Influenza : $b An epidemiologic studyVaughan, Warren T. (Warren Taylor)
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Influenza : $b An epidemiologic study
Vaughan, Warren T. (Warren Taylor)
Influenza
Not every individual acquires influenza. There are those who assume that
the disease is so wide spread that every individual in each community
attacked has been actually exposed to the disease. In that case there
must be a certain amount of natural immunity which protects around sixty
to eighty per cent. of most populations from the disease. The other
extreme would be that every exposed individual falls victim to the
disease and that only twenty to thirty or forty per cent. are actually
exposed. The true state probably lies between these two extremes.
Nevertheless it is a fact that some individuals naturally insusceptible
to the disease fall victim as a result of the action of some extraneous
force, something which lowers their resistance. Raw recruits in the army
camps in the fall of 1918 contracted the disease in much greater
proportion than did the hardened soldiers. Fatigue, intercurrent
illness, environmental changes and exposure to inclement weather may all
predispose to infection in the individual. Greenwood found that the
compulsory rationing of food in England during the war was probably not
a predisposing cause of infection. The incidence of the disease in the
South Africa Union where food was abundant was even higher than that for
the British Isles. Hamer calls attention to the fact that the ages of
highest incidence during the pandemic were those ages in which the diet
was perhaps more restricted than in other ages. This, however, is but
one factor and cannot be accepted as conclusive.
It had been suggested that in the army camps in the United States
typhoid vaccination during the epidemic predisposed to the disease. The
similarity of the symptoms in vaccine reaction and in influenza may have
suggested this. V. C. Vaughan has investigated this possibility and
finds that those organizations in which anti-typhoid vaccine was
discontinued for a time after the appearance of the influenza suffered
quite as severely as those which submitted to vaccination.
Other predisposing causes, such as the incidence of crowding in a
household and the sanitary surroundings of the individual will be
discussed later.
PERIODICITY.
The phenomenon of occurrence of epidemic influenza in many countries,
even on different continents almost simultaneously and often without any
clearcut progressive spread from one of these countries to another
raises the question of periodicity in influenza. Is this simultaneous
occurrence due to some mechanism in the life cycle of the influenza
virus whereby it regularly acquires increased invasiveness, no matter
what its geographical distribution, or is it merely a feature of the
meteorologic conditions that makes the epidemic appear to be
simultaneous in widely scattered communities?
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