Influenza : $b An epidemiologic studyVaughan, Warren T. (Warren Taylor)
History
Influenza : $b An epidemiologic study
Vaughan, Warren T. (Warren Taylor)
Influenza
These factors having been found to be of little value in his attempt to
explain the varying curves in the 39 different cities, Pearl next
correlated the explosiveness of the epidemic mortality with deaths from
all causes, deaths from pulmonary tuberculosis, from organic heart
disease, from acute nephritis and Bright’s disease, from influenza, from
pneumonia (all forms), from typhoid fever, from cancer and from measles,
in the various cities.
“The outstanding fact which strikes one at once from this table is the
high order of the correlation which exists between the explosiveness of
the outbreak of epidemic mortality in these communities and the normal
death rate from certain causes of death in the same communities. In the
first four lines of the table the correlation coefficients range from
about 6 to more than 10 times the probable errors. There can be no
question as to the statistical significance of coefficients of such
magnitude.
“The highest correlation coefficient of all is that on the first line of
the table, for the correlation of epidemicity index with death rate from
all causes. The existence of this high correlation at once indicates
that an essential factor in determining the degree of explosiveness of
the outbreak of epidemic influenza in a particular city was the normal
mortality conditions prevailing in that city. In the group of
communities here dealt with, those cities which had a relatively high
normal death rate had also a relatively severe and explosive mortality
from the influenza epidemic. Similarly, cities which normally have a low
death rate had a relatively low, and not sharply explosive, increase in
mortality during the epidemic.
“It will also be noted that the correlation in the next three lines of
the table, namely those of pulmonary tuberculosis, so-called, organic
diseases of the heart, and chronic nephritis and Bright’s disease, are
of the same order of magnitude as that between the death rate from all
causes and the explosiveness of the epidemic outbreak of influenza.”
Pearl suggests that this correlation might arise because of differences
in the constitution of populations in the different cities, or, that it
was a factor of geographical position, such as the distance from the
Atlantic seaboard; but that even after correction of the results for age
distribution and geographical position, the net correlations were
actually higher than were the gross uncorrected correlations.
“We may conclude that the most significant factor yet discovered in
causing the observed wide variation amongst these 39 American cities in
respect of the explosiveness of the outbreak of epidemic influenza
mortality in the autumn of 1918 was the relative normal liability of the
inhabitants of the several cities to die of one or another of the three
great causes of death which primarily result from a functional breakdown
of one of the three fundamental organ systems of the animal body, the
lungs, the heart and the kidneys.”
Public-domain text, read in full here on John Shaqi.
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