David Morens talks with
ScienceWatch.com and answers a few questions about
this month's New Hot Paper in the field of Immunology. The
author has also sent along images of his work.
Article Title: Predominant role of bacterial pneumonia
as a cause of death in pandemic influenza: Implications for
pandemic influenza preparedness
Authors: Morens, DM;Taubenberger,
Journal: J INFEC DIS
Year: OCT 1 2008
* NIAID, Natl Inst Hlth, Bldg 31,Room 7A-10,31 Ctr Dr,MSC 2520,
Bethesda, MD 20892 USA.
* NIAID, Natl Inst Hlth, Bethesda, MD 20892 USA.
Why do you think your paper is highly
The results, that most of the 50-100 million deaths during the 1918
pandemic influenza were due not to influenza alone, but to bacterial
complications, were surprising and have important implications for
preventing influenza deaths today.
Does it describe a new discovery, methodology, or
synthesis of knowledge?
Examples of H&E-stained post-mortem lung sections from
two influenza victims in 1918.
View/download accompanying slide and descriptions.
It describes a new synthesis of knowledge; using old autopsy specimens and
published bacteriologic and pathologic studies from 1918, at which time the
viral cause of influenza was not known, we were able to show, with a high
degree of certainty given the age of the data, that most deaths were caused
by a now treatable complication of influenza.
Would you summarize the significance of your paper
in layman’s terms?
We now have a better understanding of what killed so many people during the
1918 "Spanish flu" pandemic, the most fatal single event in human history,
and this information should help us save countless lives in future
influenza pandemics and seasonal outbreaks.
How did you become involved in this research, and
were there any problems along the way?
I became involved by accident, helping a colleague
study different historical aspects of influenza. I kept coming across old
publications that showed bacteriological and pathological findings from
1918 autopsies. After a while the strength and consistency of these
forgotten data became impressive and I resolved to do a systematic
historical/scientific search for all information I could find from 1918
influenza autopsy series.
The problems along the way were enormous and largely related to the
historical research challenges, including the lack of any comprehensive
bibliographic sources at that time. Thousands of papers had to be sought
and read and analyzed, which took more than two years to do, with the help
of many research and library colleagues.
Where do you see your research leading in the
I think the impact on public health and health policy planners and on
medical practitioners has been great and is likely to continue for some
time. The information has already substantially impacted our federal
response to the current swine H1N1
pandemic. Physicians now have to rethink preventing bacterial complications
and treating them early with antibiotics; health planners have to consider
everything from what and how much is in the national stockpile to
rethinking vaccination strategies with pneumococcal and
Haemophilus influenza vaccines, and many similar issues.
Do you foresee any social or political
implications for your research?
I believe and certainly hope that many lives will be saved through better
treatment of, management of, and public health responsiveness to influenza.
David M. Morens, M.D.
Senior Advisor to the Director
Office of the Director
National Institute of Allergy and Infectious Diseases
National Institutes of Health
Bethesda, MD, USA
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KEYWORDS: ASIAN INFLUENZA; RESPIRATORY-TRACT; A VIRUS; X-RAY; EPIDEMIC;
INFECTION; PATHOLOGY; COMPLICATIONS; PNEUMOCOCCUS; EXPRESSION.