Читать книгу Studies on Epidemic Influenza: Comprising Clinical and Laboratory Investigations - University of Pittsburgh. School of Medicine - Страница 7

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At the Army General Hospital No. 24, located at Hoboken, a few miles outside of the city of Pittsburgh, on September 28 two soldiers were taken ill and, with the disease unrecognized, they were removed to the cantonment hospital at Point Breeze, within the city proper. The men were found a few days later to be suffering from influenza, and from this presumable source an epidemic spread rapidly among the troops and student soldiers located here.

From September 28 until November 20, 1,392 cases of influenza occurred among the enlisted men. How the infection reached the first two cases at Hoboken is not known. The command here consisted of the Student Army Training Corps of the University of Pittsburgh, and Carnegie Institute of Technology, Motor Mechanics of the University of Pittsburgh and the Ordnance and Quartermasters’ Department on detached service. The strength of this command was approximately 7,000. The first case appeared on September 30 and the diagnosis was made on the following day. Beginning October 13, all soldiers of this group were inoculated with two 1 cc. doses of vaccine, obtained from the New York State Board of Health. At the height of the epidemic there were about 840 soldier patients in the several hospitals of the city at one time. Cubicles were used in the hospitals, and in the barracks a floor space of 50 square feet was allowed to each man. The men slept alternately head to foot, with paper screens intervening, which were changed daily. In company formation they were instructed to gargle their throats and clean their teeth morning and night under the supervision of their officers. Strict military quarantine was maintained throughout the entire camp, no congregating was allowed, classes were suspended and only open-air drills were permitted. For the entire command there were 220 cases of pneumonia, with 99 deaths, an average mortality of 44 per cent. The dishes were boiled in the hospitals, and sanitary dishwashers were used in all mess halls. The kitchen help and personnel were inoculated with influenza vaccine, with apparently good results. The Magee Hospital, with 375 beds, was under strict military control. When this was full, all others were treated in the civilian hospitals.

In the city of Pittsburgh the disease was not made reportable until October 5. However, one case was reported on October 1, and it was known that there were a few isolated cases in Pittsburgh previous to that date. During the months of October, November and up to December 21 there were 23,268 cases of influenza reported, and the deaths were 1,374 from lobar pneumonia and 678 from broncho-pneumonia. We cannot but feel that most of the deaths reported during the period of the epidemic as lobar pneumonia were broncho-pneumonia associated with influenza. It was well known among civilians that true lobar pneumonia was exceedingly rare and has remained so up to the present time. This is especially noticeable, as this is the time of the year when lobar pneumonia is usually widespread in Western Pennsylvania. This district was particularly favored with a mild fall and winter. On October 1 the first case was reported, on October 15 the epidemic reached its peak—on that day 957 persons being reported ill with the disease. From October 16 until October 28 it maintained an average of 600 cases daily; from October 29 until October 31 there was a sharp decline from 600 cases daily down to 200 cases daily. From November 1 until December 21 the decline has been uniform, and on this latter date 58 cases of influenza and 7 of pneumonia were reported. The height of the epidemic was reached between October 15 and October 29. During the period of the epidemic in Pittsburgh, from October 1 until December 15, 62 days were recorded as cloudy, or partially cloudy, and only 14 days as clear, although the cloudy days seemed distributed and not in decided groups. The mean temperature for October was 58 degrees, with normal 54.9; for November, 44 degrees, normal 42.9; for December, 41 degrees, normal 34.7. The precipitation in October was 3.08, as against a normal of 2.36; in November, 1.79, with normal 2.55; and in December, 3.50, normal 2.73. From a study of these weather reports we see that the epidemic occurred during a period of abnormally warm, cloudy and slightly more moist autumnal season than usual, but these variations were relatively slight and far from decided. The confusion of diagnosis between lobar pneumonia and broncho-pneumonia, associated with or following influenza, occurred in the Pittsburgh health reports as well as in other cities. The presumption that almost all, if not all, of the cases reported as pneumonia of different types were really cases of influenzal pneumonia, seems justified.