Deaths from Bacterial Pneumonia during 1918–19 Influenza Pandemic
2008

Deaths from Bacterial Pneumonia during the 1918–19 Influenza Pandemic

publication Evidence: high

Author Information

Author(s): Brundage John F., Shanks G. Dennis

Primary Institution: Armed Forces Health Surveillance Center

Hypothesis

A sequential-infection hypothesis is consistent with characteristics of this pandemic.

Conclusion

Most deaths during the 1918–19 influenza pandemic were caused by secondary bacterial pneumonias rather than the influenza virus itself.

Supporting Evidence

  • Most deaths during the pandemic were attributed to secondary bacterial pneumonias.
  • Contemporaneous reports indicated that the influenza virus did not directly cause most deaths.
  • Mortality rates were higher for young adults and certain closed populations.
  • Common respiratory bacteria were often recovered from pneumonia patients during the pandemic.
  • Nonpharmaceutical interventions were associated with lower mortality rates.

Takeaway

During the 1918 flu pandemic, many people got sick, but it was often bacteria that made them die, not just the flu virus.

Digital Object Identifier (DOI)

10.3201/eid1408.071313

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