Pathogenic Responses among Young Adults during the 1918 Influenza Pandemic

Details

• Alternative Title:
  Emerg Infect Dis
• Personal Author:
  Shanks, G. Dennis ; Brundage, John F.
• Description:
  Of the unexplained characteristics of the 1918-19 influenza pandemic, the extreme mortality rate among young adults (W-shaped mortality curve) is the foremost. Lack of a coherent explanation of this and other epidemiologic and clinical manifestations of the pandemic contributes to uncertainty in preparing for future pandemics. Contemporaneous records suggest that immunopathologic responses were a critical determinant of the high mortality rate among young adults and other high-risk subgroups. Historical records and findings from laboratory animal studies suggest that persons who were exposed to influenza once before 1918 (e.g., A/H3Nx 1890 pandemic strain) were likely to have dysregulated, pathologic cellular immune responses to infections with the A/H1N1 1918 pandemic strain. The immunopathologic effects transiently increased susceptibility to ultimately lethal secondary bacterial pneumonia. The extreme mortality rate associated with the 1918-19 pandemic is unlikely to recur naturally. However, T-cell-mediated immunopathologic effects should be carefully monitored in developing and using universal influenza vaccines.
• Subjects:
  Animals History, 19th Century History, 20th Century Humans Influenza, Human Influenza A Virus, H1N1 Subtype Influenza Pandemic, 1918-1919 Models, Biological Pandemics Perspective Pneumonia, Bacterial World War I

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• Source:
  Emerg Infect Dis. 18(2):201-207.
• Document Type:
  Journal Article
• Volume:
  18
• Issue:
  2
• Collection(s):
  Emerging Infectious Diseases
• Main Document Checksum:
  urn:sha256:22908bedb746ade8a105c5f772728d01a0f85aec1680eea096ac17fa888b8003
• Download URL:
  https://stacks.cdc.gov/view/cdc/18541/cdc_18541_DS1.pdf
• File Type:
  [PDF - 152.88 KB ]