Influenza and bacterial pathogen coinfections in the 20th century
Xuan-Yi Wang1, Paul E Kilgore, Kyung Ah Lim
1Center for Public Health and Infectious Disease, Institutes of Biomedical Sciences, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, China.
Abstract:
To help understand the potential impact of bacterial coinfection during pandemic influenza periods, we undertook a far-reaching review of the existing literature to gain insights into the interaction of influenza and bacterial pathogens. Reports published between 1950 and 2006 were identified from scientific citation databases using standardized search terms. Study outcomes related to coinfection were subjected to a pooled analysis. Coinfection with influenza and bacterial pathogens occurred more frequently in pandemic compared with seasonal influenza periods. The most common bacterial coinfections with influenza virus were due to S. pneumoniae, H. influenzae, Staphylococcus spp., and Streptococcus spp. Of these, S. pneumoniae was the most common cause of bacterial coinfection with influenza and accounted for 40.8% and 16.6% of bacterial coinfections during pandemic and seasonal periods, respectively. These results suggest that bacterial pathogens will play a key role in many countries, as the H1N1(A) influenza pandemic moves forward. Given the role of bacterial coinfections during influenza epidemics and pandemics, the conduct of well-designed field evaluations of public health measures to reduce the burden of these common bacterial pathogens and influenza in at-risk populations is warranted.
Insights
Bacterial coinfections, especially with Streptococcus pneumoniae, are more common during pandemic influenza. Public health measures are needed to reduce the burden of these coinfections in at-risk populations.
Area of Science:
- Infectious Diseases
- Epidemiology
- Microbiology
Background:
- Bacterial coinfections complicate influenza illness, particularly during pandemics.
- Understanding the interplay between influenza viruses and bacteria is crucial for public health preparedness.
Purpose of the Study:
- To review and analyze the frequency and types of bacterial coinfections associated with influenza.
- To provide insights into the role of bacterial pathogens during pandemic influenza periods.
Main Methods:
- A comprehensive literature review of studies published between 1950 and 2006.
- Pooled analysis of study outcomes related to influenza and bacterial coinfections.
Main Results:
- Bacterial coinfections were more frequent during pandemic influenza periods than seasonal periods.
- Streptococcus pneumoniae was the most common bacterial coinfecting agent, accounting for 40.8% of coinfections during pandemics.
- Other common coinfecting bacteria included Haemophilus influenzae, Staphylococcus spp., and Streptococcus spp.
Conclusions:
- Bacterial pathogens, particularly S. pneumoniae, play a significant role in influenza-related morbidity and mortality.
- Public health strategies should address bacterial coinfections alongside influenza prevention and treatment.
- Further field evaluations are warranted to develop effective public health measures for at-risk populations.
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