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 communicability of influenza has been observed by all, and the ease
with which it passes from one individual to another noted. One
observation made by us was of considerable interest. In a house where a
patient lay sick with a severe attack of influenza for nearly three
weeks several members of the household passed the door of the sick room
a number of times daily, and yet they did not contract the disease. This
is in marked contrast with the immediate contact between the two
physicians and the young flying officer, who sat in the same railway
carriage compartment for four hours. The same observation was made in
the hospital among nurses in direct contact with patients. A large
number of these contracted the disease, while those not immediately
associated with influenza patients almost invariably escaped. This
speaks strongly against the idea that the epidemic was a so-called
“plague,” or that it passed without intermediate means through the air
and pervaded all places.
From information thus far at hand it seems, therefore, that the
prodromal stage, or stage of incubation, is one which covers about 48
hours, and that it is usually without symptoms unless it be a peculiar
prostration which had been described by some patients. It would also
appear from the experiences just narrated that it was necessary to be in
rather close contact with a patient, so that there could be an exchange
of respired air before infection could take place.
_Duration of the Disease_
In all descriptions of the disease the duration is spoken of as “several
days, more or less,” “a three-day fever,” or “a seven-day fever.”
Because of the careful supervision under which the soldiers were kept
while in the barracks an excellent opportunity was afforded to note the
duration of uncomplicated cases. The shortest time observed was 1 day,
and the longest 10 days. The average duration of temperature among 87
soldiers without inflammation of the lungs or other certain
complications was 6⅓ days. Among the civilians the shortest time of
pyrexia was a few hours only, while the longest in 73 male patients was
14 days, and in 84 female patients was 16 days. The average length of
pyrexia in the males was 4⅝ days, and in the females was 5¼ days.
While the very definite clinical description of the former epidemics of
a so-called uncomplicated influenza seems to have served satisfactorily
to the present time, the laboratory studies and the possibly more
thorough clinical observations which have been carried out recently in
this epidemic make it necessary to present anew the whole disease
picture of influenza, with the hope of suggesting a classification more
in accord with our present knowledge of the disease.
_Forms and Varieties of Influenza_
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