Influenza : $b An epidemiologic studyVaughan, Warren T. (Warren Taylor)
History
Influenza : $b An epidemiologic study
Vaughan, Warren T. (Warren Taylor)
Influenza
The fatal case had the subjective symptoms familiar to influenza. The
physical findings were similar to those occurring in influenza in the
later epidemics. The leucocyte count was 4,300. A blood culture showed
in twenty-four hours a heavy growth of small non-motile, gram-negative
bacilli which the authors concluded to be Bacillus influenzae. The
leucocyte counts made at five hour intervals on a later date were
respectively, 3,400, 2,200 and 2,300. A second blood culture taken on
April 10th, a day later, also showed a pure culture of the same
organism. The leucocyte count had risen to 5,600. At necropsy a
confluent bronchopneumonia was found. There was no pleural effusion and
the other viscera showed nothing remarkable. Bacillus influenzae was
recovered from cultures taken from the lung and spleen.
Throughout this epidemic the clinical picture of the disease was
characteristic. Nearly every patient gave as the initial symptoms
backache, headache, slight cough or sore throat. Conjunctivitis and a
marked injection of the soft palate were noted in ninety per cent. of
the cases. In addition, a slight or moderate general adenopathy was
often observed. The face was flushed and in a few cases the skin of the
thorax presented a mild erythema. In three cases a provisional diagnosis
of scarlet fever was made until the blood count showed a leucopenia.
Leucopenia was characteristic of all cases.
During the early April epidemic at this camp, nasopharyngeal cultures
showed an organism resembling Bacillus influenzae in seventeen out of
thirty-three cases, but the identity of the organism was not established
by subcultures. In ten cases in which sputum examinations were made,
Bacillus influenzae was found in only four; streptococci were present in
six. Blood cultures on twenty consecutive non-fatal cases, only one of
which was complicated by bronchopneumonia, were all negative.
V. C. Vaughan reports that at Camp Shelby, Hattiesburg, Miss., there was
in April a division of troops numbering about 26,000. An epidemic of
mild influenza struck this camp in April, 1918, and within ten days
there were about 2,000 cases. This included not only those who were sent
to the hospitals, but also those who were cared for in barracks. This
was the only division that remained in this country without change of
station from April until the fall of 1918. During the summer this camp
received 20,000 recruits. In October, 1918, the virulent form of
influenza reached this camp. It confined itself almost exclusively to
the recruits of the summer, and scarcely touched the men who had lived
through the epidemic of April. Not only the 2,000 who had the disease in
April, but the 24,000 who apparently were not affected, escaped the fall
epidemic.
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