Pathologic Anatomy and Bacteriology of Influenza

Lucké, Balduin; Wight, Toynbee; Kime, Edwin

doi:10.1001/archinte.1919.00090250027002

Cited by 51 publications

(33 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…By examining influenza autopsy materials from a range of patients in different stages of disease, pathologists in 1918–1919 identified the primary lesion in early severe influenza-associated pneumonia as desquamative tracheobronchitis and bronchiolitis extending diffusely over all or much of the pulmonary tree to the alveolar ducts and alveoli, associated with sloughing of bronchiolar epithelial cells to the basal layer, hyaline membrane formation in alveolar ducts and alveoli, and ductal dilation [20, 24, 27, 29-33]. …”

Section: Resultsmentioning

confidence: 99%

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

2008

View full text Add to dashboard Cite

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 information 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. Conclusions The majority of deaths in the 1918–1919 influenza pandemic likely resulted directly from secondary bacterial pneumonia caused by common upper respiratory–tract bacteria. Less substantial data from the subsequent 1957 and 1968 pandemics are consistent with these findings. If severe pandemic influenza is largely a problem of viral-bacterial copathogenesis, pandemic planning needs to go beyond addressing the viral cause alone (e.g., influenza vaccines and antiviral drugs). Prevention, diagnosis, prophylaxis, and treatment of secondary bacterial pneumonia, as well as stockpiling of antibiotics and bacterial vaccines, should also be high priorities for pandemic planning.

show abstract

Section: Resultsmentioning

confidence: 99%

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

2008

View full text Add to dashboard Cite

show abstract

“…Secondary or coincident bacterial pneumonias frequently occur and complicate the pathologic picture. In such cases, a massive infiltration of neutrophils into alveolar air spaces is observed, and alveolar hemorrhage and edema are less pronounced than in primary influenza virus pneumonia (73). An example of the massive neutrophil infiltration in acute bacterial bronchopneumonia is shown in Figure 3.…”

Section: Influenza Virus Pneumoniamentioning

confidence: 98%

“…Air spaces may be filled with edema, fibrin, and varying numbers of neutrophils (19). Lucke et al (73) reported desquamative bronchiolitis, often accompanied by ulceration. They noted submucosal capillary congestion and thrombi and found that the bronchiolar wall was sometimes entirely necrotic and associated with a polymorphonuclear cell infiltrate.…”

Section: Tracheobronchial Changes In Influenzamentioning

confidence: 99%

See 1 more Smart Citation

The Pathology of Influenza Virus Infections

Taubenberger

Morens

2008

Annu. Rev. Pathol. Mech. Dis.

944

709

View full text Add to dashboard Cite

Influenza viruses are significant human respiratory pathogens that cause both seasonal, endemic infections and periodic, unpredictable pandemics. The worst pandemic on record, in 1918, killed approximately 50 million people worldwide. Human infections caused by H5N1 highly pathogenic avian influenza viruses have raised concern about the emergence of another pandemic. The histopathology of fatal influenza virus pneumonias as documented over the past 120 years is reviewed here. Strikingly, the spectrum of pathologic changes described in the 1918 influenza pandemic is not significantly different from the histopathology observed in other less lethal pandemics or even in deaths occurring during seasonal influenza outbreaks.

show abstract

“…They found that " in every case the convoluted tubules were more affected than the straight tubules," and here their observations differ from the findings in the present series of cases. Nuzum, Pilot, Stangl, and Bonar (1918), Blanton andIrons (1918), Symmers (1918), Dever, Boles, and Case (1919), Plenge (1952), and Fischer (1957), though dealing in much less detail with renal lesions in influenza than did Lucke et al (1919), agreed with the latter authors as to their nature and distribution.…”

Section: Discussionmentioning

confidence: 51%