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 B. influenzæ has been recovered from the respiratory tract during
the clinically pure influenza, from the sputum and lung in influenzal
pneumonia, and from the purulent sputum in all grades of bronchitis.
These should all be looked upon as true infections by the influenza
bacillus, the varying manifestations merely differing with the
resistance of the individual. In the epidemic in the fall of 1918
pneumonia was the outstanding feature. Preceding this in the English
publications we have reports of outbreaks of purulent bronchitis.
Macdonald and his co-workers, finding the B. influenzæ frequently
present, considered the condition as one indication of a virulent
infection by this organism. Hammond, Rolland and Shore reported similar
cases, and Abrahams and his co-workers looked upon the cases of purulent
bronchitis as occupying a position, without any definite line of
demarcation, between those with definite broncho-pneumonia on the one
side and those with simple bronchial catarrh on the other. H. E.
Robertson emphasized the serious nature of influenzal purulent
bronchitis and the almost epidemic character and rather high mortality
of the outbreak in the winter and spring of 1917-1918. There were also
numerous mild outbreaks of influenza before the overwhelming culmination
of the last three months of 1918, as reported by Orticoni and many
others and noted by Johnston in this series of papers. Greenwood in an
epidemiological study emphasized the point, previously made evident by
Parsons for the pandemic of 1889-1892, that the mass attack is preceded
by numbers of individual cases. In this country it was noted during the
winter of 1917-1918 and the following spring that the B. influenzæ was
rather frequently found in the respiratory infection in our army camps
(Soper, Cole and MacCallum and others).
It is well recognized that when the actual epidemic struck there were
comparatively few bacteriologists familiar with the B. influenzæ. The
real difficulties of isolation, the more favorable media, the facts of
symbiosis, the importance of carriers, the varying manifestations of the
infection and many of the other vitally important points, although more
or less fully reported in the literature, were nevertheless practically
unknown. It was my own experience, and that of many others. This must be
seriously considered in analyzing many of the reports on bacteriological
findings throughout the period of the severe wave and even after.
_Results of Others During the Recent Pandemic_
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