Influenza : $b An epidemiologic studyVaughan, Warren T. (Warren Taylor)
History
Influenza : $b An epidemiologic study
Vaughan, Warren T. (Warren Taylor)
Influenza
“Of 65 towns which experienced all three waves 47 (72 per cent.) had
their maxima in the summer and spring epidemics within an interval of
32–34 weeks; but comparing the week in which any given town had its
epidemic peak in the summer and autumn, and autumn and spring epidemics
only 27 (41 per cent.) and 31 (47 per cent.) respectively fell within
the limit of a week on either side. The time relationships of the maxima
in summer and spring were much closer to each other than they were to
the autumn maxima.
“If it should prove correct that there were three strains of the
influenzal virus, each with a periodicity of about 33 weeks, and that
simultaneously all three strains became enhanced in both virulence and
infectivity, then we are faced with a phenomenon without an exact
parallel, although the behavior of the meningococcal viruses during the
war presents some points of similarity. So far the weight of evidence
leans to such an exaltation of a widespread endemic strain or strains
rather than to dissemination from any particular focus in the world. In
any case doubtless a good deal of spread of infection took place.”
Spear takes exception to the work of Brownlee and Stallybrass, and
points out that the periodogram is not applicable to the study of
recurrent epidemics unless the recurring waves are of approximately
uniform “amplitude.” In that case nothing could be less appropriate for
this study than the influenza waves which vary from very small to
extremely high, as in 1918.
Spear describes two simple tests which he applied to demonstrate the
existence or non-existence of periodicity.
First he divided each of the last thirty years into 13 four-weekly
periods, and tabulated the frequency with which the observed week of
maximum mortality falls into one or other of the 13 groups. He
discovered that the climax of an influenza prevalence falls more
frequently in the second and third four-weekly period than in
others—_i.e._, the months of February and March. Had there been a
33-week periodicity there would have been an equal number of these
climaxes in each of the 13 divisions of the year.
Brownlee, according to Spear, was correct in his prediction that
influenza would occur in February, 1920, for the reason that January or
February is the most likely time for an influenza prevalence in any
year.
Spear’s second test of periodicity consisted in plotting the
interepidemic periods according to the number of weeks intervening. Were
there a 33-week periodicity, he says, that nearly all interepidemic
periods should fall in this group. As a matter of fact, more than twice
as many periods fall in the 42–58 weeks interval than in any other
interval. Fifteen fall within this period, six in the period 59–75
weeks, five in the period 8–24 weeks, and only four in the period 25–41
weeks. There was one in the period 76–92 and one 110 plus. Finally in
the thirty years 1890–1919 there were thirty-two climaxes or peaks in
the “influenza” mortality.
Public-domain text, read in full here on John Shaqi.
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