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CORRESPONDENCE
Bacterial Pathogens and Death during the 1918 Influenza Pandemic
N Engl J Med 2009; 361:2582-2583December 24, 2009DOI: 10.1056/NEJMc0908216
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The insensitivity of blood culture for identifying pneumococcal pneumonia (with detection in only approximately 3% and 20% of cultures from children and adults, respectively) as compared with the high percentage of positive lung cultures3 suggests that bacterial infections, especially pneumococcal infections, were a major cause of influenza-associated pneumonia and death among both military personnel and civilians in 1918?1919. The distribution of pneumococcal serotypes shifted toward less invasive serotypes during that period as compared with the pre-1918 period, suggesting that the 1918 influenza virus increased host susceptibility to less-invasive pneumococci.2
Bacterial Pathogens and Death during the 1918 Influenza Pandemic
N Engl J Med 2009; 361:2582-2583December 24, 2009DOI: 10.1056/NEJMc0908216
snip
The insensitivity of blood culture for identifying pneumococcal pneumonia (with detection in only approximately 3% and 20% of cultures from children and adults, respectively) as compared with the high percentage of positive lung cultures3 suggests that bacterial infections, especially pneumococcal infections, were a major cause of influenza-associated pneumonia and death among both military personnel and civilians in 1918?1919. The distribution of pneumococcal serotypes shifted toward less invasive serotypes during that period as compared with the pre-1918 period, suggesting that the 1918 influenza virus increased host susceptibility to less-invasive pneumococci.2
