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 material presented in this section of the report consists of
clinical and bacteriologic observations made during the course of an
investigation of influenza and its associated bronchitis and pneumonia
at Camp Pike, Ark., between September 6 and December 15, 1918,
comprising part of a correlated study of the epidemiology, bacteriology,
pathology, and clinical features of these diseases. The bacteriologic
studies are in the main limited to those made during life, those made at
necropsy being reported in another section of this report.
=Methods.=—All cases upon which the clinical and bacteriologic data
presented are based, were examined by the authors and our own clinical
histories and physical examinations were recorded. This was considered
of special importance, since in studying a group of diseases in which
secondary infection of the respiratory tract might supervene at any
time, it was essential to determine as far as possible the exact
clinical condition of the patient at the time when bacteriologic
examinations were made. The bacteriologic methods employed were the
direct culture of nose and throat swabbings and of selected and washed
specimens of sputum on the surface of 5 per cent defibrinated horse
blood agar plates, the intraperitoneal inoculation of white mice with
specimens of sputum according to the method described by Blake[28] for
the determination of pneumococcus types, and in some cases the method of
Avery.[29] B. influenzæ pneumococci and hemolytic streptococci were
identified by the methods described elsewhere. Note was made in most
instances of the presence of other organisms such as members of the
Gram-negative diplococcus group, staphylococci, diphtheroids, and
members of the streptococcus viridans group, but no attempt was made to
further isolate or identify them since they played no significant part
in the cases studied except in rare instances.
Influenza
The fall epidemic of influenza at Camp Pike began about September 1,
1918, and reached epidemic proportions on September 23 when 214 cases
were admitted to the base hospital. The epidemic was at its height from
September 27 to October 3, during which period there were in the
neighborhood of 1,000 new cases daily. From this date until October 31
the number of new cases occurring daily steadily decreased and by the
latter date the epidemic was over. Scattered cases continued to occur,
however, throughout November, and during the last week of this month and
the first week of December a second epidemic wave of relatively mild
character occurred. From September 1 to October 31 the total number of
cases of influenza reporting sick was 12,393. During the same period
there were 1,499 cases of pneumonia with 466 deaths.
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