Influenza : $b An epidemiologic studyVaughan, Warren T. (Warren Taylor)
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Influenza : $b An epidemiologic study
Vaughan, Warren T. (Warren Taylor)
Influenza
He believes that many of the conditions diagnosed as influenza have been
no more than ordinary colds, and that the average patient will call any
upper respiratory tract infection grip during or around the time of an
epidemic. He further believes that a misdiagnosis of tuberculosis is
frequently made in influenza convalescents who show some signs of
moisture in their lungs which does not clear up for some time, causing
doubt in the mind of the examiner, but which is not truly tuberculous in
origin. Fishberg cites P. J. Murphy, Hawes, Armstrong, McRae, and
Dickinson, as well as Geiber and Schlesinger, in Vienna, and Rickmann
and Ladeck in Germany, as having observed the same phenomenon of
relative insusceptibility of tuberculous patients and failure of
influenza to hasten the progress of tuberculosis. He also calls
attention to the low incidence of influenza in tuberculosis sanatoria,
but apparently compares this incidence with the incidence for the public
at large, and not with that in similar institutions devoted to the care
of invalids with diseases other than tuberculosis, or with other
institutions in general.
Amberson and Peters, as well as Minor, take sharp exception to the
statement of Fishberg, and the former have collected the evidence
against Fishberg’s view. They first point out that a comparison of the
incidence of 5.4 per cent. among hospitalized tuberculous patients at
Chicago cannot be compared with a much higher incidence of the epidemic
in the various military camps. As Heiser has pointed out, the mere
quartering of men in barracks seems to have a tendency to increase the
risk from acute respiratory diseases. Furthermore, the incidence at some
sanatoria was low, while at others it was high, nearly as high as for
the community at large. In Hawes’ report of the epidemic among the
Massachusetts sanatoria, Lakeville had escaped entirely, while Rutland
which consisted chiefly of ambulatory cases, less easily controlled, had
an influenza incidence of 18.3 per cent. among the patients, and 21.3
per cent. among the employees. At Montefiore Home, the proportion of
tuberculous patients and employees contracting the infection was
practically the same as among the nontuberculous employees, and about
the same percentage of both groups developed evidence of
bronchopneumonia.
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