Influenza : $b An epidemiologic studyVaughan, Warren T. (Warren Taylor)
History
Influenza : $b An epidemiologic study
Vaughan, Warren T. (Warren Taylor)
Influenza
Let us assume that in the interpandemic periods the influenza virus is
widely distributed over the earth, existing in an avirulent form. The
basis for this assumption is the previously described occurrence of
localized epidemics in interpandemic periods. The occurrence of solitary
cases, although of interest, could scarcely be considered as evidence of
the widespread distribution of the virus, but in the case of the small
outbreaks as in 1900, 1907 and 1915, and as in the numerous small
outbreaks described by Hirsch, the character of the epidemic curve is
characteristic. Let us, then, assume that the disease has been endemic
in the United States, together with other localities. It requires no
keen observation to discover in the years 1917 and 1918, Theobald
Smith’s “movement of individuals and masses from one part of the world
to another, whereby the partly adapted parasites become planted, as it
were, into new soil, and the original equilibrium is disturbed.” Not
only was there a tremendous redistribution and concentration of
individuals in our camps in this country, but also there was a further
disturbance of the equilibrium in the outbreak of other infectious
diseases, particularly measles. The effect of the measles epidemic on
the virulence of the streptococcus and allied organisms has been
discussed; presumably the same occurred with respect to the influenza
virus. Howard and Love report that approximately 40,512 cases of
influenza were reported in the United States Army during 1917. They
write:
“In 1917, the death rate for the acute respiratory diseases (influenza,
pneumonias and the common types) increased to 1.71. During the fall of
1917, after the camps were filled with drafted men, acute epidemic
diseases swept through a number of them. Measles was one of the most
prevalent and one of the most fatal of the infectious diseases that
occurred. It was noted during the fall and early winter that there were
a number of cases of pneumonia which were unlike the pneumonia that
ordinarily occurred. This was apparent both to the physicians in civil
life and in the army camps. It was reported by all classes of
practitioners that numerous cases of pneumonia were occurring which
resembled the pneumonia following measles, but occurring among men who
had not had measles recently. In a number of the camps, both in the
north and in the south, rather extensive epidemics of pneumonia occurred
and a number of deaths resulted. The same variety of pneumonia occurred
in the late winter and spring of 1918. In many of the camps pneumonia
was practically epidemic during March and April. In many camps a number
of cases occurred later in the spring and summer. It was again reported
by a number of medical men that these cases of pneumonia that were
occurring were different from the types of pneumonia ordinarily
encountered and very similar to pneumonia following measles, but, again,
that the cases occurred among men who had not had measles recently.”
Public-domain text, read in full here on John Shaqi.
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