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
It is evident from the figures presented in Table XII that a large
percentage of the measles cases studied were at one time or another
carriers of B. influenzæ. In consideration of this fact, it must be
borne in mind that all these cases were cultured during the period when
the influenza epidemic was at its height and that many of these cases
had influenza while in the hospital for measles. No data are available
as to the exact number, since a definite diagnosis of influenza could
hardly be made during the acute stage of measles. It is probable that
approximately 25 per cent developed influenza, since that was the
incidence of influenza in the total population of Camp Pike. The
consistent increase in the percentage of influenza carriers clearly
demonstrates that this was due to wide dissemination of B. influenzæ
with the progress of the epidemic. Another point of exceeding interest
is that the percentage of measles cases carrying B. influenzæ in the
throat was lowest during the acute stage of the disease and increased
during convalescence. This is in direct contrast with the results found
in cases of influenza where the number of cases carrying B. influenzæ in
the throat was highest during the acute stage and rapidly diminished in
uncomplicated cases with the onset of convalescence.
=Summary.=—Multiple cultures made simultaneously from the nose, throat
and lower respiratory tract showed that B. influenzæ was invariably
present in all cases of influenza from the onset of the disease. Not
only was B. influenzæ present in all cases, but it was frequently
present in predominant numbers, sometimes in nearly pure culture. In the
majority of cases that went on to rapid recovery without the development
of an extensive bronchitis or complicating pneumonia, the predominance
of B. influenzæ over other organisms rapidly diminished coincident with
onset of convalescence. Many cases, however, continued to carry B.
influenzæ in large numbers in the throat throughout convalescence. No
data on the possible duration of the carrier state have been obtained.
By the culture methods employed no other organism has been found that
would suggest any etiologic relationship to the disease. The two
organisms most frequently associated with B. influenzæ in postinfluenzal
pneumonias, pneumococcus and S. hemolyticus, have not differed in their
incidence in early uncomplicated cases of influenza from that found in
normal individuals.
The incidence of B. influenzæ in normal men, in different groups
studied, has varied between 11.1 and 88 per cent. This wide variation
has depended upon the prevalence of respiratory diseases, more
particularly influenza, in the groups studied and the opportunity
thereby offered for the wide dissemination of B. influenza. With the
progress of the epidemic, the number of normal men carrying B. influenzæ
has steadily increased until it reached its maximum at the end of the
epidemic.
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