Studies on Epidemic Influenza: Comprising Clinical and Laboratory InvestigationsUniversity of Pittsburgh. School of Medicine
History
Studies on Epidemic Influenza: Comprising Clinical and Laboratory Investigations
University of Pittsburgh. School of Medicine
Influenza; Influenza Epidemic, 1918-1919
Before satisfactory conclusions can be drawn from these figures it is
necessary to know how many of the 10,036 persons became sick before
vaccination, and whether or not the rate of decrease in this group was
not similar to that shown by the number of patients who developed
influenza during the intervals between their doses of vaccine. The
relatively high percentage of cases following the first and second doses
are capable of explanation on one, or perhaps on all, of the three
following grounds: (a) the general subsidence of the epidemic, which
showed a rapid decrease by the time the third dose was given; (b) the
increased protection afforded by the three doses of vaccine, and (c) the
broken resistance of the patient following sudden sensitization by the
vaccine.
3. Rosenow (21) prepared a mixed vaccine by growing the various bacteria
in glucose broth, for from 18 hours to 36 hours, centrifuging and
suspending the sediment in salt solution and making up the vaccine on a
percentage basis.
FORMULA OF VACCINE
Pneumococci, Types I (10 per cent.), II (14 per cent.) and
III (6 per cent.) 30 per cent.
Pneumococci Group IV and the allied
green-producingdiplostreptococci described 30 per cent.
Hemolytic Streptococci 20 per cent.
Staphylococcus Aureus 10 per cent.
Influenza bacillus 10 per cent.
Most of the vaccine was distributed within a radius of 200 miles of
Rochester, Minn., but samples were furnished to physicians all over the
country, who agreed to return statistics on its use. No evidence was
found that this vaccine caused a temporary break in the resistance of
the user. Out of a total of 20,972 persons vaccinated, 14.6 cases of
influenza, 1.8 cases of pneumonia, with 1.8 mortality, occurred per
thousand in the six weeks following vaccination. As controls, he took
“such persons in institutions, colleges, factories and communities where
vaccine was used, and included only those reports which contained
accurate data as to the incidence and mortality among them.” Among
61,753 such controls he found 229 cases of influenza, 15.7 cases of
pneumonia and 3.4 deaths per thousand. He concluded from his results
that “it appears possible to afford a definite degree of immunity by
prophylactic inoculations to persons against the more serious
respiratory infections during the present epidemic.” It is quite
difficult to agree with Rosenow in his interpretation of the figures as
presented by him, inasmuch as he made no allowance for the stage of the
epidemic at which vaccination was carried out, either among the
vaccinated or the non-vaccinated. Such a comparison would be well nigh
impossible where the vaccine was sent in varying quantities to such a
large number of places.
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