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
The second classification shows a slightly higher incidence for cases
during the acute stage of the disease, regardless of whether they were
admitted to the measles service from camp or from another service of the
hospital (2.4 per cent). These findings conform with those at Fort Riley
in a smaller series of cases and support the opinion that the hemolytic
streptococci temporarily disappear from the throat during the acute
onset of measles. Unfortunately controls among normal men in Camp Pike
were not taken at intervals throughout the period of three months
represented by this study of measles, but all controls taken show a
higher incidence than that found among measles patients on admissions
over a period of time comparable to that of the control series.
The gradual increase in the percentage of patients developing hemolytic
streptococci in their throats in wards receiving only streptococcus free
cases demonstrates that the admission culture and the subsequent weekly
cultures, with the separation of all patients identified as carriers,
did not suffice to control the spread of streptococcus in this group of
cases. It is interesting to note that the greatest incidence of
streptococcus carriers among these patients occurred three weeks after
the height of the measles epidemic, when it became about four times that
observed at the height of the measles epidemic.
When we consider the time relations of the streptococcus complications,
it is noteworthy that they begin to appear somewhat after the appearance
of streptococcus carriers and then increase parallel with the increase
in the numbers of carriers. The relative number of complications
developing among the first carriers which were identified is less than
that among the carriers appearing later. This suggests an increase in
virulence of hemolytic streptococci attending their wider dissemination.
Tables LXII and LXIII are introduced for the purpose of showing to what
extent duration of stay in the hospital increases the individual’s
chances of acquiring hemolytic streptococci. Table LXII includes all
cases admitted to and treated in the measles wards. On repeated
cultures, previous positives and negatives were cultured alike and the
total positives reported for each week.
Table LXIII includes only those cases treated in the “clean” wards and
known to be negative on previous culture.
TABLE LXII
INCIDENCE OF HEMOLYTIC STREPTOCOCCI IN THROATS OF MEASLES CASES WITH
REFERENCE TO PERIOD IN HOSPITAL
(All cases treated in the wards)
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