Influenza : $b An epidemiologic studyVaughan, Warren T. (Warren Taylor)
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Influenza : $b An epidemiologic study
Vaughan, Warren T. (Warren Taylor)
Influenza
This question cannot be definitely answered, and yet it is one of
extreme importance, particularly with regard to prevention and combat of
the disease. How universally is the influenza virus distributed during
pandemics? What proportion of the population is actually exposed by
invasion with the virus? What proportion of actually exposed individuals
develops the disease? We will refer to this again when comparing
influenza with other infectious diseases, but it is of particular
interest now to review our individuals who were exposed by sleeping with
cases of influenza. Fifty-five per cent. of all individuals sleeping in
the same bed with cases of influenza in 1918 _did not_ contract clinical
influenza. Seventy per cent. of all individuals sleeping with influenza
cases in 1920 _did not_ contract the disease, in recognizable form.
Sixty-nine per cent. of all individuals in 1920 who had not had the
disease previously and who slept with cases _did not_ develop evidences
of the disease.
It is difficult to conceive of a degree of exposure much closer than
that of sleeping in the same bed with a sick individual. And yet it is
equally conceivable that many individuals sleeping in the same bed with
a patient were not penetrated by the virus of influenza. This does not
aid us in answering our question. We do not know whether the more
important factor is that of a natural immunity or that of absence of
actual invasion by the virus.
These results with sleeping contacts form an interesting link in the
chain of evidence started during 1918 by the U. S. Navy and Public
Health Service, and reported by Rosenau and by McCoy and others. These
experimenters working in Boston and in San Francisco carried out
inoculation experiments on human volunteers. The work in Boston, as
reported by Rosenau, was carried on with 100 volunteers from the Navy
between the ages of eighteen and thirty, most of them between eighteen
and twenty-five; all of them entirely well, and with the exception of a
few controls, none having experienced known attacks of influenza
previously. First, suspensions of thirteen different strains of
influenza bacilli, all from cases of influenza during the epidemic, were
sprayed into the nose, eyes and throat of nineteen volunteers. None of
them took sick. Next, secretions from the mouth, nose and throat and
bronchi of acute cases of influenza were collected, pooled, and without
filtration sprayed into each nostril, into the throat during
inspiration, and onto the conjunctiva of each of ten volunteers. None of
them took sick. Some of this same material was filtered through a
porcelain filter and administered in the same manner, with similar
results. One cubic centimeter of each type was administered to each
individual. The interval between the time of collection and time of
inoculation was then decreased to one hour and forty minutes, the
minimum time in which the material could be transferred from hospital to
experiment station.
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