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 (to Who) and to the UK- Swine flu. News of death from Streptococcal septicaemia of a girl is reported in the Times. Should we not look at the role bacteria might play? Given a choice would you rather have Tamiflu or a broacd spectrum antibiotic?
David M. Morens, Jeffery K. Taubenberger, and Anthony S. Fauci
National Institute of Allergy and Infectious Diseases, National Institutes of Health,
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.