Epidemic Respiratory Disease: The pneumonias and other infections of the repiratory tract accompanying influenza and measlesOpie, Eugene L. (Eugene Lindsay)
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Epidemic Respiratory Disease: The pneumonias and other infections of the repiratory tract accompanying influenza and measles
Segregation of patients in wards according to type of bacterial
infection while theoretically an improvement over the indiscriminate
mixing of patients with many different types of infection presents many
practical difficulties which make it impossible to carry out in the
presence of an overwhelming epidemic. It is quite obvious that grouping
of influenzal patients on the basis of the types of pneumococci that
they carry in their mouths is impossible since the great majority of
mouth pneumococci belong to Group IV and comprise a heterologous
immunologic group. The separation of influenza patients who carry S.
hemolyticus from those who do not would appear to offer a more hopeful
field. Since we cannot make an immediate distinction between
streptococcus carriers and noncarriers by inspection of the patient,
this procedure requires the taking of throat cultures at time of
admission to the hospital, the holding of patients for eighteen to
twenty-four hours in receiving wards until the bacteriologic diagnosis
has been made, and their subsequent distribution to streptococcus and
nonstreptococcus wards. This is feasible when the admission rate is low
and the number of streptococcus carriers found at time of admission is
small. In the presence of an influenza epidemic it immediately becomes
impossible to carry out in base hospitals as now constituted, since the
demand for beds under such conditions at once converts a large part of
the hospital into a group of receiving wards with little room remaining
for subsequent separation of patients. The amount of bacteriologic work
involved at once becomes prohibitive and the time required to make the
bacteriologic diagnosis defeats its purpose since it allows the spread
of hemolytic streptococcus to occur in the receiving wards during the
interval.
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