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
From cultures of the nose and throat of 357 examined before the epidemic
struck, B. influenzæ was found in 5.1 per cent.; in 366 throat cultures
of influenza cases without physical signs of pneumonia the same organism
was grown in 44, or 8 per cent.; sputa typed for pneumococci 740 times
from influenza cases with pneumonia gave isolations of B. influenzæ 38
times, or 5 per cent.—8 times alone, but here it should be remarked that
these latter isolations were only attempted after the organism was
suspected from the morphological picture of the smears; from 280
autopsies B. influenzæ was recovered 8 times from the lung and 3 times
from the heart’s blood. This report covered the period from the outbreak
of the epidemic, October 5 (or as given by Soper, September 30) to
October 22, at the outside a period of 22 days. During this time 366
throat cultures, 510 blood cultures, 740 sputa typed for pneumococci,
280 autopsies with cultures from both lung and heart’s blood, made a
total of primary cultures of well over 2,000. The technical difficulties
would make it almost impossible to handle such a mass of material and
get reliable results for the incidence of B. influenzæ.
Brem, Bolling and Casper in Camp Fremont found B. influenzæ in 259 from
537 selected cases in swabs from the nasopharynx. It was also noted in a
fair number of other examinations. Opie and his co-workers found B.
influenzæ to be very frequent at Camp Pike. Spooner, Scott and Heath
isolated B. influenzæ at Camp Devens from the sputa of 104 cases, from
nasopharyngeal swabs in 11 out of 18 attempts and from the pleural fluid
8 times out of 45, twice pure. From 37 autopsies they found B. influenzæ
in 23 and in pure culture in at least 1 lobe of the lung in 16. From 82
blood cultures at autopsy B. influenzæ was recovered twice. Nichols and
Stimmel studied lung punctures during life and grew the B. influenzæ
from 7 out of 10 attempts, 5 times in pure culture. Stone and Swift at
Fort Riley found B. influenzæ in 18.7 per cent. of 928 sputa and in 5.2
per cent. of 77 sputa from fatal cases. He recovered it from autopsy
material; 21 times from 51 lungs, once alone; twice from 26 pleural
fluids; twice from 30 heart bloods; 19 times from the sinuses of 40, and
9 times from the ear and mastoid of 17 cases.
Lamb and Brannin at Camp Cody examined 80 typical cases early in the
epidemic. They found B. influenzæ predominated in 46 per cent. being
present with pneumococci on 41 per cent. of the plates. They also grew
the influenza bacillus from a fair number of other cases.
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