OT: Flu may not have killed most in 1918 pandemic (strep cited)

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Flu may not have killed most in 1918 pandemic

Bacterial infection may have been responsible for most deaths, report

says

Reuters

updated 10:43 a.m. ET, Fri., Feb. 6, 2009

WASHINGTON - Strep infections and not the flu virus itself may have

killed most people during the 1918 influenza pandemic, which suggests

some of the most dire predictions about a new pandemic may be

exaggerated, U.S. researchers said.

The findings suggest that amassing antibiotics to fight bacterial

infections may be at least as important as stockpiling antiviral

drugs to battle flu, they said.

In the report released Thursday, Klugman of Emory University in

Atlanta and colleagues looked at what information is available about

the 1918 flu pandemic, which killed anywhere between 50 million and

100 million people globally in the space of about 18 months.

Some research has shown that on average it took a week to 11 days for

people to die — which fits in more with the known pattern of a

bacterial infection than a viral infection, Klugman's group wrote in

a letter to the journal Emerging Infectious Diseases.

" We observed a similar 10-day median time to death among soldiers

dying of influenza in 1918, " they wrote.

People with influenza often get what is known as a " superinfection "

with a bacterial agent. In 1918 it appears to have been Streptococcus

pneumoniae.

" Neither antimicrobial drugs nor serum therapy was available for

treatment in 1918, " Klugman's team wrote.

Now there are also vaccines that protect against many different

strains of S. pneumoniae, which cause infections from pneumonia to

meningitis.

Worst-case scenario

Most health experts agree that another pandemic of influenza is

inevitable. There were smaller pandemics in 1958 and in 1967.

Many government projections have been based on a worst-case 1918

scenario, in which tens of millions of people would die globally and

up to 40 percent of the work force would be out for weeks, either

sick, caring for others who are sick, or avoiding public places for

fear of infection.

" Based on 1918 we would project less mortality in an era of

antibiotics, " Klugman said in an e-mail.

" We -are currently modeling this — assuming of course that the

bacterial superinfections remain susceptible to the antibiotics and

that sufficient antibiotics are available. "

No one knows when a pandemic of flu might strike. Every year seasonal

influenza kills between 250,000 and 500,000 people.

A pandemic occurs when a new strain of flu begins infecting people.

One big fear is that H5N1 influenza, currently infecting many birds

in Asia, Europe and Africa, might make the jump to people.

H5N1 currently infects people only rarely but it has killed 254 out

of 405 infected since 2003, according to the World Health

Organization. Many countries and companies are stockpiling antiviral

drugs and vaccines in case it does strike.

Copyright 2009 Reuters. Click for restrictions.

URL: http://www.msnbc.msn.com/id/29038301/