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
Infection of the accessory sinuses of the head has long been recognized
as occurring in influenza. Frankel found B. influenzæ in 4 from 40
infected antra. Lindenthal, who was particularly interested in the
question of sporadic influenza, found the bacillus in one or more of the
head sinuses in six of eight carefully studied cases. He considered that
the B. influenzæ remained in these areas during inter-epidemic times and
from hence caused the sporadic outbreaks of influenza. Howard and
Ingersoll reviewed the literature up to 1898 and grew B. influenzæ from
one of three acute antral diseases. They did not find it, however, in 12
chronic cases. Clemens believed the influenza bacillus to be present in
the sinuses rather frequently in cases where it was overgrown or
difficult to culture from the lower respiratory secretions. Moszkowski
grew it in one case from the pus of the antrum. Tedesko recorded several
positive results and many others are reported in the literature.
The two cases reported by Lacy (1918), the findings during the present
epidemic by Stone and Swift of B. influenzæ in 13 of 28 sphenoidal and 6
of 12 ethmoidal sinuses cultured at necropsy, those by Spooner, Scott
and Heath, of B. influenzæ in four frontal sinuses and in eight
sphenoidal, and the recovery by Wolbach of B. influenzæ in cultures from
the sinuses in certain cases where the lung cultures were negative,
emphasize the importance and frequency of the infection by this organism
in these cavities. Keegan, who laid particular stress on lung punctures
and autopsy examinations, pointed out that in throat cultures the
probability that the influenza focus is often not in the pharynx but in
some recess of the nasal cavity.
H. E. Robertson in the spring of 1918 reported the infection of the
sinuses in seven cases of tracheo-bronchitis with patches of
broncho-pneumonia and the growth of B. influenzæ from sphenoid, ethmoid
or frontal sinuses of all these cases. He also found this organism in
the sphenoid of six cases dying with various diseases as well as in two
accident cases with death under 24 hours. The importance of these
results was laid stress on by the author, not only on account of the
probable toxic absorption and the general menace of spread, but, more
particularly, because such individuals, acting as carriers, could
furnish foci for the spread of epidemics.
_Eye and Ear_
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