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
Our commission[78] has shown that an epidemic of influenza, well
characterized by its epidemiology and symptoms, preceded and accompanied
the outbreak of pneumonia just described. Between March 4 and 29 1,127
men from Camp Funston, which then contained 29,000 men, were sent to the
base hospital with influenza and many more were treated in the
infirmaries of the camp; on March 11 107 patients with influenza were
admitted to the hospital. The greatest incidence of pneumonia in the
history of the encampment up to this time occurred between March 9 and
29, immediately following the outbreak of influenza, the maximum
incidence of pneumonia occurring five days after the maximum for
influenza.
The foregoing observations are cited to prove that streptococcus
pneumonia, which occurred during the spring of 1918 at Camp Funston and
doubtless at other camps, had its origin in influenza and did not differ
in character from that which occurred on a much larger scale in the fall
of 1918.
=Table of Autopsies.=—In order to present as briefly as possible the
data upon which the present study has been based, autopsies have been
assembled in tabular form in the order of their performance (Table
XXVII). During the early period of the epidemic autopsies were performed
on all who died with pneumonia, but later, with increase in the number
of deaths, this became impossible and autopsies were performed on all
those who died in certain wards.
Comparison of charts representing incidence of influenza and of deaths
from pneumonia furnishes evidence that fatal pneumonia during the period
of investigation was with few exceptions referable to influenza. During
two weeks, namely, from September 1 to 14, before the presence of the
epidemic was evident, there were only 2 fatal cases of pneumonia. In
most instances the relation of pneumonia to influenza is established by
a definite history of influenza having its onset during the epidemic.
Bronchopneumonia usually develops gradually as a sequence of influenza
in which purulent bronchitis has occurred. Lobar pneumonia may develop
in cases of influenza complicated by purulent bronchitis. In some
instances there is apparent recovery from influenza indicated by return
of temperature to normal; after from one to three days of normal
temperature there is typical lobar pneumonia with rusty sputum. In many
instances of pneumonia having their onset at the height of the epidemic
of influenza, the history indicates that pneumonia was present
immediately after the onset of symptoms, so that the onset resembled
that of pneumonia rather than of influenza.
Cases of pneumonia following measles have been excluded from the table
in order that they may be studied separately and compared with the
pneumonias of influenza. It is noteworthy that the lesions of pneumonia
following measles have shown a very close resemblance to the pneumonias
of influenza, with regard both to pathologic characters and to
bacteriology.
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