| Table IV | ||
|---|---|---|
| Pneumococcus in Cases of Influenza | ||
| NUMBER | PER CENT | |
| Pneumococcus, Type I | 0 | 0 |
| Pneumococcus, Type II | 0 | 0 |
| Pneumococcus, Atypical II | 0 | 0 |
| Pneumococcus, Type III | 2 | 8.3 |
| Pneumococcus, Group IV | 15 | 62.5 |
| No pneumococci found | 7 | 29.2 |
From November 27 to December 1, the pneumococci present in 47 consecutive cases of influenza were determined. In this group specimens of sputum were collected shortly after admission of the patients to the receiving ward of the hospital. The results are shown in Table V.
| Table V | ||
|---|---|---|
| Pneumococci in Cases of Influenza | ||
| NUMBER | PER CENT | |
| Pneumococcus, Type I | 0 | 0 |
| Pneumococcus, Type II | 0 | 0 |
| Pneumococcus, Atypical II | 2 | 4.3 |
| Pneumococcus, Type III | 0 | 0 |
| Pneumococcus, Group IV | 25 | 53.2 |
| No pneumococci found | 20 | 42.5 |
The results obtained show that pneumococci found in early uncomplicated cases of influenza, both early and late in the course of the epidemic, differ in no respect from those found in the mouths of normal individuals at any time.
Similar studies of the prevalence of S. hemolyticus as determined by throat cultures in early cases of influenza are shown in Table VI.
The only point of interest in these observations is the increased prevalence of S. hemolyticus in cases examined late in the epidemic of influenza as compared with that found early in the epidemic. The significance of this will be discussed in other parts of this report.
| Table VI | ||||
|---|---|---|---|---|
| S. Hemolyticus in Cases of Influenza | ||||
| DATE | NUMBER OF CASES CULTURED | S. HEMOLYTICUS FOUND | S. HEMOLYTICUS NOT FOUND | PER CENT POSITIVE FOR S. HEMOLYTICUS |
| Sept. 25–26 | 100 | 6 | 94 | 6 |
| Nov. 27–Dec. 5 | 138 | 39 | 99 | 28.3 |
Presence of Bacillus Influenzæ in Normal Men.—For comparison with the results obtained in cases of influenza a fairly extensive study of the prevalence of B. influenzæ in normal individuals has been made at various times prior to and throughout the course of the epidemic. This was deemed of special importance, since it was obvious that the results obtained by previous workers during interepidemic periods would not in all probability coincide with those obtained in the presence of a widespread epidemic of influenza where the opportunity for the dissemination of B. influenzæ was almost unlimited.
From the results obtained in the multiple cultures in cases of influenza it is obvious that only like methods can be compared. The results obtained in normal individuals have, therefore, been tabulated in groups dependent upon the culture method employed. These groups have been subdivided according to the time and the place of the study, such explanatory notes as seem necessary being added. (See Tables VII-IX.)
The most striking feature of the figures presented in Table VII is the wide variation in the incidence of B. influenzæ in different groups varying all the way from 11.1 to 68 per cent. Analysis of these differences brings out certain points of great interest. It is apparent that the percentage of cases carrying B. influenzæ depended in large part upon the prevalence of respiratory diseases in the group from which the data were obtained. In the studies made at Camp Funston prior to the fall outbreak of influenza in epidemic proportions, it is noteworthy that “bronchitis” and pneumonia were prevalent throughout the summer in those groups showing a relatively high incidence of B. influenzæ. At the time these studies were made the presence of influenza in these organizations was not recognized, but in view of knowledge gained throughout the course of the epidemic at Camp Pike, it seems not improbable that influenza in mild form was present throughout the summer in certain organizations at Camp Funston. This would seem more likely in view of the fact that this commission has clearly demonstrated that a considerable epidemic of influenza swept through Camp Funston in March, 1918, and was followed by recurring smaller epidemics in April and May.[[21]] In contrast with these groups showing a high incidence of B. influenzæ is that of the 210th Engineers, an organization entirely free from respiratory diseases during the period of our study.