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<title xml:lang="en">The possible roles of solar ultraviolet-B radiation and vitamin D in reducing case-fatality rates from the 1918–1919 influenza pandemic in the United States</title>
<author>
<name sortKey="Grant, William B" sort="Grant, William B" uniqKey="Grant W" first="William B" last="Grant">William B. Grant</name>
<affiliation>
<nlm:aff id="A1">Sunlight, Nutrition and Health Research Center (SUNARC); San Francisco, CA USA;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Giovannucci, Edward" sort="Giovannucci, Edward" uniqKey="Giovannucci E" first="Edward" last="Giovannucci">Edward Giovannucci</name>
<affiliation>
<nlm:aff id="A2">Departments of Nutrition and Epidemiology; Harvard School of Public Health; and Department of Medicine; Brigham and Women’s Hospital; Boston, MA USA</nlm:aff>
</affiliation>
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<idno type="wicri:source">PMC</idno>
<idno type="pmid">20592793</idno>
<idno type="pmc">2835877</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835877</idno>
<idno type="RBID">PMC:2835877</idno>
<date when="2009">2009</date>
<idno type="wicri:Area/Pmc/Corpus">000438</idno>
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<title xml:lang="en" level="a" type="main">The possible roles of solar ultraviolet-B radiation and vitamin D in reducing case-fatality rates from the 1918–1919 influenza pandemic in the United States</title>
<author>
<name sortKey="Grant, William B" sort="Grant, William B" uniqKey="Grant W" first="William B" last="Grant">William B. Grant</name>
<affiliation>
<nlm:aff id="A1">Sunlight, Nutrition and Health Research Center (SUNARC); San Francisco, CA USA;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Giovannucci, Edward" sort="Giovannucci, Edward" uniqKey="Giovannucci E" first="Edward" last="Giovannucci">Edward Giovannucci</name>
<affiliation>
<nlm:aff id="A2">Departments of Nutrition and Epidemiology; Harvard School of Public Health; and Department of Medicine; Brigham and Women’s Hospital; Boston, MA USA</nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Dermato-endocrinology</title>
<idno type="ISSN">1938-1972</idno>
<idno type="eISSN">1938-1980</idno>
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<date when="2009">2009</date>
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<div type="abstract" xml:lang="en">
<p>Deaths during the 1918–1919 influenza pandemic have been linked to both the influenza virus and secondary bacterial lung infections. Case fatality rates and percentage of influenza cases complicated by pneumonia were available from survey data for twelve United States locations in the 1918–1919 pandemic. This study analyzes case fatality rates and cases complicated by pneumonia with respect to estimated summertime and wintertime solar ultraviolet-B (UVB) doses as indicators of population mean vitamin D status. Substantial correlations were found for associations of July UVB dose with case fatality rates (r = −0.72, p = 0.009) and rates of pneumonia as a complication of influenza (r = −0.77, p = 0.005). Similar results were found for wintertime UVB. Vitamin D upregulates production of human cathelicidin, LL-37, which has both antimicrobial and antiendotoxin activities. Vitamin D also reduces the production of proinflammatory cytokines, which could also explain some of the benefit of vitamin D since H1N1 infection gives rise to a cytokine storm. The potential role of vitamin D status in reducing secondary bacterial infections and loss of life in pandemic influence requires further evaluation.</p>
</div>
</front>
</TEI>
<pmc article-type="brief-report">
<pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Dermatoendocrinol</journal-id>
<journal-id journal-id-type="publisher-id">DE</journal-id>
<journal-title-group>
<journal-title>Dermato-endocrinology</journal-title>
</journal-title-group>
<issn pub-type="ppub">1938-1972</issn>
<issn pub-type="epub">1938-1980</issn>
<publisher>
<publisher-name>Landes Bioscience</publisher-name>
</publisher>
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<article-meta>
<article-id pub-id-type="pmid">20592793</article-id>
<article-id pub-id-type="pmc">2835877</article-id>
<article-id pub-id-type="publisher-id">1938-1972-1-4-4</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Report</subject>
</subj-group>
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<title-group>
<article-title>The possible roles of solar ultraviolet-B radiation and vitamin D in reducing case-fatality rates from the 1918–1919 influenza pandemic in the United States</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Grant</surname>
<given-names>William B</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Giovannucci</surname>
<given-names>Edward</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<aff id="A1">
<label>1</label>
Sunlight, Nutrition and Health Research Center (SUNARC); San Francisco, CA USA;</aff>
<aff id="A2">
<label>2</label>
Departments of Nutrition and Epidemiology; Harvard School of Public Health; and Department of Medicine; Brigham and Women’s Hospital; Boston, MA USA</aff>
</contrib-group>
<author-notes>
<corresp>Correspondence to: William B. Grant; Sunlight, Nutrition and Health Research Center (SUNARC); P.O. Box 641603; San Francisco, CA 94164-1603 USA; Tel.:
<phone>415.409.1980</phone>
; Email:
<email>wbgrant@infionline.net</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub">
<season>Jul-Aug</season>
<year>2009</year>
</pub-date>
<volume>1</volume>
<issue>4</issue>
<fpage>215</fpage>
<lpage>219</lpage>
<history>
<date date-type="received">
<day>29</day>
<month>4</month>
<year>2009</year>
</date>
<date date-type="accepted">
<day>18</day>
<month>5</month>
<year>2009</year>
</date>
</history>
<permissions>
<copyright-statement>© 2009 Landes Bioscience</copyright-statement>
<copyright-year>2009</copyright-year>
</permissions>
<abstract>
<p>Deaths during the 1918–1919 influenza pandemic have been linked to both the influenza virus and secondary bacterial lung infections. Case fatality rates and percentage of influenza cases complicated by pneumonia were available from survey data for twelve United States locations in the 1918–1919 pandemic. This study analyzes case fatality rates and cases complicated by pneumonia with respect to estimated summertime and wintertime solar ultraviolet-B (UVB) doses as indicators of population mean vitamin D status. Substantial correlations were found for associations of July UVB dose with case fatality rates (r = −0.72, p = 0.009) and rates of pneumonia as a complication of influenza (r = −0.77, p = 0.005). Similar results were found for wintertime UVB. Vitamin D upregulates production of human cathelicidin, LL-37, which has both antimicrobial and antiendotoxin activities. Vitamin D also reduces the production of proinflammatory cytokines, which could also explain some of the benefit of vitamin D since H1N1 infection gives rise to a cytokine storm. The potential role of vitamin D status in reducing secondary bacterial infections and loss of life in pandemic influence requires further evaluation.</p>
</abstract>
<kwd-group>
<title>Key words</title>
<kwd>H1N1 influenza</kwd>
<kwd>bacterial pneumonia</kwd>
<kwd>cathelicidin</kwd>
<kwd>cytokines</kwd>
<kwd>ultraviolet-B</kwd>
<kwd>vitamin D</kwd>
<kwd>pandemic influenza</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>

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