Animal Cell Diagram

Influenza Epidemic and Methicillin Resistant - Staphylococcus Aureus (MRSA)
By Dr. W. John Martin, M.D., Ph.D.

Specialization among infectious disease experts has worked against an in depth understanding of the complexities of different pathogens working cooperatively to cause serious and even fatal human infections. The anticipated human epidemic of an avian derived strain of H5N1 influenza should be a wake up call to address this important question. Influenza can render the body particularly susceptible to certain types of bacteria that can thereby flourish; and could potentially become the driving force of a continuing worldwide pandemic. Prominent among these bacteria, are toxin producing Staphylococcus aureus, some of which can be resistant to various antibiotics, including methicillin.

Pioneering research during the 1918 influenza epidemic clearly identified a virus component as the initiating cause of illness. Yet there are ample indications that bacteria were responsible for "the gravity of the secondary pulmonary complications," and the "common causes of death." The idea of a mixed infection is contained in the oft quoted letter written by a military physician in 1919.

"Camp Devens is near Boston, and has about 50,000 men, or did have before this epidemic broke loose…. This epidemic started about four weeks ago, and has developed so rapidly that the camp is demoralized and all ordinary work is held up till it has passed….. These men start with what appears to be an ordinary attack of LaGrippe or Influenza, and when brought to the Hosp. they very rapidly develop the most viscous type of Pneumonia that has ever been seen. Two hours after admission they have the Mahogany spots over the cheek bones, and a few hours later you can begin to see the Cyanosis extending from their ears and spreading all over the face, until it is hard to distinguish the coloured men from the white. It is only a matter of a few hours then until death comes, and it is simply a struggle for air until they suffocate. It is horrible. One can stand it to see one, two or twenty men die, but to see these poor devils dropping like flies sort of gets on your nerves. We have been averaging about 100 deaths per day, and still keeping it up. There is no doubt in my mind that there is a new mixed infection here, but what I don't know."

Among the bacteria commonly cultured were Pneumococcus, Streptococcus and Staphylococcus. While H1N1 influenza virus has been retrieved from victims of the 1918 epidemic, no formal study has been reported of possible toxin producing bacteria from this period.

The vast majority of bacteria are essentially harmless to mankind. Bacteria can, however, become infected with their own sets of viruses, some of which can transfer toxin producing capacities to otherwise relatively harmless bacteria. Bacteria viruses can also transfer the capacity of bacteria to resist certain types of antibiotics. The combination of toxin producing capacity with antibiotic resistance is now occurring, especially among Staphylococcus aureus. Of great concern is a toxin complex known as Panton-Valintine-Leucocidin or PVL. This toxin can easily incapacitate the host inflammatory response by directly killing white blood cells (leucocytes). The toxin can also destroy otherwise healthy tissues if the bacteria producing the toxin can gain entry into the tissues. The PVL toxin was originally detected in antibiotic susceptible bacteria.