Australian Defence Force Malaria and Infectious Diseases Institute, Brisbane, Queensland, Australia.
School of Public Health, University of Queensland, Brisbane, Queensland, Australia.
Intern Med J. 2019 Jul;49(7):919-923. doi: 10.1111/imj.14344.
The modern world's most lethal single event, the 1918-1921 influenza pandemic, remains an anomaly which is still unexplained. The pandemic's unprecedented mortality was very unevenly distributed with young adults and isolated populations worst affected. Australia was the last continent involved with about 12 000 influenza deaths in 1919. Most cases were clinically unremarkable and recovered quickly, but a small minority developed severe tracheobronchitis compromising oxygenation and immune defences usually dying in the second week of illness. Histopathology showed massive destruction of the respiratory epithelium with evidence of secondary bacterial invasion. No simple explanation (e.g. hypervirulent virus) is consistent with these observations.
现代世界最致命的单一事件，即 1918-1921 年流感大流行，仍然是一个尚未解释清楚的异常事件。大流行的空前死亡率分布极不均匀，年轻人和孤立人群受影响最严重。澳大利亚是最后一个受到影响的大陆，1919 年有大约 12000 人死于流感。大多数病例临床表现不明显，很快康复，但少数人发展为严重的气管支气管炎，损害氧气供应和免疫防御能力，通常在发病的第二周死亡。组织病理学显示呼吸道上皮大量破坏，并伴有继发性细菌入侵的证据。没有一个简单的解释（例如，超级病毒）能与这些观察结果一致。
