Further report and papers on epidemic influenza, 1889-92 / with an introduction by the Medical Officer of the Local Government Board.

  • Great Britain. Local Government Board
Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: Further report and papers on epidemic influenza, 1889-92 / with an introduction by the Medical Officer of the Local Government Board. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    67/204 page 51
    but there is a difference of opinion among observers as to wliether any On the luHuenza protection at all is afforded, some considering that a certain degree of i8S9-9i?T89i, an i protection is afforded, though it may be an incomplete or transitory one ; Va^rsons while others, on the other hand, consider that one attack rather pre- disposes than otherwise to another. In this matter we have to distinguish between relapses occurring Relapses, shortly after the primary attack, and second attacks occurring iu a subsequent epidemic. The frequency of relapses is admitted, as men- tioned in my previous report (p. 68). Dr. William Squire has published (Lancet, August 16th, 1890), some cases of I'elapse oc- curring, wliere every care was taken to prevent fatigue and exposure during convalescence. As regards second attacks in a subsequent epidemic. Dr. Squire says, Second attacks. Not only is one attack not protective against a recurrence, but it seems to me rather to predispose to it. The medical officer of health of Ulverston states that one attack of Influenza is not protective against another. Those who had it in 1890 were the first to be seized in 1891. He himself, who had had Influenza in 1857, had it again in 1890, and three times in 1891. The medical officer of health for the Kirby Moorside rural district (who estimates that half of the popidatiou of his district were attacked during the epidemic in the spring of 1891) says that those attacked in 1890 (when the district on the whole was lightly affected) did not escape in 1891 ; thus one family tlnit had three or four well-marked cases in 1890, had three of the same members again attacked in 1891, proving that an attack does not confer immunity. The medical oflBcer for the Haresfield division of the Wheatenhurst rural district says that some persons have been attacked four times in two years (apparently including rcdapses). Dr. Davidson, of Congleton, says that one attack seems to confer no protection against another, and believes that not only may a person be attacked after three months' interval, if living in one place, but that he may after an interval of only a fortnight, if he remove into a district in which the disease has recently become epidemic; showing, he thinks, that the interval of immunity depends not upon any quality of the indi- vidual, but upon that of tlie poison necessary to infect him. A lady sufi'ered from Influenza in Congleton, early in May 1891. At the end of a fortnight she went to London, where the epidemic was more recent, and immediately became infected again. When well enough to travel she went to Scarborough where Influenza had just broken out, and con- tracted it again, thus having three severe attacks in less than six weeks. [It is possible that in this history other medical men would look upon the later attacks as relapses, perhaps brought on by exposure and fatigue in travelling, rather than as the result of repeated contracting of infection. Moreover, the dates given do not accord with my infor- mation. Influenza began to be epidemic in London at the end of April or the beginning of May 1891, and, according to Dr. Cuff, of Scar- borough, it prevailed as an epidemic in the neighbourhood of Scarborough from the beginning of April to the end of May.] On the other hand. Dr. Caldwell Smith says :— One attack does not confer complete immunity on all individuals; but looking over my cases, I find that in the last epidemic, viz., that in November and December 1891, and January 1892, 75 per cent, had never suffered in the two previous epidemics. The other 25 per cent., viz., those who did suffer before, may be divided into four classes - (L) Those suffering from any chronic lung affection, as bronchitis and phthisis. D 2
    digitised image 1
    digitised image 2
    digitised image 3