Influenza : $b An epidemiologic studyVaughan, Warren T. (Warren Taylor)
History
Influenza : $b An epidemiologic study
Vaughan, Warren T. (Warren Taylor)
Influenza
observed that tuberculosis frequently follows measles. We have recently
been thoroughly convinced that influenza lessens resistance to secondary
infection with streptococcus, pneumococcus, and other respiratory tract
organisms. Shall the tubercle bacillus be added to this list? During the
1918 epidemic we saw men in the army camps who passed through an attack
of influenza-pneumonia and died within a few weeks from tuberculous
pneumonia or miliary tuberculosis. These men had previously been so free
from signs of their tuberculosis, as to be accepted for military service
as healthy individuals. The number of these cases was small, to be sure,
but sufficiently large to convince us that there do exist instances in
which tuberculosis is tremendously fired by an intercurrent influenza.
If we may judge merely by the balance of evidence and risk any
conclusions from such conflicting testimony, we may sum up as follows:
1. Great variation in the interaction of tuberculosis and influenza must
be expected, because of the many stages at which the tuberculous may be
attacked, because of the altered mode of living of known consumptives,
and because of the protected life of most of them.
2. Phthisical patients as a group, may be _relatively_ insusceptible to
influenza infection. This may be due to the tuberculous process itself
or to some extrinsic, but nearly related cause.
3. But many individuals with pulmonary tuberculosis _do_ get influenza.
4. And the disease, having been contracted, in many cases hastens the
fatal termination of the tuberculous process.
5. It may be that this phthisical exacerbation occurs more frequently in
individuals with latent tuberculosis, individuals who are not at the
time mobilizing their protective antibodies.
_Other infectious diseases._—We have found diversity of opinion
regarding the relationship between influenza and tuberculosis, and yet
the latter, being as a rule very chronic and presenting very definite
signs which may easily be followed, should theoretically be a disease in
which the results of study would be quite definite. When it comes to a
study of other maladies we find the same difference of opinion
frequently present.
It has been the experience of many that during influenza epidemics other
acute specific infectious diseases appear to diminish, both in number of
cases and in extent. At Camp Sevier, for example, two measles wards had
been quite constantly full of patients up to the time of the fall
influenza epidemic, while during the time of the epidemic one ward
appeared sufficient to hold all cases of measles. In the stress of the
epidemic this difference was probably more apparent than real, and
certainly is not to be taken as of statistical value.
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