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
lungs at autopsy, where special cultural methods were in use and where
the laboratory personnel was large enough to devote a sufficient amount
of time to each individual culture. All of these points indicate that
the organism was overlooked in a great many instances. In our laboratory
we found the examination of sputa very unsatisfactory because of the
great amount of contamination, and because the bacillus seemed to lose
its ability to grow after a relatively short time in the sputum in
vitro. Moreover, I am convinced that the bacillus changes its morphology
to such an extent under varying conditions as to make it impossible of
identification when present among other organisms in sputum smears. The
failure of animal inoculations is also not conclusive evidence against
the Pfeiffer organism, because guinea pigs, rats and mice have a natural
immunity for them. Rabbits are only slightly susceptible, and then only
to intravenous injections. The mixture of the Pfeiffer bacillus with any
one of several other pathogenic organisms will increase the
pathogenicity of both. Monkeys inoculated intracranially develop a
typical Pfeiffer bacillus meningitis.
Whatever the ultimate outcome of the investigations as to the parasitic
cause of epidemic influenza, the Pfeiffer bacillus was the generally
accepted cause at the beginning of the 1918 epidemic, though it was at
once realized that most of the deaths were due to complicating
pneumonias and to secondary infections with other organisms. Under the
circumstances, one of two courses was open: (a) the acceptance of the
Pfeiffer bacillus as the presumptive cause of influenza and the
preparation of a specific prophylactic vaccine against infections with
that organism; or (b) the use of a mixed bacterial vaccine containing
the common and most deadly secondary infecting organisms, designed to
increase the patient’s general resistance by decreasing his
susceptibility to the allied, collateral and secondary infecting agents.
Attempts were made along both lines, with more or less unsatisfactory
results.
_The Attempt to Develop a Specific Prophylactic Vaccine by the Use of
Pure Pfeiffer Strains_
By a specific prophylactic vaccine for any given disease, we mean a
material which when inoculated into an individual will actively protect
that individual against the given disease. In infectious diseases, the
immunizing material is usually of microparasitic origin (in contrast to
desensitizing substances used in pollen diseases and those due to
unusual sensitiveness to foreign proteins), and is specific only for the
disease caused by the microparasite from which the material was
prepared. With the knowledge in hand during the epidemic, the logical
plan seemed to be to prepare a pure Pfeiffer bacillus vaccine, the
object of which was to eliminate primary infection with that organism
and thus prevent the secondary invaders from obtaining a fertile soil.
Public-domain text, read in full here on John Shaqi.
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