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
While specific Pfeiffer bacillus vaccines had been tried in treatment,
the field was a comparatively new one so far as prevention was
concerned. Many of the biological products companies had so-called
influenza vaccines on the market for treatment purposes, and many of
these contained Pfeiffer bacilli. A few preparations of pure strains of
the bacilli were also available, but I was unable to find any records of
their use for prophylaxis. Lacy (2) reported two cases of sinusitis
treated with autogenous vaccines made from pure Pfeiffer strains—one
patient improved rapidly and the other showed no change. Investigation
of several of the other references on influenza vaccines showed that
mixed vaccines had been used in each instance. The work of Flexner and
Wolstein (3, 4 and 5) indicated that active immunizing substances could
be prepared from the Pfeiffer bacillus, although they worked with serum
instead of vaccines. They prepared an anti-influenza-meningitis serum by
immunizing goats and horses. These sera cured monkeys of experimentally
produced influenzal meningitis. The sera showed agglutinins and
bacteriotropins for Pfeiffer bacilli, as well as positive fixation tests
in dilutions of 1 in 100, but they contained no lysins. The serum was
offered for intradural use in treating influenzal meningitis, but was
found to have no value when used in human cases.
The first references which we have found on the use of pure Pfeiffer
bacillus vaccines for the prevention of epidemic influenza were those of
Leary (6), (7), and of Rosenau (8). Shortly after the appearance of the
first influenza cases in Boston, Leary used a vaccine prepared from
several strains of Pfeiffer bacilli both for the treatment of influenza
and for its prevention. The vaccine for the latter purpose was given to
medical students and nurses, and the first results were apparently very
encouraging. Continued use has not been convincing. Barnes (9) reported
an attempt to protect the employees and patients of an institution near
Woonsocket. On October 9 a case of influenza developed in the female
ward, and was followed five days later by another. On October 22 the
disease appeared in the male ward, and the same day 172 employees and
patients were given their first inoculation with Leary’s vaccine. Doses
of 400, 800 and 1,200 million bacilli were given at 24–hour intervals.
All persons who had developed influenza before the three doses had been
completed were excluded from the computation of the disease incidence,
which was found to be 20 per cent. both among vaccinated and
unvaccinated individuals. The mortality rate was 16 per cent. for the 25
cases among the vaccinated, and 15.8 per cent. among 57 unvaccinated
patients. The result failed to show any protective qualities for the
vaccine.
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