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Bacteria (Not A Virus) Caused
Most Deaths In The Great
'Flu' Pandemic Of 1918

By Lawrence Broxmeyer, MD and Alan Cantwell, MD
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 undiagnosed. 
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).
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