Different virulence of influenza A virus strains and susceptibility to pneumococcal otitis media in chinchillas

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Abstract
Chinchillas infected with a multiply passaged laboratory strain of influenza A/NWS/33 (H1N1) develop negative middle-ear pressure, polymorphonuclear leukocyte oxidative, bactericidal and chemotactic dysfunction and increased susceptibility to pneumococcal otitis media. Because influenza A virus strains show different virulence in humans, 3 such strains were compared in the chinchilla model. Negative middle-ear pressure and tympanic membrane inflammation developed significantly more often in chinchillas infected with wild-type H3N2 virus than with wild-type H1N1 virus or an attenuated, cold-adapted H3N2 vaccine strain, CR29. Marked depression in polymorphonuclear leukocyte chemiluminescent activity also developed significantly more often in H3N2 infected animals than in H1N1- or CR29-infected animals. Intranasal challenge of influenza virus-infected animals with type 7 Streptococcus pneumoniae resulted in a significantly greater occurrence of pneumococcal otitis media in H3N2-infected animals than in H1N1-, CR29- or noninfluenza-infected control animals. Clearance of pneumococci from nasal washings of animals infected with wild-type H3N2 was significantly delayed in comparison with the other groups. Thus, the previously demonstrated increased susceptibility to otitis media among children infected with H3N2 influenza virus may relate to the capacity of this strain to induce negative middle-ear pressure, polymorphonuclear leukocyte dysfunction and alteration in the mucosal clearance of pneumococci.