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
When a sufficiently large dose of vaccine is given to an individual
there is usually a transient rise in temperature for from 12 to 48
hours; the local focus of injection becomes sore and inflamed, and a
white count often shows an actual increase in the number of
polymorphonuclear leucocytes in the general circulation. A series of
doses are usually given. If after a few days blood is withdrawn from the
patient and immuniological tests made, it will generally be found that
the patient’s leucocytes take up bacteria, and particularly the type of
bacteria of which the vaccine was composed, more readily and in greater
numbers than the leucocytes of the ordinary individual. Wright and
Douglas (52) and Neufeld and Rimpau (53) have shown that this effect of
increased phagocytosis is brought about by the vaccine through the
production of substances which act specifically on the bacteria and
render them more susceptible to inclusion within the white cells. These
substances belong to the group of antibodies, and are known as
“opsonins” or “bacteriotropins,” and are specific for any given
bacteria. Moreover, the serum of the patient will, as a rule, be found
to have developed the faculty of agglutinating and bacteriolysing
suspensions of the specific organism injected and of fixing complement
in the presence of an antigen prepared from that organism. In animal
work it has been possible to go still farther, for it can be shown that
the resistance of the animal can be raised until it is no longer
possible to kill it with the same dose which is found to be fatal for
the unimmunized animals. Not only has animal work made it possible to
determine the protective powers of vaccines, but it has also served to
show the specific nature of the protective power and the relative extent
to which “group” or “crossed” protection can be conferred by vaccinating
with closely allied organisms—as, for instance, paratyphoid bacilli in
typhoid fever. The non-toxic nature of vaccines is also determined by
animal experiment before such preparations are injected into humans.
The most successful prophylactic bacterial vaccine which has been
developed so far is that for typhoid fever. A comparison of the
occurrence of typhoid fever in the United States Army before and since
the use of anti-typhoid vaccine is all that need be cited to convince
one of its value. At the time of the Spanish War there was no
vaccination against typhoid fever, and there were 20,738 cases, with
1,580 deaths, among 107,973 men who remained in the camps in the United
States during the war (54).
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