No abstract

From a knowledge of what other camps were experiencing with the epidemic of so-called "influenza," and in anticipation of an outbreak of a similar infection in this camp, certain preliminary bacteriologic work was attempted. Several days before any cases of influenza were reported at Camp Custer, a study was begun to determine the prevalent mouth flora of healthy individuals. For this purpose cultures were made from the throats of enlisted men of the Fourteenth Sanitary Train. Smears and cultures on plain blood agar plates were made from the nose and nasopharynx; in all, 357 cultures were taken. The usual mouth organisms were recovered. In addition, 75 per cent. of the cultures showed a hemolyzing streptococcus. In only five cases, or in a little more than 1 per cent., was the influenza bacillus identified. Before these studies could be extended, the epidemic broke. However, this much was apparent: A high percentage of healthy individuals were carrying hemolyzing streptococci somewhere in their respiratory tract. The influenza bacillus was not present in greater numbers than one is accustomed to find this organism in normal throats. INFLUENZAInfluenza patients who showed no physical signs of pneumonia were first studied. Throat cultures, blood cultures, blood counts and urinalyses were made. Throat Cultures.-Smears and cultures of the throat were made in 366 cases. Plain blood agar plates were employed, and special care was taken to identify the influenza bacillus. Organisms recovered were: hemolyzing streptococci, 34 per cent.; nonhemolyzing streptococci, 33 per cent.; pneumococci, 12 per cent.; influenza bacilli, 8 per cent. Blood Cultures.-One hundred and forty cultures were made on these patients at various stages of the disease. In all cases the cultures remained sterile. Blood Counts.-Five hundred and eighty leukocyte counts were made with the results as shown in Table 1.Seventy per cent, of these counts showed 8,000 cells or less per cubic millimeter. This leukopenia was the most impressive feature of the blood count. The polymorphonuclear leukocytes showed but slight increase over the normal. There has been no conspicuous lymphocytosis, nor other noteworthy features of the blood count.Urinalyses.-Twenty per cent, of the urines examined have shown albumin. In the majority of cases this was recorded as a faint trace. Casts were an infrequent finding, occurring in 4.7 per cent, of the cases. PNEUMONIA It became apparent with the development of a large number of cases of pneumonia that the greatest impor-Compilation to and including Oct. 22, 1918. tance attached to their study. Blood cultures, sputum typings, blood counts and urinalyses were made in as many cases as possible. Blood Cultures.-Five hundred and ten blood cultures in cases of pneumonia have been made to date. Of these, eleven have shown organisms as follows: hemolyzing streptococcus in ten cases, Pneumococcus mucosus once.In other words, only 2 per cent, of pneumonia patients have shown a bacteremia. These cultures were taken from the sickest ...