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
The question of the value of wearing a gauze mask over the mouth and
nostrils during an influenza epidemic is still an open one. Masks,
however, have been found useful in protecting against some other
diseases of respiratory origin. In December, 1917, Weaver (40) reported
favorably on the use of gauze masks in the Durand Hospital of Infectious
Diseases. The masks were used by nurses in attendance upon patients with
contagious diseases, and also by patients who were convalescing from
diphtheria, meningitis or pneumonia and who were in the same wards with
those having other respiratory diseases. In a later article Weaver (41)
stated that by the use of masks they had been able to reduce the
percentage of diphtheria carriers among their nurses in the diphtheria
wards to 5.2 per cent., as compared to the average of 23.25 per cent.
during the 20 months immediately preceding their adoption of their use.
He recommended the general use of masks for physicians when in contact
with all types of respiratory diseases. In March, 1918, Capps (39a)
reported encouraging results in the control of infections through the
masking of all patients at Camp Grant. During the epidemic the wearing
of masks became quite general, and was very popular in many sections.
Several sets of laboratory experiments have been carried out recently to
determine whether the masks are of practical value or not. The
experiments have generally consisted in spraying cultures of living
bacteria over sterile bacterial plates which were protected by one or
more layers of gauze. A number of variations were made in the manner in
which this was done: (a) the distance between the nozzle of the spray
and the mask was varied, and the distance between the plate and the mask
kept constant; (b) the distance between the plate and the mask varied,
and the distance between the nozzle and the mask kept constant; (c) the
use of masks both over the nozzle of the spray and over the plate being
kept constant, and the distance between the two masks varied. In a
somewhat different set of experiments the mask was placed over the mouth
of a person, who was told to talk or cough over an agar plate, and the
bacterial plate being held at various measured distances from the face.
By counting the number of colonies which developed upon the plates it
was possible to get fairly reliable data as to the efficiency with which
the bacteria were intercepted by the gauze. Weaver (42) found that if
enough gauze was used, it would filter out all of the bacteria passing
from the spray in the direction of the plate. The efficiency of the mask
being in direct proportion to the fineness of the mesh and the number of
layers employed. Doust and Lyon (43) made a series of experiments to
determine the distance through which droplets are carried when expelled
under different circumstances. They found that in ordinary speech
infected material is projected for about four feet, and that during
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