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
history of this epidemic, and in the light of modern medical science,
must feel that the rapidity of distribution was nowhere greater than the
most speedy means of transportation. This very necessary close
connection was demonstrated also in regard to the mode of spread of the
disease; the large cities and the commercial centers were affected
earlier, smaller and country districts followed later, railroad towns
were more frequently attacked than isolated villages, and even from
jails, prisons and workhouses, where quarantine was immediately
attempted, as well as from remote villages where the disease had been
brought, there could be traced a zone of infection spreading into the
country. One interesting point was raised at this time—namely, that in
some places it seemed to spread by leaps and bounds, and at other places
radiating as stated above.
The old controversy of whether influenza is distributed in a radiating
manner or in so-called leaps and bounds is believed to be settled by
consensus of opinion that it occurs in both ways. An opinion expressed
by the study at this time as to whether influenza spreads more rapidly
than any other infectious disease is found in the statement that the
contagion is markedly virulent, the micro-organisms are easily conveyed
from their original seat in the mucous membrane by coughing, sneezing
and expectoration, the great number of persons who, though slightly
affected, carried on their ordinary way of life without hindrance, the
probable longevity of the organisms in convalescents, the brief period
of incubation of two or three days, the susceptibility of all people of
every age and vocation, and the possibility of carrying the contagion by
merchandise and even through short distances in the air, are all
suggestive reasons for this. No one at present accepts the so-called
miasmatic nature of the contagion. Proofs are ample to show that one
case must be present in a locality or even family, although it may be
frequently overlooked, from which the epidemic spreads. During this
period of 1889 and 1890 the duration of the actual epidemic period in
different localities in Europe was from four to six weeks. This was
subsequently shown to be consistent with the recorded reports from the
various cities in the United States. Following this pandemic in the
first part of the year in 1891 there were numerous epidemic outbreaks in
various parts of America, including New Orleans, Chicago, Boston, and
simultaneously in England. Strange to say, at this time neither Germany
nor France had such epidemics, although both were exposed by travelers,
particularly from England and America. The question was raised at that
time whether the Germans, French or other continental nations were more
immune than Americans and English. In the fall of 1891 and the entire
winter of 1892 the disease was extensively prevalent both in Europe and
Northern America. In these later epidemics there was no definite
direction of spread.
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