Influenza : $b An epidemiologic studyVaughan, Warren T. (Warren Taylor)
History
Influenza : $b An epidemiologic study
Vaughan, Warren T. (Warren Taylor)
Influenza
Up to the present time we have discovered no one characteristic by which
we may say that a case or an epidemic is positively influenza. We have
had to rely on the general symptomatology, which indeed is sufficiently
characteristic, although so nearly like the symptoms of certain other
diseases as to make us hesitate to make an absolute diagnosis, and on
the epidemic characteristics. The necessity of an absolute criterion in
the clinical diagnosis is particularly felt in the presence of an
isolated interepidemic case, or a small endemic outbreak. It is at this
point that the opinions of epidemiologists diverge, a divergence which
results in two schools of thought in the explanation of the endemic
source of epidemic influenza. Are the interepidemic cases and the small
localized epidemics due to the virus which causes the great pandemics;
are they _influenza vera_, or are they entirely different diseases with
similar symptomatology, caused by some other microorganism and should
they be designated by some other name? Thus Leichtenstern remarks: “When
we go over the records of the years 1173 to 1875, and particularly those
of the last century, when the information has been more extensive and
more accurate, we find that scarcely a year has passed without news of
the epidemic occurrence of influenza at some point or other of the
earth. Some of these local and territorial epidemics are merely endemic
recurrences of the great pandemics which have left the germ deposited in
the various localities. Others of these small epidemics probably have
nothing to do with _influenza vera_, but are local outbreaks of
_catarrhal fever_.”
Contrary to the usual belief, influenza is a disease of quite definite
and distinct characteristics, both clinical and epidemiological. The
symptoms are clear cut, with sudden onset, severe prostration out of all
proportion to the clinical symptoms and to the fever, headache and pain
in the back, general body pains, and fever of greater or less degree.
There is usually a lack of leucocytosis or a true leucopenia. In
uncomplicated influenza there are as a rule no localizing symptoms.
There may be a slight soreness of the throat, or a slight cough, but
these are at best mild. The fever lasts from three to five days and
disappears, while at the same time all of the symptoms clear up with the
exception of the profound prostration, which as a rule continues for
some time, rendering convalescence surprisingly slow. The pain in the
back may remain for a week or so. This is the description of
uncomplicated influenza.
Public-domain text, read in full here on John Shaqi.
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