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
Cole and MacCallum[74] have published almost simultaneously, with that
just cited, a report upon the pneumonia which has occurred at Fort Sam
Houston and have shown the importance of hemolytic streptococci in its
causation. They have found two varieties of pneumonia, namely, acute
lobar pneumonia which does not differ essentially from that which occurs
elsewhere and bronchopneumonia which in most cases has followed measles
and is caused by S. hemolyticus. They think this infection is usually
acquired in the hospital. They believe that the pulmonary lesions are
characteristic. In this publication and elsewhere MacCallum has
designated the lesion “interstitial bronchopneumonia.”
The epidemic of streptococcus pneumonia and empyema occurring at Camp
Dodge, Iowa, from March 20 to May 10 is described by Miller and
Lusk[75]. During this period there were 400 cases of pneumonia, whereas
from September 20, 1917, to March 20 there had been only 276 instances
of lobar pneumonia. The type of pneumonia changed, there was more severe
intoxication and empyema became very frequent; in 85 of 95 exudates
streptococci were found. The outbreak of pneumonia bore no relation to
measles. The authors state that a mild tracheitis was prevalent in the
cantonment during March, and whenever a large group of soldiers
congregated coughing was noticeable.
MacCallum[76] studied the pneumonia at Camp Dodge during May and found
17 instances of the lesion which he had designated interstitial
bronchopneumonia; of these, 9 followed measles, although in the earlier
part of the epidemic there appear to have been, he states, few such
cases. Cultures made at autopsy, except in a few fatal cases of
uncomplicated lobar pneumonia caused by the pneumococcus, showed the
hemolytic streptococcus in every situation throughout the respiratory
tract and pleura.
The pneumonia which occurred at Camp Funston is of special interest to
our commission because we were for a time stationed at this camp and had
the opportunity of following in the excellent records of the hospital
the history of the occurrence of pneumonia during the year following the
establishment of the camp in September, 1917. Stone, Phillips and
Bliss[77] have described the outbreak of pneumonia which occurred in
March, 1918. At this time there was, the authors state, severe pneumonia
with frequent empyemas due to hemolytic streptococci. This condition
which did not follow measles was responsible for the greatly increased
death rate in March; 9 deaths occurred in February, 45 in March, 25 in
April and 14 in May. They found during March 26 instances of multiple
pulmonary abscess. In 29 autopsies they found a pleural lesion which
they designate “subcostosternal pus pockets”; it occurs only in
association with empyema caused by hemolytic streptococci.
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