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
Agglutination tests have been used by many investigators in attempts to
determine a specific reaction in the sera of persons suffering from
influenza. Such reactions develop, as we know, against secondary
infecting bacteria, so that unqualified conclusions cannot be drawn that
agglutinins in the sera of patients against B. influenzæ indicate the
etiological importance of this organism. Vagedes using a dilution of
1-50 found 8 positives among 27 patients tested. Lord found the test
most inconstant. Ghedini obtained useful results by using serum in
dilutions 1-20 to 1-30, and had 17 positives from 28 influenza cases. He
found agglutinins present three to four days after the height of the
infection, and noted that the sera became practically normal after three
to four weeks. Fichtner, although he obtained agglutination with sera of
influenza patients in high dilutions (1-100 and 1-750), found his
controls were often agglutinated, and consequently drew no conclusions.
Wollstein (1906) did a series of agglutination tests, using various
strains of B. influenzæ. The sera of patients she found very
unsatisfactory, but by immunizing rabbits with this organism she
obtained sera with titres up to 1 in 400. She could find no differences
among the various strains studied. Somewhat similar results were
obtained by her in 1915 working with strains from the meninges and the
respiratory tract. Odaira carried out a rather extensive series of
tests, using immunized rabbit sera and a special method of making his
bacterial emulsions. He was able to distinguish B. influenzæ from both
B. pertussis and the so-called Cohen’s bacillus of meningitis.
Friedberger’s dog bacillus, however, could not be differentiated from B.
influenzæ by this means. A. Fleming during the recent epidemic had good
results with the sera of 21 patients. He incubated at 50° C. for two
hours. He also used sera of immunized rabbits and got marked
agglutination against the homologous strain, but varying results with
other strains. He noted some strains agglutinated readily, while others
did not. Eyre and Lowe noted an increase in agglutinins in the sera of
people vaccinated against the influenza bacillus. Couret and Herbert
could distinguish two types and a possible third among their strains.
Park and his co-workers found numerous types by means of agglutination.
Absorption of agglutinins was found helpful by these last two workers.
There are so many factors capable of altering the sensitiveness of
bacteria to agglutination, as in the well-known experiments of Neufeld,
that we must recognize that much work is still to be done before we can
properly interpret the results of these agglutination tests.
_Binding of Complement_
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