On 2014 Nov 30, Harri Hemila commented:

Brundage JF, 2008 suggest that the high mortality associated with 1918-19 flu pandemic was caused by secondary bacterial pneumonia. They propose that antibiotics and bacterial vaccines should be stockpiled for the next flu pandemic.

I would like to suggest that as part of pandemic-related research activities, the effect of vitamin C on bacterial pneumonia should be investigated. In dozens of animal studies, vitamin C protected against infections by various viruses and bacteria, see Hemilä 2006, pp. 5-9, 105-21.

In the early 20th century, Alfred Hess carried out extensive studies of scurvy and summarized a large series of autopsy findings as follows: “pneumonia, lobular or lobar, is one of the most frequent complications [of scurvy] and causes of death” and “secondary pneumonias, usually broncho-pneumonic in type, are of common occurrence, and in many [scurvy] epidemics constitute the prevailing cause of death”, see Hemilä H, 2007. Thus, there seemed to be a close association between vitamin C and pneumonia.

Hemilä H, 2013 carried out a Cochrane review, and found 3 controlled trials that looked at whether vitamin C prevents pneumonia and 2 that looked at whether it might help in curing pneumonia; 2 of them were RCTs. Each of the 5 trials found that vitamin C supplementation was beneficial.

As to bacterial pneumonia caused by influenza A infection, Kimbarowski JA, 1967 is particularly relevant as they administered vitamin C to soldiers of the former USSR who were hospitalized because of influenza A. Their main purpose was to examine an investigational laboratory test; but, as a secondary issue, they reported the number of bronchopneumonia cases in the vitamin C and control groups after hospitalization. There were 10 cases of bronchopneumonia in the control group compared with 2 cases in the vitamin C group (P = 0.02, Fisher’s exact test). Although the trial is methodologically unsatisfactory in comparison with current standards, the difference in the occurrence of pneumonia in the study groups cannot be dismissed because of obvious biases Hemilä H, 2013. Methodologically satisfactory trials are needed to corroborate or refute the possibility that vitamin C has an effect on bacterial pneumonia caused by influenza.

On 2014 Nov 30, Harri Hemila commented:

Brundage JF, 2008 suggest that the high mortality associated with 1918-19 flu pandemic was caused by secondary bacterial pneumonia. They propose that antibiotics and bacterial vaccines should be stockpiled for the next flu pandemic.

I would like to suggest that as part of pandemic-related research activities, the effect of vitamin C on bacterial pneumonia should be investigated. In dozens of animal studies, vitamin C protected against infections by various viruses and bacteria, see Hemilä 2006, pp. 5-9, 105-21.

In the early 20th century, Alfred Hess carried out extensive studies of scurvy and summarized a large series of autopsy findings as follows: “pneumonia, lobular or lobar, is one of the most frequent complications [of scurvy] and causes of death” and “secondary pneumonias, usually broncho-pneumonic in type, are of common occurrence, and in many [scurvy] epidemics constitute the prevailing cause of death”, see Hemilä H, 2007. Thus, there seemed to be a close association between vitamin C and pneumonia.

Hemilä H, 2013 carried out a Cochrane review, and found 3 controlled trials that looked at whether vitamin C prevents pneumonia and 2 that looked at whether it might help in curing pneumonia; 2 of them were RCTs. Each of the 5 trials found that vitamin C supplementation was beneficial.

As to bacterial pneumonia caused by influenza A infection, Kimbarowski JA, 1967 is particularly relevant as they administered vitamin C to soldiers of the former USSR who were hospitalized because of influenza A. Their main purpose was to examine an investigational laboratory test; but, as a secondary issue, they reported the number of bronchopneumonia cases in the vitamin C and control groups after hospitalization. There were 10 cases of bronchopneumonia in the control group compared with 2 cases in the vitamin C group (P = 0.02, Fisher’s exact test). Although the trial is methodologically unsatisfactory in comparison with current standards, the difference in the occurrence of pneumonia in the study groups cannot be dismissed because of obvious biases Hemilä H, 2013. Methodologically satisfactory trials are needed to corroborate or refute the possibility that vitamin C has an effect on bacterial pneumonia caused by influenza.