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Cited by 37Influenza Virus Research StudiesPneumonia and Respiratory InfectionsRespiratory viral infections research

THE RELATION OF INFLUENZA VIRUS AND BACTERIA IN THE ETIOLOGY OF PNEUMONIA 12

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Maxwell, Elizabeth Starbuck, Ward, Thomas G., Van Metre, Thomas E.·1949·Journal of Clinical Investigation
DOI 10.1172/jci102073PMC PMC439604
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Abstract

Evidence is accumulating that influenza virus plays a role in the etiology of certain pneumonias generally considered to be primarily bacterial in origin.The earliest recorded observations (1, 2) describe influenza as a mild self-limited disease of the upper respiratory tract which progressed oc- casionally in certain individuals to produce more serious symptoms involving the pulmonary tissue.Soon after the discovery of bacteria, clinicians (3) pointed out that pneumonia caused by strepto- cocci, staphylococci and pneumococci often fol- lowed symptoms of influenza.During the pandemic of 1918 influenza was fre- quently complicated by bacterial pneumonia.Cer- tain investigators (4, 5) believed that the primary disease was of unknown virus etiology and that the pulmonary involvement was a manifestation of the secondary invasion of the respiratory tissues by pathogenic organisms.Epidemiological data (6-10) show a significant increase in pneumonia deaths accompanying and following epidemics of clinical influenza.Other similar data (11, 12) indicate that localized epi- demics of pneumococcus pneumonia have been as- sociated with outbreaks of clinical influenza.Laboratory evidence (13-22) on clinical cases of bacterial pneumonia in man and experiments on laboratory animals (23-28) during the past decade have further supported these observations.The studies reported herein show that there was a simultaneous infection with pneumococci and in- fluenza virus in about one-half of the human cases of lobar pneumonia studied during an influenza epidemic.Such mixed infections were also ob- served during interepidemic periods.

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  • Between 1890 and 1950, most observers believed fatal influenza was a polymicrobial infection in which an inciting agent of low pathogenicity acted synergistically with known pneumopathogenic bacteria.

    “Between 1890 and 1950, most observers believed fatal influenza to be a polymicrobial infection in which an inciting agent of low pathogenicity (either a bacterium such as Bacillus influenzae or a “filter passing agent”—most of which have now been identified as viruses) acted synergistically with known pneumopathogenic bacteria [13, 14, 20, 33, 64-66].”

    From Predominant Role of Bacterial Pneumonia as a Cause of Death in Pandemic Influenza: Implications for Pandemic Influenza Preparedness (2008) · cites this paper as [65]

    The opening section says that certain investigators viewed 1918 influenza as a primary viral illness followed by secondary bacterial pneumonia; the Discussion also describes mixed viral–bacterial infections. But the paper does not say that most observers held this view throughout 1890–1950, or establish a low-pathogenicity inciting agent as the historical consensus. Page numbers are unavailable in our copy. (LLM, conf=0.84)

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  • Maxwell first noted that bacterial pneumonia could occur during interepidemic periods when sporadic cases of influenza were investigated.

    “Maxwell first noted that bacterial pneumonia could occur during interepidemic periods when sporadic cases of influenza were investigated.”

    From Bacterial and viral infections associated with influenza (2013) · cites this paper as [46]

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Cites

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Research works printed but not linked: 25

