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
=Studies at Camp Funston.=—The work done at Camp Funston is limited
strictly to the identification of hemolytic streptococci in the throats
of all patients with measles coming into the base hospital at Ft. Riley
and to the same study of a group of normal men on duty. During the
period of study hemolytic streptococci were identified by throat culture
in about 1 in 5 of all the normal men examined. Two instances of otitis
media represent the only complications developing in the 112 cases of
measles. Cultures from both patients showed staphylococci. The entire
absence of streptococcus complications appears the more surprising in
view of the fact that the prevalence of hemolytic streptococci among
patients under treatment in the ward was for a time as great as that
among the normal men. No special hospital management was instituted on
the basis of the findings in throat culture. S. hemolyticus carriers
remained in the wards and were treated alongside the “clean” cases. The
sheet cubicle system was used for bed patients. Face masks were not
worn. Convalescent patients were not segregated, and they assisted in
the care of the bed patients and in the ward kitchen. After the initial
throat culture on admission, the throats were gargled with argyrol and
afterwards sprayed with the same solution three times a day. This
solution was also employed to relieve the discomfort caused by the
conjunctivitis during the acute stage of the disease.
=Throat Culture and Identification of Hemolytic Streptococci.=—In
general the methods for the isolation and identification of hemolytic
streptococci as adopted by the Medical Department of the Army were used.
All organisms were isolated in pure culture, grown in broth, examined
microscopically and subjected to tests for hemolysis, (a 5 per cent
suspension of sheep corpuscles being employed), and for bile solubility.
Beef infusion broth and beef infusion agar constituted the two basic
media used. They were prepared so that the finished product titrated
about 0.3 per cent acid to phenolphthalein.
Broth tubes were carried to the bedside. In swabbing, the attempt was
made to produce gagging. This causes the tonsils to protrude from behind
the anterior pharyngeal pillars and places a slight tension on the
capsule which tends to squeeze material from the crypts. The surfaces of
the tonsils thus protruding toward the midline were brushed quickly with
a small cotton swab which was lastly touched to the posterior pharyngeal
wall and withdrawn so as to avoid touching any other parts. The swab was
immediately introduced into a tube of broth, twirled freely under the
surface of the liquid and discarded. The material thus washed into the
broth was carried to the laboratory and kept in the ice box until
plating, which was accomplished with as little delay as possible.
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