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
If B. influenzæ is the causative agent in clinical influenza, there is
certainly ample evidence that it is pathogenic to man. The symptoms of
toxemia, which are so manifest in the pandemic disease as well as in the
sporadic cases, would indicate that the etiological agent is markedly
toxicogenic. Animal experiments by Pfeiffer, and a long list of
investigators following him, would seem to show that the majority of
cultures of B. influenzæ do not have any power of establishing
themselves in the animal tissue. Killed cultures showed equally as high
toxic effects as the living, and so it was generally concluded that many
of the general effects in influenzal infections were of a toxic nature.
There are many exceptions to the above-mentioned failures to produce
infections in animals. Cantani obtained very constant positive results
by subdural injections. He first clearly showed that killed cultures
were markedly toxic and that virulence could be raised very definitely
by animal passage. By injecting brain emulsion with a culture he
obtained a subcutaneous abscess in a rabbit which after eight days still
contained the living organism. Nastjukoff found that animals with a
lowered resistance, or definitely ill from, for example, an artificial
tuberculosis, became infected while others did not. Jacobson showed that
B. influenzæ injected with streptococci caused a definite mixed
infection, and that after six passages the influenza bacillus alone
could produce a fatal infection. Saathoff (1907) confirmed Jacobson’s
findings and found pneumococci equally effective. Davis (1915) also
confirmed the principle established by Jacobson of the symbiotic
relation of other bacteria to infection with B. influenzæ. He used a
culture of a non-virulent staphylococcus pyogenes aureus, and was able
to produce death invariably in guinea pigs after intraperitoneal
injection. From the heart’s blood, as a rule, only the hemophilic
bacillus was recovered. He also found animal passage increased the
virulence, and further that M. catarrhalis and an avirulent
streptococcus had the same effect as the staphylococcus. Slatineanu
(1901) found that he could infect animals with B. influenzæ if the
cultures were injected along with weak solutions of lactic acid, and
that after animal passage by this method the bacillus became more
virulent and would eventually kill by itself. It must not be forgotten
in this connection that strains of B. influenzæ from meningitis cases
are frequently definitely pathogenic for animals. The importance of
considering these various factors in a discussion of infection by this
organism is, of course, very evident. Ecker found his strains pathogenic
for mice after subcutaneous injection, and the bacilli were readily
obtained from the heart’s blood. Spooner and his co-workers from their
results of more than a hundred intraperitoneal injections concluded that
the organism is not pathogenic for mice.
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