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
Many observers have described isolated phases of the recent epidemic and
of past epidemics of influenza. Few have had an opportunity to follow
the pathology of influenza from the onset of an epidemic through a
period of several months and to observe the succession of acute and
chronic changes which occur in the lungs. Our commission arrived on
September 5, 1918, at Camp Pike two weeks before the outbreak of
influenza. The commission had previously made a careful study of the
clinical course, the bacteriology and to a limited extent the pathology
of pneumonia occurring at Camp Funston where there was little if any
influenza. Study of the records preserved at the base hospital at Camp
Funston had convinced us that this camp had passed through an epidemic
of influenza during the spring of 1918, this epidemic being followed by
a very severe outbreak of pneumonia. Our investigation at Camp Funston
had brought to our attention those phases of pneumonia which with the
facilities of a base hospital laboratory could be most profitably
studied with a view to determining the causation, the epidemiology and
the prevention of the pneumonias prevalent in the American army.
Study of pneumonia after death offers the only opportunity of
determining the relation of pulmonary lesions to the considerable
variety of microorganism associated with them. Clinical diagnosis
furnishes no certain criterion for distinguishing lobar and
bronchopneumonia; suppurative pneumonia is rarely recognizable during
life. The relation of pneumococci, streptococci, staphylococci or B.
influenzæ to one or other type of pneumonia can be determined with
accuracy only after death; for the demonstration of one or more of these
microorganisms in material obtained from the upper respiratory passages
in life, though of value, furnishes us no definite evidence that the
organism which has been identified has entered the lung and passed from
the bronchi to produce pneumonia.
Study of autopsies following examination of the sputum during life has
shown that an individual primarily attacked by influenza may suffer with
a succession of pneumonias, one microorganism having prepared the way
for another. The complexity of the subject is much increased by the
truth that pyogenic microorganisms, like the tubercle bacilli, are
capable of producing a considerable variety of pulmonary lesions.
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