Epidemic Respiratory Disease: The pneumonias and other infections of the repiratory tract accompanying influenza and measles — John Shaqi
Epidemic Respiratory Disease: The pneumonias and other infections of the repiratory tract accompanying influenza and measlesOpie, Eugene L. (Eugene Lindsay)
History
Epidemic Respiratory Disease: The pneumonias and other infections of the repiratory tract accompanying influenza and measles
Because of the wide variations in opinion concerning the relationship of
various bacteria to influenza that have arisen during the progress of
the recent pandemic, a brief review of the salient features of the
earlier literature seems advisable. In 1892 Pfeiffer[8] found a small,
Gram-negative, hemophilic bacillus in all cases of influenza, often in
almost pure culture, both during life and at autopsy. He stated that the
organism was found only in cases of influenza or in those convalescent
from the disease. Similar bacilli occasionally found in other conditions
he classified as pseudoinfluenza bacilli. He furthermore showed that
freshly isolated cultures were pathogenic for monkeys, producing a
disease not unlike influenza, though lacking in what he considered the
characteristic lung lesions. He therefore felt justified in claiming
that this bacillus, which he designated B. influenzæ, was the cause of
epidemic influenza. Pfeiffer’s work, though hailed by many as
unassailable, has failed to stand the test of time in two respects. It
has been definitely shown, by Wollstein[9] in particular, that there is
no justification for recognizing a group of pseudoinfluenza bacilli,
organisms so classified by Pfeiffer being indistinguishable from B.
influenzæ. Furthermore, numerous investigations have demonstrated that
B. influenzæ may frequently be found in a variety of diseases affecting
the respiratory tract and in a small proportion of normal individuals.
Kretz[10] found it 47 times in 950 examinations, usually associated with
disease of the respiratory tract. Süsswein,[11] Liebscher,[12]
Jehle,[13] Wollstein,[9] Davis[14] and many others have demonstrated its
presence in cases of measles. Lord[15] isolated B. influenzæ in 30 per
cent of 186 sputums from patients with acute and chronic infection of
the respiratory tract. Boggs[16] found it in frequent association with
chronic bronchiectasis. Wollstein[9][17] showed that it was often
present in the respiratory diseases of infants, and was not an
infrequent cause of meningitis. Rosenthal[18] found that one in six of
normal individuals harbors influenza bacilli and therefore considered it
purely a saprophyte, a position, of course, thoroughly untenable in the
face of indisputable evidence that it may be highly pathogenic. The
widely accepted statement that B. influenzæ is nonpathogenic for animals
has apparently served in considerable degree to shake belief in its
etiologic relationship to epidemic influenza. It would appear, however,
that this opinion is not founded upon fact. Reference is again made to
the work of Wollstein[19], who has shown that virulent strains of B.
influenzæ, when freshly isolated from the human host, are highly
pathogenic for rabbits and monkeys and that nearly all strains are more
or less pathogenic for mice and guinea-pigs.
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