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
Sporadic cases of influenza appear during inter-epidemic periods and
more or less healthy carriers are frequent. Scheller’s study in
Königsberg showed, if we can rely on his figures, that the carriers were
very numerous during an epidemic year (winter 1906-1907), being 24 to 33
per cent.; that as the epidemic became less widespread (winter
1907-1908) it fell to 10 to 13 per cent.; as it was disappearing (summer
1908) he found only 1.5 to 3.3 per cent.; while when the epidemic was
completely over (winter 1908-1909) there were no carriers of B.
influenzæ found. These results are taken from studies of sputa and
throat smears of 138, 218, 155 and 185 cases, respectively, for the
periods mentioned. The monumental work of Tedesko, who reported the
results of 1,479 cultures, covering 11 years (1896-1906), would indicate
that B. influenzæ is continually present in the population. However, in
carefully analyzing his results, it is very clear that in the great
majority of his cases it was of definite etiological significance.
Lobular pneumonia, acute, purulent and chronic bronchitis, and most
frequently clinical influenza, are the prominent diagnoses in all his
tables. He was able to grow B. influenzæ repeatedly from individual
patients for many months.
Lord in similar studies (1902, 1905, 1908) brought out somewhat similar
facts. He laid particular stress on the cases of chronic bronchitis with
numerous B. influenzæ in the sputum and a probable confusion of these
with pulmonary tuberculosis. He was able to follow a number of his
patients for several years. B. influenzæ was grown in culture from the
sputum of one of these in 1902; in November, 1903; in February, 1904,
and in February, 1905. In other cases the organism was shown to be
present by culture practically continuously for months and even years.
Lord, with Scott and Nye, in a recently published article (1919)
reviewed his former results and showed a relatively high incidence of B.
influenzæ in the respiratory tract of apparently healthy people. Davis
studied 534 cases, further indicating the prevalence of this organism in
the community.
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