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Synergism between respiratory viruses and bacteria.

Yale Journal of Biology and Medicine
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  • Research Article
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University of Southern California CLAYTON G. LOOSLI School of Medicine Los Angeles, California 90033 SYNERGISM BETWEEN RESPIRATORY VIRUSES AND BACTERIA* * Many studies concerning the etiology of acute and chronic diseases of the respiratory tract have been triggered by outbreaks of epidemic influenza in man. Parsons,' in his report of the influenza pandemic of 1889-90, sum- marizes the evidence for and against the many hypotheses concerning its etiology which had been considered over the centuries. Shortly before this pandemic, several groups of organisms associated with acute upper and lower respiratory tract infections had been identified. These included, among others, Diplococcus pneumoniae, Streptococcus viridans, Streptococcus hemolyticus, and Friedlander's bacillus. Different investigators, particularly in Germany, isolated the above organisms from the secretions of the respiratory tract, lungs, or blood of patients having influenza and ascribed a primary etiological role to them.' Pfeiffer isolated the bacillus which bears his name from the secretions and tissues of patients suffering from or dying of influenza.' Following his report, the frequent close association of Pfeiffer's bacillus with human influenza infections was widely confirmed by others, and this organism came to be considered gen- erally as the specific cause of epidemic influenza."' With the world-wide outbreak of influenza in 1918, an opportunity pre- sented itself to investigate with improved methods and design the etiological role of Pfeiffer's bacillus in this disease. Its primary causative role was soon questioned, for outbreaks of influenza during the summer months of 1918 occurred, from which cases the influenza bacillus could not be iso- lated. Jordan,' the British Ministry of Health,7 and David and Robert Thomson,8.9 reviewed the bacteriological findings from thousands of pub- lished reports made during the 1890 and 1918 pandemics and other lesser influenza outbreaks. In summarizing the available evidence, bact

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