- A Press Release issued on August 19, 2008,
by the National Institute of Allergy and Infectious Diseases (NIAID), contains
a striking finding and conclusion: The 20 to 40 million deaths
worldwide from the great 1918 Influenza
("Flu") Pandemic were NOT due to a virus,
but to pneumonia caused by massive bacterial infection of the lungs
weakened by the flu virus (The full NIAID report is attached
at the end of this report).
- The research of Lawrence Broxmeyer first
proclaimed that the 1918 pandemic was due to bacteria, particularly
mutant forms of fowl, bovine and human tuberculosis (TB)
bacteria. In 2006, in a Medline paper published
in Elsevier's Medical Hypothesis, he wrote: "Influenza
is Italian for "influence", Latin: influentia. It used to be
thought that the disease was caused by a bad influence from the heavens.
Influenza was called a virus long, long before it was proven to be one." Elsevier
is a major medical publisher which also publishes The Lancet.
- In 2005, an article in the New England Journal of Medicine
estimated that a recurrence of the 1918 influenza epidemic could kill between
180 million and 360 million people worldwide. A large part of the recent bird-flu
hysteria is fostered by a distrust among the lay and scientific community
regarding the actual state of our knowledge regarding the bird flu or H5N1
and the killer "Influenza" Pandemic of 1918 that it is compared
to. And this distrust is not completely unfounded. Traditionally, "flu"
does not kill. Experts, including Peter Palese of the Mount School of Medicine
in Manhattan, remind us that even in 1992, millions in China already had
antibodies to H5N1, meaning that they had contracted it and that their
immune system had little trouble fending it off.
- In 2000 Dr. Andrew Noymer and Michel Garenne, UC Berkeley
demographers, reported convincing statistics showing that undetected tuberculosis
may have been the real killer in the 1918 flu epidemic. Aware of recent
attempts to isolate the "Influenza virus" on human cadavers and
their specimens, Noymer and Garenne concluded that: "Frustratingly,
these findings have not answered the question why the 1918 virus was so
virulent, nor do they offer an explanation for the unusual age profile
of deaths". Bird flu would certainly be diagnosed in the hospital
today as Acute Respiratory Distress Syndrome (ARDS). Roger and others favor
suspecting tuberculosis in all cases of acute respiratory failure of unknown
origin. And the same techniques used by Burnett in isolating
Infulenza from the allointoic sac of chicken embryo's is also an ideal culture
medium for TB and the mycobacteria.
- By 1918, it could be said, in so far as tuberculosis
was concerned, that the world was a supersaturated sponge ready to ignite
and that among its most vulnerable parts was the very Midwest where the
1918 unknown pandemic began. It is theorized that the lethal pig epidemic
that began in Kansas just prior to the first human outbreaks was a disease
of avian and human tuberculosis genetically combined through mycobacteriophage
interchange, with the pig susceptible to both, as its involuntary
living culture medium. What are the implications of mistaking a virus such
as Influenza A for a disease caused by TB-like bacteria? They would be
disastrous, with useless treatment and preventative stockpiles. The obvious
need for further investigation is presently imminent and pressing.
- In commenting on the new NIAID report, Broxmeyer writes that euphemisms like
"pneumonia", "bronchitis" , "chest ailment",
"the flu" etc. have been with us since time immemorial
to describe tubercular involvement. This was noted in 1944 in pathologist
Arnold Rich's classic test, "The Pathogenesis of Tuberculosis." It
is also well known that bacterial secondary infection in TB
cases is common.
- Pioneer TB physician Sir John Crofton (1912- )
was convinced that bacteria (not viruses) in the form of Haemophillus
Influenza were at the root of the great the Pandemic of 1918.
He claimed it was bacteria (not viruses), which started the epidemic of
1918. Haemophillus Influenza itself is but a small bacillus,
and was discovered by Richard Pfieffer in Koch's laboratory
(the doctor who discovered the mycobacterial cause of TB). During the pandemic, one
-third of patients who had Haemophillus influenza where
also found to have tuberculosis and many other cases went
- Broxmeyer was never able to prove a direct link between between H.
influenza and the mycobacteria that cause TB, but he continues to
speculate that TB was a big factor in the many deaths in the
pandemic, specifically because it is well known that secondary bacterial
infections, be they from Haemophillus influenza or any other common
bacteria, can also create pneumonia in TB-infected lungs.
- Whatever the "connection" between TB bacteria
, and influenza bacteria, and a virus-caused "flu"
epidemic, the new report by the NIAID is a reminder that epidemics and
pandemics are complex disease processes, which should not simply be assumed
to due merely to a "virus" of great ferocity.
- Reference: <http://www.ncbi.nlm.nih.gov/pubmed/16806732?ordinalpos=2&itool=EntrezSystem
2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum>Broxmeyer L. Bird
flu, influenza and 1918: The case for mutant Avian tuberculosis. Med
Hypotheses. 2006;67(5):1006-15. Epub 2006 Jun 27.
