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 symptoms, the prospect of recovery was better. This is, of course,
not peculiar to influenza, but it seemed particularly striking during
the epidemic. Sixth, _a gradually rising rate in respiration_, which
often was not more than two per minute per day, if progressive, even in
the absence of other untoward signs, conveyed a serious prognosis.
Our mortality among the civilians in comparison with the soldiers was
exceedingly high. The first cases seen by us were among the soldier
patients sent to the hospital. These were as fine a lot of healthy young
men as one can well imagine. They came to the hospital comparatively
early in the infection. After the first week it appeared as though our
experience would be entirely different from those in other localities,
for we had very few deaths. In another week our mortality began to rise,
but never as high as among the civilians, as will be seen by the
following figures.
Of the 153 soldiers 87 were without lung involvement, and of these none
died; 66 had lung involvement, and of these 16 died. Mortality among the
153 was 10 per cent. Of the 394 civilians 157 were without lung
involvement, and of these 1 died; 237 had lung involvement, or some
other complication, and of these 93 died. Mortality among the 394 was
23.6 per cent.
It will be seen that the mortality in the civilians was more than twice
as high as in the soldiers. It has already been mentioned that the
soldiers were ordered to the hospital promptly. The civilian patients,
on the other hand, were later in coming to the hospital, some of them
appearing when they had already developed serious complications. Another
factor in determining the mortality were the ages of the patients. The
soldiers ranged from 18 to 34 years, with an average of 20 years. The
civilians ranged from 6 months to 73 years, with an average of 30 years.
Generally speaking, the greater the age the higher was the mortality.
A third factor which should be considered in determining the actual
mortality is the result of later complications and sequelæ. The figures
as given are those of 547 patients, 110 of whom had died in the Mercy
Hospital and 437 of whom had been discharged therefrom between September
22 and November 30, 1918, the length of the quarantine. Those who were
discharged had been up and about for a week or 10 days before leaving
the hospital. From our experience with post-influenzal patients admitted
to the Mercy Hospital since November 30, we are of the opinion that some
of the patients discharged before November 30 as recovered may have
later developed sequelæ which might have proved fatal. No follow-up
system has been pursued as yet which enables us to speak definitely and
statistically of the present condition of those discharged.
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