There would be ample work for all groups at all times. The study would not be limited to a consideration of infectious diseases. Sociologic conditions may be of importance. We have recorded instances of this. Wherever there is an unusual concentration of large masses of individuals the investigators should study the results of such concentration.
An advantage of this organization would be that the groups through their central bureau would establish an information bureau of infectious disease prevalence analogous to the popular weather bureau of today. They would report the presence of a cloud before it had appeared on the local horizon.
In the absence of any epidemics resembling influenza, there would be abundant opportunity for correlated work. We have mentioned the epidemiologic resemblances between influenza and certain other infectious diseases. Comparative study of any or all of them is of importance. The bacteriologist and the immunologist would find plenty of material in the study of measles prevalences. The two diseases are so similar in their manner of spread, in the probable mode of transmission, in their clinical characteristics and in the results of laboratory attempts at transmission, that one must assume that the causative viruses are not dissimilar. Any new facts that we may gain concerning measles will be of value in the study of influenza.
Many years could be well devoted merely to a study of immunity in influenza.
The results obtained by this proposed organization for the investigation of influenza would be slow in achievement. The study is not of a type calculated to appeal to the popular imagination. Communities in which the dread of an imminent pestilence is not present would subscribe with some hesitation to appeals for pecuniary assistance. Fortunately, however, there are in existence several organizations already well developed along these lines, organizations chiefly interested in certain other diseases. There can be no doubt but that at the present time the financing of such a broad project could be arranged, and that the groups could be efficiently organized on the basis of experience already gained in similar projects.
Crookshank well remarks that our present epidemiologic intelligence service is hardly superior to that of a Meteorologic Office which only gives warning of rain when unfurled umbrellas pass along the street. Influenza will surely return. There will be mild epidemics within the next few years. In time another pandemic will arrive, and after it will come pandemic after pandemic. In 1918 as in 1889 we were caught unprepared. Let us do our utmost to prevent the recurrence of this tragedy. To delay is to loose the valuable information gained during the last two years. The future is not without well grounded hope, but success will not be achieved until we have attained a much deeper understanding of the epidemiology of influenza.
BIBLIOGRAPHY.
Abbott, Samuel W.
1890. The influenza epidemic of 1889–90. 21st Annual Report of State Board of Health of Mass. Pub. Doc. No. 34, 307–384.
1892. Twenty-third Annual Report of the State Board of Health of Mass., 745.