- National Institute of Allergy and Infectious Diseases
(NIAID) For Immediate Release Tuesday, August 19, 2008
- Subscribe Contact: Anne A. Oplinger 301-402-1663
- Bacterial Pneumonia Caused Most Deaths in 1918 Influenza
Pandemic Implications for Future Pandemic Planning
- The majority of deaths during the influenza pandemic
of 1918-1919 were not caused by the influenza virus acting alone, report
researchers from the National Institute of Allergy and Infectious Diseases
(NIAID), part of the National Institutes of Health. Instead, most victims
succumbed to bacterial pneumonia following influenza virus infection. The
pneumonia was caused when bacteria that normally inhabit the nose and throat
invaded the lungs along a pathway created when the virus destroyed the
cells that line the bronchial tubes and lungs.
- A future influenza pandemic may unfold in a similar manner,
say the NIAID authors, whose paper in the Oct. 1 issue of The Journal of
Infectious Diseases is now available online. Therefore, the authors conclude,
comprehensive pandemic preparations should include not only efforts to
produce new or improved influenza vaccines and antiviral drugs but also
provisions to stockpile antibiotics and bacterial vaccines as well.
- The work presents complementary lines of evidence from
the fields of pathology and history of medicine to support this conclusion.
"The weight of evidence we examined from both historical and modern
analyses of the 1918 influenza pandemic favors a scenario in which viral
damage followed by bacterial pneumonia led to the vast majority of deaths,"
says co-author NIAID Director Anthony S. Fauci, M.D. "In essence,
the virus landed the first blow while bacteria delivered the knockout punch."
- NIAID co-author and pathologist Jeffery Taubenberger,
M.D., Ph.D., examined lung tissue samples from 58 soldiers who died of
influenza at various U. S. military bases in 1918 and 1919. The samples,
preserved in paraffin blocks, were re-cut and stained to allow microscopic
evaluation. Examination revealed a spectrum of tissue damage "ranging
from changes characteristic of the primary viral pneumonia and evidence
of tissue repair to evidence of severe, acute, secondary bacterial pneumonia,"
says Dr. Taubenberger. In most cases, he adds, the predominant disease
at the time of death appeared to have been bacterial pneumonia. There also
was evidence that the virus destroyed the cells lining the bronchial tubes,
including cells with protective hair-like projections, or cilia. This loss
made other kinds of cells throughout the entire respiratory tract - including
cells deep in the lungs - vulnerable to attack by bacteria that migrated
down the newly created pathway from the nose and throat.
- In a quest to obtain all scientific publications reporting
on the pathology and bacteriology of the 1918-1919 influenza pandemic,
Dr. Taubenberger and NIAID co-author David Morens, M.D., searched bibliography
sources for papers in any language. They also reviewed scientific and medical
journals published in English, French and German, and located all papers
reporting on autopsies conducted on influenza victims. From a pool of more
than 2,000 publications that appeared between 1919 and 1929, the researchers
identified 118 key autopsy series reports. In total, the autopsy series
they reviewed represented 8,398 individual autopsies conducted in 15 countries.
- The published reports "clearly and consistently
implicated secondary bacterial pneumonia caused by common upper respiratory
flora in most influenza fatalities," says Dr. Morens. Pathologists
of the time, he adds, were nearly unanimous in the conviction that deaths
were not caused directly by the then-unidentified influenza virus, but
rather resulted from severe secondary pneumonia caused by various bacteria.
Absent the secondary bacterial infections, many patients might have survived,
experts at the time believed. Indeed, the availability of antibiotics during
the other influenza pandemics of the 20th century, specifically those of
1957 and 1968, was probably a key factor in the lower number of worldwide
deaths during those outbreaks, notes Dr. Morens.
- The cause and timing of the next influenza pandemic cannot
be predicted with certainty, the authors acknowledge, nor can the virulence
of the pandemic influenza virus strain. However, it is possible that -
as in 1918 - a similar pattern of viral damage followed by bacterial invasion
could unfold, say the authors. Preparations for diagnosing, treating and
preventing bacterial pneumonia should be among highest priorities in influenza
pandemic planning, they write. "We are encouraged by the fact that
pandemic planners are already considering and implementing some of these
actions," says Dr. Fauci.
- Visit <http://www.pandemicflu.gov/>http://www.PandemicFlu.gov for
one-stop access to U.S. Government information on avian and pandemic flu.
- NIAID conducts and supports research - at NIH, throughout
the United States, and worldwide - to study the causes of infectious and
immune- mediated diseases, and to develop better means of preventing, diagnosing
and treating these illnesses. News releases, fact sheets and other NIAID-related
materials are available on the NIAID Web site at <http://www.niaid.nih.gov/>http://www.niaid.nih.gov.
- The National Institutes of Health (NIH) - The Nation's
Medical Research Agency - includes 27 Institutes and Centers and is a component
of the U.S. Department of Health and Human Services. It is the primary
federal agency for conducting and supporting basic, clinical and translational
medical research, and it investigates the causes, treatments, and cures
for both common and rare diseases. For more information about NIH and its
programs, visit <http://www.nih.gov/>www.nih.gov. Reference:
DM Morens et al. Predominant role of bacterial pneumonia as a cause of
death in pandemic influenza: Implications for pandemic influenza preparedness.
The Journal of Infectious Diseases DOI: 10.1086/591708 (2008).