the most recent influenza pandemic that occurred during the era prior to the use of antibiotics, the 1918–1919 “Spanish flu” pandemic. We examined lung tissue sections obtained during 58 autopsies and reviewed pathologic and bacteriologic data from 109 published autopsy series that described 8398 individual autopsy investigations.

Results. The postmortem samples we examined from people who died of influenza during 1918–1919 uniformly exhibited severe changes indicative of bacterial pneumonia. Bacteriologic and histopathologic results from published autopsy series clearly and consistently implicated secondary bacterial pneumonia caused by common upper respiratory– tract bacteria in most influenza fatalities.

In an article in PBS:

"Conventional wisdom tod

ay is that everyone who died then died of viral infection, but that's just not true -- and that was known back then," said Morens.

“The research suggests that public health officials planning for the next flu outbreak should consider both viral and bacterial infections. The 1918 flu outbreak occurred before modern antibiotics. It's unclear whether modern antibiotics would have been able to mitigate it, Morens said, because even modern antibiotics would have had to have been used very quickly to be effective against such severe bacterial pneumonia.”

Also: NIH Review, NPR, PBS

News: Times. Swine flu misery.Nightmares

Learning from SARS : Dr Yannie Soo, Tom Buckley.

Useful link: Hong Kong Chinese University Recommendations. CDC CNN

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