Influenza : $b An epidemiologic studyVaughan, Warren T. (Warren Taylor)
History
Influenza : $b An epidemiologic study
Vaughan, Warren T. (Warren Taylor)
Influenza
The date and site of onset of the great pandemic are subjects concerning
which there is no conclusive information. There have been small
outbreaks of clinical influenza with epidemic tendencies at one place or
another during nearly all of the intervening years since 1889. In all of
them the question is open as to whether they were true influenza, and
also assuming that some were true influenza, how many of them should be
so included. There are some who believe that the increase of morbidity
following the measles epidemic in the United States Army camps in the
winter of 1917–18 is genetically associated with the great pandemic. In
short, there is no one point in the last few years at which we may say
that influenza which had previously been non-existent started at a focus
and spread throughout the world.
It follows from the experience of 1889 that we should at least attempt
to find an endemic focus and to follow the progression of the disease.
It is safe to say that once having become pandemic the disease spread as
it did thirty years previously. Experience in this country, where the
autumn spread began in the New England States and continued West and
South; knowledge of the late spread to remote localities; the fact that
the disease first appeared in England, etc. in sea coast towns; the
introduction of the influenza into new countries at seaport towns, after
the arrival of infected ships, all coincide well with the past history.
But which of the several local epidemics of the preceding years was the
direct progenitor of the great pandemic? In order to follow more clearly
the development of the facts we will record here the various hypotheses
that will come up for consideration as to the site of origin of the
disease.
1. Influenza is endemic in some one locality, such as Turkestan in Asia,
from which place the disease spreads throughout the earth at intervals,
after having acquired in some way greatly increased virulence. The local
outbreaks of interepidemic times are not due to the virus which causes
the great pandemics and should be called pseudo-influenza in contrast to
influenza vera. Following the pandemic it is true, however, that for a
succession of years local outbreaks occur, due to the pandemic virus
which has been left deposited in small endemic foci. These disappear in
the course of a few years.
2. The second hypothesis is similar to the first, except that in it is
considered the possibility of there being more than one endemic focus,
at least two, one in the old world and one in the new. Although
Leichtenstern believed in the first hypothesis he did not deny the
possibility of the second.
Public-domain text, read in full here on John Shaqi.
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