Pathogenic responses among young adults during the 1918 influenza pandemic

Shanks, G. Dennis and Brundage, John F. (2012) Pathogenic responses among young adults during the 1918 influenza pandemic. Emerging Infectious Diseases, 18 2: 201-207. doi:10.3201/eid1802.102042

Author Shanks, G. Dennis
Brundage, John F.
Title Pathogenic responses among young adults during the 1918 influenza pandemic
Journal name Emerging Infectious Diseases   Check publisher's open access policy
ISSN 1080-6040
Publication date 2012-02-01
Sub-type Article (original research)
DOI 10.3201/eid1802.102042
Open Access Status DOI
Volume 18
Issue 2
Start page 201
End page 207
Total pages 7
Place of publication Atlanta, United States
Publisher U.S. Department of Health and Human Services * Centers for Disease Control and Prevention
Language eng
Subject 2726 Microbiology (medical)
2725 Infectious Diseases
2713 Epidemiology
Formatted abstract
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.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Public Health Publications
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Citation counts: TR Web of Science Citation Count  Cited 35 times in Thomson Reuters Web of Science Article | Citations
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Created: Mon, 05 May 2014, 20:16:23 EST by Ms Kate Rowe on behalf of School of Public Health