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 incidence of B. influenzæ in cases of measles studied during the
epidemic of influenza has been relatively high though never equaling
that found in cases of influenza. As in normal men, the incidence in
cases of measles has steadily increased during the period of the
epidemic. Repeated throat cultures at weekly intervals in cases of
measles have shown that approximately 80 per cent became temporary
carriers of B. influenzæ at one time or another during the period of the
epidemic. Many of these cases had influenza during the time that they
were in the hospital. The carrier state in cases of measles was found to
bear no relation to the acute stage of the disease since the number of
carriers at the time of admission to the hospital was considerably lower
than that found during convalescence as determined by repeated cultures
in the same cases.
Discussion
The bacteriologic studies in cases of influenza described in this report
fully support Pfeiffer’s claim that B. influenzæ is invariably present
in the disease. It is particularly important to note that these results
were obtained in early uncomplicated cases of influenza and are not
dependent upon cultures made from cases complicated by pneumonia or
obtained at autopsy. In view of this fact the tendency so apparent in
much of the recent literature to relegate B. influenzæ to a place of
secondary or minor importance in the disease seems hardly justifiable.
It would seem that this tendency is largely dependent upon three
factors: first, the failure of many to find B. influenzæ either during
life or at autopsy in any considerable proportion of cases; second, the
frequent failure to draw a clear distinction between influenza itself
and the pneumonia to which it predisposes with a consequent overemphasis
upon autopsy bacteriology where a considerable variety of secondary
organisms have attracted particular attention; and third, an incorrect
interpretation of the undoubtedly large number of B. influenzæ carriers
found among normal individuals and those with other diseases during the
period of the epidemic and to less extent in interepidemic times.
Since the majority of workers who are thoroughly familiar with the
technic of cultivating B. influenzæ have encountered little difficulty
in finding it in a large majority of cases, it is felt that the
considerable number of negative reports that have appeared can depend
only upon the unfamiliarity of those who have failed to find it with the
proper bacteriologic methods. This is quite apparent in many of the
reports that have been published, and is not surprising in the face of
the excessive demand for well-trained bacteriologists occasioned by the
war.
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