kent nickell
Well-known member
Just to re-emphasize the importance of also aggresively looking for bacterial co-infections esp Staphylococcus and esp MRSA this is from a 1958 British Medical Journal article reviewing the pathology of the 1957 pandemic
""But the much commoner combination of influenza virus plus staphylococcal pneumonia is worth keeping in mind, because therapy may be successful in such cases.""
They also noted toxic effects on the liver and brain.
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2026057&blobtype=pdf
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Other info on the 1957 pandemic
http://www.cdc.gov/ncidod/EID/vol12no01/05-1254.htm
With the arrival of Asian influenza in 1957, the sheer number of cases associated with pandemicity again brought the phenomenon of primary influenza virus pneumonia to the attention of physicians in teaching hospitals. In contrast to the observations in 1918, underlying chronic disease of the heart or lungs was found in most of these patients, although deaths of previously healthy persons were not uncommon. In the case of carefully studied patients at the New York Hospital, rheumatic heart disease was the most common antecedent factor, and women in the third trimester of pregnancy were among those vulnerable (11).
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and MRSA co-infections
http://pediatrics.aappublications.org/cgi/content/abstract/122/4/805
Published online October 1, 2008
PEDIATRICS Vol. 122 No. 4 October 2008, pp. 805-811 (doi:10.1542/10.1542/peds.2008-1336)
________________________________
ARTICLE
Influenza-Associated Pediatric Mortality in the United States: Increase of Staphylococcus aureus Coinfection
Lyn Finelli, DrPHa, Anthony Fiore, MDa, Rosaline Dhara, MPHa, Lynnette Brammer, MPHa, David K. Shay, MDa, Laurie Kamimoto, MDa, Alicia Fry, MDa, Jeffrey Hageman, MPHb, Rachel Gorwitz, MDb, Joseph Bresee, MDa and Timothy Uyeki, MDa
a Influenza Division, National Center for Immunization and Respiratory Diseases
b Division of Healthcare Quality Promotion, National Center for Preparedness, Detection, and Control of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
OBJECTIVE. Pediatric influenza-associated death became a nationally notifiable condition in the United States during 2004. We describe influenza-associated pediatric mortality from 2004 to 2007, including an increase of Staphylococcus aureus coinfections.
METHODS. Influenza-associated pediatric death is defined as a death of a child who is younger than 18 years and has laboratory-confirmed influenza. State and local health departments report to the Centers for Disease Control and Prevention demographic, clinical, and laboratory data on influenza-associated pediatric deaths.
RESULTS. During the 2004?2007 influenza seasons, 166 influenza-associated pediatric deaths were reported (n = 47, 46, and 73, respectively). Median age of the children was 5 years. Children often progressed rapidly to death; 45% died within 72 hours of onset, including 43% who died at home or in an emergency department. Of 90 children who were recommended for influenza vaccination, only 5 (6%) were fully vaccinated. Reports of bacterial coinfection increased substantially from 2004?2005 to 2006?2007 (6%, 15%, and 34%, respectively). S aureus was isolated from a sterile site or endotracheal tube culture in 1 case in 2004?2005, 3 cases in 2005?2006, and 22 cases in 2006?2007; 64% were methicillin-resistant S aureus. Children with S aureus coinfection were significantly older and more likely to have pneumonia and acute respiratory distress syndrome than those who were not coinfected.
CONCLUSIONS. Influenza-associated pediatric mortality is rare, but the proportion of S aureus coinfection identified increased fivefold over the past 3 seasons. Research is needed to identify risk factors for influenza coinfection with invasive bacteria and to determine the impact of influenza vaccination and antiviral agents in preventing pediatric mortality.
""But the much commoner combination of influenza virus plus staphylococcal pneumonia is worth keeping in mind, because therapy may be successful in such cases.""
They also noted toxic effects on the liver and brain.
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2026057&blobtype=pdf
---------
Other info on the 1957 pandemic
http://www.cdc.gov/ncidod/EID/vol12no01/05-1254.htm
With the arrival of Asian influenza in 1957, the sheer number of cases associated with pandemicity again brought the phenomenon of primary influenza virus pneumonia to the attention of physicians in teaching hospitals. In contrast to the observations in 1918, underlying chronic disease of the heart or lungs was found in most of these patients, although deaths of previously healthy persons were not uncommon. In the case of carefully studied patients at the New York Hospital, rheumatic heart disease was the most common antecedent factor, and women in the third trimester of pregnancy were among those vulnerable (11).
--------
and MRSA co-infections
http://pediatrics.aappublications.org/cgi/content/abstract/122/4/805
Published online October 1, 2008
PEDIATRICS Vol. 122 No. 4 October 2008, pp. 805-811 (doi:10.1542/10.1542/peds.2008-1336)
________________________________
ARTICLE
Influenza-Associated Pediatric Mortality in the United States: Increase of Staphylococcus aureus Coinfection
Lyn Finelli, DrPHa, Anthony Fiore, MDa, Rosaline Dhara, MPHa, Lynnette Brammer, MPHa, David K. Shay, MDa, Laurie Kamimoto, MDa, Alicia Fry, MDa, Jeffrey Hageman, MPHb, Rachel Gorwitz, MDb, Joseph Bresee, MDa and Timothy Uyeki, MDa
a Influenza Division, National Center for Immunization and Respiratory Diseases
b Division of Healthcare Quality Promotion, National Center for Preparedness, Detection, and Control of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
OBJECTIVE. Pediatric influenza-associated death became a nationally notifiable condition in the United States during 2004. We describe influenza-associated pediatric mortality from 2004 to 2007, including an increase of Staphylococcus aureus coinfections.
METHODS. Influenza-associated pediatric death is defined as a death of a child who is younger than 18 years and has laboratory-confirmed influenza. State and local health departments report to the Centers for Disease Control and Prevention demographic, clinical, and laboratory data on influenza-associated pediatric deaths.
RESULTS. During the 2004?2007 influenza seasons, 166 influenza-associated pediatric deaths were reported (n = 47, 46, and 73, respectively). Median age of the children was 5 years. Children often progressed rapidly to death; 45% died within 72 hours of onset, including 43% who died at home or in an emergency department. Of 90 children who were recommended for influenza vaccination, only 5 (6%) were fully vaccinated. Reports of bacterial coinfection increased substantially from 2004?2005 to 2006?2007 (6%, 15%, and 34%, respectively). S aureus was isolated from a sterile site or endotracheal tube culture in 1 case in 2004?2005, 3 cases in 2005?2006, and 22 cases in 2006?2007; 64% were methicillin-resistant S aureus. Children with S aureus coinfection were significantly older and more likely to have pneumonia and acute respiratory distress syndrome than those who were not coinfected.
CONCLUSIONS. Influenza-associated pediatric mortality is rare, but the proportion of S aureus coinfection identified increased fivefold over the past 3 seasons. Research is needed to identify risk factors for influenza coinfection with invasive bacteria and to determine the impact of influenza vaccination and antiviral agents in preventing pediatric mortality.