Complications of Viral Influenza
Open accessAbstract
Viral influenza is a seasonal infection associated with significant morbidity and mortality. In the United States more than 35,000 deaths and 200,000 hospitalizations due to influenza occur annually, and the number is increasing. Children aged less than 1 year and adults aged more than 65 years, pregnant woman, and people of any age with comorbid illnesses are at highest risk. Annual vaccination is the cornerstone of prevention, but some older patients may derive less benefit from immunization than otherwise fit individuals. If started promptly, antiviral medications may reduce complications of acute influenza, but increasing resistance to amantadine and perhaps neuraminidase inhibitors underscores the need for novel prevention and treatment strategies. Pulmonary complications of influenza are most common and include primary influenza and secondary bacterial infection. Either may cause pneumonia, and each has a unique clinical presentation and pathologic basis. Staphylococcus aureus, including methicillin-resistant strains, is an important cause of secondary bacterial pneumonia with high mortality. During influenza season, treatment of pneumonia should include empiric coverage for this pathogen. Neuromuscular and cardiac complications are unusual but may manifest in persons of any age.
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The spread of methicillin-resistant Staphylococcus aureus and highly pathogenic Streptococcus pyogenes clones poses broader risks.
“The spread of bacteria such as methicillin-resistant Staphylococcus aureus and highly pathogenic clones of Streptococcus pyogenes pose more general risks [86].”
From Predominant Role of Bacterial Pneumonia as a Cause of Death in Pandemic Influenza: Implications for Pandemic Influenza Preparedness (2008) · cites this paper as [86]
The Secondary Bacterial Pneumonia section reports severe influenza-associated pneumonia due to methicillin-resistant Staphylococcus aureus, supporting a risk from that bacterium. It does not describe its spread, or the spread of highly pathogenic Streptococcus pyogenes clones; the Pulmonary Complications with Unusual Pathogens section mentions only β-hemolytic streptococci as a cause of secondary pneumonia. Page numbers were not available in our copy. (LLM, conf=0.84)
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- Authors
- Rothberg, M. B., Haessler, S. D., & Brown, R. B.
- Affiliations
- Tufts University (US)
- Corresponding author
- Rothberg, Michael B.
- Venue
- The American Journal of Medicine
- Publisher
- Elsevier BV
- Published
- 2008-04
- Volume
- 121
- Issue
- 4
- Pages
- 258-264
- ISSN
- 0002-9343 (ISSN-L)
- PMC
- PMC7172971
- OpenAlex
- W2039118188
- Cited by
- 456
- References
- 97
- Citations by year
- 2026: 10 · 2025: 22 · 2024: 22 · 2023: 22 · 2022: 22 · 2021: 41 · 2020: 31 · 2019: 21 · 2018: 16 · 2017: 37 · 2016: 24 · 2015: 18 · 2014: 29 · 2013: 24 · 2012: 27
- FWCI
- 3.14
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The American Journal of Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Keywords
- influenza complications, influenza-associated pneumonia, secondary bacterial pneumonia, Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, influenza vaccination, antiviral resistance, amantadine, neuraminidase inhibitors, influenza mortality, influenza hospitalization, neuromuscular complications, cardiac complications
- MeSH terms
- Aged, Female, Follow-Up Studies, Humans, Infant, Influenza, Human, Influenza Vaccines, Male, Orthomyxoviridae, Pneumonia, Viral, Pregnancy, Severity of Illness Index, United States, Vaccination, Superinfection, Survival Analysis, Age Distribution, Sex Distribution, Risk Assessment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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