If the H1N1 pandemic flu follows the pattern of the 1918 Great Pandemic it could come back with more vigor in a second wave next fall. In 1918, three separate recurrences of influenza followed each other with unusual rapidity, resulting in three pandemic waves within a year's time. Dr. Thomas O'Brien, vice president of the Alliance for the Prudent Use of Antibiotics (APUA) and microbiology lab director at Brigham and Women's Hospital, stated this concern on May 14 before a Congressional Subcommittee, chaired by Congressman Stephen Lynch from the Ninth District of Massachusetts. Lynch called the hearing to consider how to protect federal workers who are first responders during flu epidemics.
The work of APUA is given a special relevance to this danger by recent evidence that secondary bacterial infection was a major contributor to the 1918 influenza death rate and by recent changes in methicillin-resistant Staphylococcus aureus (MRSA). Because of overuse of related antibiotics, MRSA has spread widely in the community in recent years and on multiple occasions has acquired resistance to vancomycin, the drug that has been relied on for treating it. “MRSA will thus be a very likely major contributor to the mortality of future influenza infections, and preventing its further acquisition of antibiotic resistance is necessary to keep those infections from becoming untreatable,” according to O'Brien.
