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Interdisciplinary Perspectives on Infectious Diseases
Volume 2011 (2011), Article ID 146376, 6 pages
Research Article

Influenza and Bacterial Pathogen Coinfections in the 20th Century

1Center for Public Health and Infectious Disease, Institutes of Biomedical Sciences, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, China
2Key Laboratory of Medical Molecular Virology of MoH & MoE, Shanghai Medical College, Fudan University, Shanghai 200032, China
3International Vaccine Institute, Seoul 151-818, Republic of Korea
4Laboratory of Medical Molecular Biology, Shanghai Medical College, Fudan University, Shanghai 200032, China
5Department of Biostatistics, School of Public Health, Fudan University, Shanghai 200032, China

Received 6 October 2010; Revised 25 January 2011; Accepted 13 March 2011

Academic Editor: Melinda Pettigrew

Copyright © 2011 Xuan-Yi Wang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


To help understand the potential impact of bacterial coinfection during pandemic influenza periods, we undertook a far-reaching review of the existing literature to gain insights into the interaction of influenza and bacterial pathogens. Reports published between 1950 and 2006 were identified from scientific citation databases using standardized search terms. Study outcomes related to coinfection were subjected to a pooled analysis. Coinfection with influenza and bacterial pathogens occurred more frequently in pandemic compared with seasonal influenza periods. The most common bacterial coinfections with influenza virus were due to S. pneumoniae, H. influenzae, Staphylococcus spp., and Streptococcus spp. Of these, S. pneumoniae was the most common cause of bacterial coinfection with influenza and accounted for 40.8% and 16.6% of bacterial coinfections during pandemic and seasonal periods, respectively. These results suggest that bacterial pathogens will play a key role in many countries, as the H1N1(A) influenza pandemic moves forward. Given the role of bacterial coinfections during influenza epidemics and pandemics, the conduct of well-designed field evaluations of public health measures to reduce the burden of these common bacterial pathogens and influenza in at-risk populations is warranted.