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
Influenza as observed at Camp Pike differed in no essential respects
from that occurring elsewhere. In brief, it presented itself as a highly
contagious, self-limited infectious disease of relatively short duration
in most instances, the principal manifestations of which were sudden
onset with high fever, profound prostration, severe aching pains in back
and extremities, conjunctival injection, flushing of the face, neck, and
upper thorax often amounting to a true erythema, and a rapidly
progressing attack upon the mucous membranes of the respiratory tract as
manifested by coryza, pharyngitis, tracheitis and bronchitis with a
marked tendency to hemorrhage; in itself it is rarely serious, but in
reality serious because of the large number of individuals attacked and
temporarily incapacitated and because it predisposed to widespread and
highly fatal secondary infection of the lungs.
=Clinical Features.=—A clinical study of 100 consecutive cases of
influenza admitted during the height of the epidemic was made.
The onset was sudden, in most instances being initiated with marked
sensations of chilliness in 82 cases. Although a severe chill was
probably relatively uncommon, 44 of these patients considered the
symptom of sufficient severity to describe it as such. This was
accompanied by extreme general malaise with severe aching pains
throughout the whole body. Intense backache was complained of in 40
cases, headache in 54 cases. A varying degree of prostration, sometimes
leading to complete collapse, was almost universal; 5 patients
complained of extreme asthenia and 2 of marked dizziness. At time of
admission to the hospital the face, neck and upper chest exhibited a
uniform erythematous flush, never macular in appearance. The conjunctivæ
were deeply injected, but lacrimation was not noticeable and a true
exudative conjunctivitis was not encountered. Onset was accompanied by a
sharp elevation of temperature ranging from 100° F. to 106° F., in most
cases being between 102° F. and 105° F., at the time of admission. No
constant type of temperature curve was maintained. Excluding the 15
cases in this group that developed pneumonia, the temperature was well
sustained throughout the course of the disease in 46, irregular in 33,
and definitely remittent in 6. The duration of the fever varied between
one and seven days, the temperature having returned to normal in all but
19 of the 85 cases by the end of four days. The duration of fever was
one day in 18 cases, two days in 12, three days in 19, four days in 17,
five days in 10, six days in 4, and seven days in 5. Of the 4 cases with
fever for six days, 2 had a fairly extensive bronchitis, 1 a laryngitis.
Of the 5 cases with fever of seven days’ duration, 3 had signs of an
extensive bronchitis, 2 of only a mild bronchitis.
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