Читать книгу Studies on Epidemic Influenza: Comprising Clinical and Laboratory Investigations онлайн

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The length of the prodromal stage—the stage from the time of contact to the earliest onset of symptoms—has always led to interesting observations and discussion. In this epidemic we have rather definite information bearing upon this subject.

A young married farmer living in a rural community where no influenza had occurred up to the time of the present experience went to a city about 40 miles distant. On the train he sat in the same seat with a man who was apparently ill, and who was sneezing and coughing. He was in the city only a few hours, and was not in any place of congregation except the railway train. Forty-eight hours after his return to his home he noticed the first symptoms and began a mild course of influenza. About 50 hours later his wife was taken with the same symptoms, and in two days more their only child was afflicted. Other members of the household were also afflicted, and one of them died of pneumonia.

It might be interesting to quote a similar observation made by Macdonald and Lyth, of York, England, published in a recent issue of the British Medical Journal (November 2, 1918, p. 488), which corroborates this experience. They say: “We traveled from London together on Thursday, October 3, by train, leaving King’s Cross at 5.30 P. M., arriving in York at 9.30, and as we were leaving the carriage a young flying officer, who had come the whole way with us and was coughing and sneezing at intervals, informed us that he was ill and had had influenza for several days. On Saturday, October 5, we both became ill and had developed typical attacks of influenza. With both of us the illness developed suddenly with laryngitis; in both the first signs were a severe attack of coughing; and in both the time was noted fairly accurately as being between 2 and 2.30 P. M. One case was quite mild, the temperature never over 101. The other was more severe; the temperature arose to 104½ and the catarrh extended to the bronchi. His wife and two children also developed influenza, and in their case the symptoms showed suddenly, about 2 P. M., on Monday, October 7. Now we are convinced that we became infected from our traveling companion during the train journey—more likely toward the end of the journey; and if we take the time of infection as 9.30, this fixes the incubation period for both of us at a minimum of 41 hours, with a maximum margin of error of 4 hours. The three cases developing in the family of one of us point to a similar incubation period, as their illness started almost exactly 48 hours after his, and as it is likely that the infection would not take place until a few hours after the first symptom, the incubation period in these three cases must have been nearly the same as our own two.