Influenza : $b An epidemiologic studyVaughan, Warren T. (Warren Taylor)
History
Influenza : $b An epidemiologic study
Vaughan, Warren T. (Warren Taylor)
Influenza
An objection will be raised, and justly so, that we have up to this
point been studying influenza in families irrespective of how many cases
there are in each family. Until now the family with one case was
classified exactly the same as the family with eight cases. In the
following classification we have taken first all families with a maximum
of one sleeping in one room, and sub-divided these into families with no
influenza, those with one case, two cases, etc. We have likewise
classified families with maxima from two to six per bedroom. For the
sake of brevity we will consider only the last column of Table VII,
influenza incidence among the individuals of the various classes of
families for both epidemics. Study of the table will show a
correspondence in the other columns. Solitary cases were more numerous
in families with but one or two per bedroom (27 per cent.) and less
frequent in families with three, four and five per bedroom, (23 per
cent., 18 per cent., and 20 per cent., respectively). The families of
six per bedroom form such a small group that here again they should not
be considered. Multiple cases become progressively more numerous as the
number of individuals per bedroom increases (14 per cent. in families of
one per bedroom, 29 per cent. in two per bedroom, 41 per cent. in three,
51 to 52 per cent. in four, and 45 per cent. in five). Fifty-eight per
cent. of families with a maximum of one per bedroom, 43 per cent. with
two per bedroom, 35 per cent. with three, 31 per cent. with four and 35
per cent. with five had no influenza at all.
But here again, the fact that crowded families are usually large
families interferes with drawing any conclusions. A family with four per
bed room would generally be larger than one with two per bed room.
Frost observed that, considering the ratio of incidence in total white
populations irrespective of housing as 100, and after adjusting all
groups to a uniform sex and age distribution, the ratio where there were
more than 1.5 rooms per person was 77, from 1 to 1.5 rooms per person
the ratio was 94, and for individuals averaging less than one room per
person it was 117. _The attack rate showed a consistent increase as the
number of rooms per person decreased._
Woolley observed, “Housing, if one includes in the term overcrowding,
has surely been an important factor in spreading the epidemic. Whether
it has had any appreciable effect upon the incidence of complications is
a question. The epidemic has certainly gone faster and was over sooner
because of the crowding; the hospital was filled sooner than it should
have been as a result of the rapidity of spread of the disease, and
overcrowding of the hospital occurred when with a less rapid spread it
would not have occurred; but whether the number of fatalities or the
number of pneumonias was greater than they should have been with less
crowded conditions may be doubted.”
Public-domain text, read in full here on John Shaqi.
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