  1. [1]1. Hirsch, August, Handbook of geographical and his- torical pathology. Vol. I. Tr. from 2nd German edition by C. Creighton, The New Sydenham Society, London, 1883.
  2. [5]5. MacCallum, W. G., A Textbook of Pathology. W. B. Saunders Co., Philadelphia, 1940, 7th Ed.
  3. [8]8. Gover, M., Influenza and pneumonia mortality in a group of 90 cities in the United States, August 1935-March 1943. Pub. Health Rep., 1943, 58, 1033.
  4. [10]10. Koller, S., Der jahrzeitliche Gang der Sterblichkeit an Krankheiten des Kreislaufs mit der Antmungs- organe. II. Der Verlauf in Jahren mit und ohne Grippeepidemic. Arch. f. Kreislaufforsch., 1941, 8, 296.
  5. [11]11. Commission on Acute Respiratory Diseases and the New York State Department of Health, Albany: The relation between epidemics of acute bacterial pneumonia and influenza. Science, 1945, 102, 561.
  6. [12]12. Smillie, G. H., Warnock, G. H., and White, H. J., A study of a Type I pneumococcus epidemic at the State Hospital at Worcester, Mass. Am. J. Pub. Health, 1938, 28, 293.
  7. [14]14. Stokes, J., Jr., and Wolman, I. J., The probable synergism of human influenza virus and Staphylo- coccus aureus in a rapidly fatal respiratory infec- tion. Internat. Clin., 1940, 1, 115.
  8. [16]16. Michael, M., Jr., Staphylococcus aureus pneumonia with special reference to its occurrence as a com- plication of influenza. J. A. M. A., 1942, 118, 869.
  9. [18]18. Finland, M., Barnes, M. W., and Samper, B. A., Influenza virus isolation and serological studies made in Boston during winter 1943-44. J. Clin. Invest., 1945, 24, 192.
  10. [20]20. Dudgeon, J. A., Stuart-Harris, C. H., Andrews, C. H., Glover, R. E., and Bradley, W. H., Influ- enza B in 1945-46. Lancet, 1946, 2, 627.
  11. [22]22. Finland, M., Ory, E. M., Meads, M., and Barnes, M. W., Influenza and pneumonia. Serological studies during and after an outbreak of influenza B. J. Lab. & Clin. Med., 1948, 33, 32.
  12. [24]24. Brightman, I. J., Streptococcus infection occurring in ferrets inoculated with human influenza virus. Yale J. Biol. & Med., 1935, 8, 127.
  13. [25]25. Glover, R. E., Spread of infection from the respira- tory tract of the ferret. II. Association of influ- enza A virus and Streptococcus group C. Brit. J. Exper. Path., 1941, 22, 98.
  14. [28]28. Schwab, J. L., Blubaugh, F. C., and Woolpert, 0. C., The response of mice to intranasal inoculation of mixtures of streptococcus hemolyticus and influ- enza virus. J. Bact., 1941, 41, 59.
  15. [29]29. Taylor, R. M., and Chialvo, R. J., Simplified tech- nique for inoculating into the amniotic sac of chick embryos. Proc. Soc. Exper. Biol. & Med., 1942, 51, 328.
  16. [30]30. Salk, J. E., A simplified procedure for titrating he- magglutination capacity of influenza virus and the corresponding antibody. J. Immunol., 1944, 49, 87.
  17. [34]34. Hirst, G. K., Plummer, N., and Friedewald, W. F., Human immunity following vaccination with for- malized influenza virus. Am. J. Hyg., 1945, 42,45.
  18. [40]40. Reed, L. J., and Muench, H., A simple method of estimating 50 percent endpoints. Am. J. Hyg., 1938, 27, 493.
  19. [41]41. Van Metre, T. E., Jr., Ward, T. G., and Maxwell, E. S., To be published. 42. Oppenheimer, E. H., Congenital chicken pox with disseminated visceral lesions. Bull. Johns Hop- kins Hosp., 1944, 74, 240.
  20. [42]42. Wolbach, S. B., Comments on the pathology and bacteriology of fatal influenza cases as observed at Camp Devens, Mass. Bull. Johns Hopkins Hosp., 1919, 30, 104.
  21. [44]44. Opie, E. L., Blake, F. G., Small, J. C., and Rivers, T. M., Epidemic Respiratory Diseases. The Pneu- monias and Other Infections of the Respiratory Tract Accompanying Influenza and Measles. C. V. Mosby Co., St. Louis, 1921.
  22. [45]45. Winternitz, M. G., Wason, I. M., and McNamara, F. P., The Pathology of Influenza. Yale Uni- versity Press, New Haven, 1920.
  23. [48]48. Reimann, H. A., The viral pneumonias and pneu- monia of probable viral origin. Medicine, 1947, 26, 167.
  24. [51]51. Taylor, R. M., Experimental infection with influenza A virus in mice-the increase in intrapulmonary virus after inoculation and the influence of various factors thereon. J. Exper. Med., 1941, 73, 43.
  25. [53]53. Stuart-Harris, C. H., Glover, R. E., and Mills, H. C., Influenza in Britain, 194243. Lancet, 1943, 2, 790.

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Authors
Maxwell, E. S., Ward, T. G., & Van Metre, T. E.
Affiliations
Johns Hopkins University (US)
Venue
Journal of Clinical Investigation
Publisher
American Society for Clinical Investigation
Published
1949-03-01
Volume
28
Issue
2
Pages
307-318
ISSN
0021-9738 (ISSN-L)
DOI
10.1172/jci102073
PMC
PMC439604
OpenAlex
W2059609782
Cited by
37
References
32
Citations by year
2020: 1 · 2014: 2 · 2013: 1 · 2012: 1
FWCI
12.77
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Investigation (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 virus, bacterial pneumonia, pneumococcal pneumonia, Streptococcus pneumoniae, co-infection, lobar pneumonia, influenza epidemic, pneumonia etiology, 1918 influenza pandemic, secondary bacterial infection
MeSH terms
Bacteria, Humans, Influenza, Human, Orthomyxoviridae, Pneumonia

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