Evening Republican, Volume 22, Number 259, Rensselaer, Jasper County, 27 October 1919 — “FLU” EPIDEMIC WILL BE MILDER [ARTICLE]

“FLU” EPIDEMIC WILL BE MILDER

If There Is Recurrence It Will Not Be as Severe as Last Winter. If revious Attack Brings Immunity in Percentage of Cases—Enforcement and Avoid- - ---- - ‘ of Personal Contact Necessary Precautions. Public 'ReaftW Service.)

■ Probably, but 1h uo'ineans ret- ; ’ tainly, there will be a recurrence 1 i of lhe influenza epidemic Ibis ; ; year. - . j ; Indication* are. that should ; ! It occur, It will not be as severe i ’ as the pandemic of the previous ; ; winter.* i 1 City officials, state and city i ! boards of health, should be pre- ; pared in the event of a recur- ; ’ rerice. ! The fact that n previous at- ■ > tack brings immunity in a cer- ] tain percentage of cases should 1 : allay fear on the part of those ■ ; afflicted In the previous ephlem-T : ic. ■ Influenza is spread by direct ■ > and Indirect contact. 1 —ls ftTIMM has been isolated. or discovered. - 1 and as a consequence there is ; yW. no positixe preventive, ex ‘ eept the enforcement of rigid i rules of sanitation and the avoid- ; ance of personal contact. ! A close relation between the I ' influenza pandemic and the con- ■ stantly increasing pneumonia ; ; mortality rate prior to the fall ! of 1918 is recognized. ■ It is now believed that the di* ; ; ease was pretty widely dissent- 1 ‘ Inated throughout the country i ■ before’ it was recognized in its ; ; epidemic state. This failure to ; - recognize the early eases appears i ■ to-haxe been largely due to the ; ; fact that every interest was then J [ centered on The - war

Above are the important facts developed by the United States health service after a careful survey and investigation of the influenza pandemic of 1918-1919, carried on In every state and Important city, and even in foreign countries. No one of the many experts of the service would make a more positive . Will there be a recurrence? All agreed, however, that a recurrence was not unlikely, and in the face of the known facts, that it would be wlse_to be prepared. more with a view of being on the safe side than actually anticipating danger. The following excerpts from the government report are published for the benefit of the public and health officers in the hope that this will serve to set at rest the daily publication in the tiewspapers of statements, which ; *>h one hand ,are catcuhiieiTTWlirilTho I alarm. Contrary to the opinion expressed <req nonily dnrinc the ear!v weeks of last year's pandemic by a number of observers, the studies of the United States public health service indicate that the epidemic was not if fresh importation from abroad. Careful study I of the mortality statistics of the Uni- 1 ted States shows that there were a number of extensive Though mild fore- : runners of the pandemic during the j previous three or four years. The epidemic was generally of a mild type and has since been almost forgotten. It occasioned, hpwever. a noticeable Rise ,in Mortality. In the spring of 1918 there was another sharp rise in the mortality rate from pneumonia. In the larger cities of the Atlantic seaboard these increases occurred during January. February tand March. In the rest of the country, especially the central and western states, the increases occurred in April, a month during which pneumonift mortality is generally on the decline. jTbis increase was sufficient to indicate a strong departure from the normal. The increased mortality rate expended into May and in some areas longer.

This occurrence has, it is believed, a definite significance in relation to :the influenza epidemic. In the United iStates in the spring of 1918. a ni'm- * her of definite local outbreaks of influenza were observed: The rise in mortality from pneumonia. this very similar type of disease. In<he spring of 1918 is so sudden, so Smarted and so general throughout the United States as to point very clearly >0 a definite relation. Everything inidicatas that the increased mortality .from pneumonia In March and April iof 1918 was the consequence of d beginning and largely unnoticed epidemic of influenza, the beginning in this jcountry of the pandemic which develjoped in the autumn of that sear. ’ In the British cities the epidemic (manifested three distinct waves—the

1 first and slightest in point of mortality occurring In June hud July, the ’ second and most severe in November, i the third Tn February and March, [ Data. which Deed not be cited here in : detail, indicate that the course of the ;■ epidemic in west tpfi • Europt*~genern By -was s ImiTier. TiFtfrw IDTTeiT Sti» I esthe ■ epliieiqjc devtdiipi'.d luorelargcly-to a single wave during September, Ocj tuber find November. *i*he - pFovati?fiiib-ofmscrnuisf epiffenu ic ofDillueuza was first recognized in and arpund—Boston—Ln—September of mis. \\ iihOTUTw s k wii ypn»iral in the AtlAntin developing a lit tle la ter among cities fur-tti-m ally attacked DlmewDat later "than large interest * in the same siMlonx. Tn 'the cities east of the line of the Appalachians the excess mortality from pneiimonifi and influenza during the weeks ended September 14. 1918, to March 1, 1919, was approximately ■I.C per 1.099; In cities between the Itoiky mountains and the Appalachians 4.35; and In those of the Pacific Coast 5.5 u per 1.000. Concerning the important question of immunity conferred by an attack of influenza, the evidence is not conclusive. but there is reason to believe that an attack during the eftrlier stages of the epidemic confers a considerable, but not absolute immunity in the later outbreaks. Transmitted by Contact. In gcnvrsrt the pandemic <»f influenza was largely similar to that of 1889-90 In Its development, first a mild form, dfftwr-vm a severe world wide ppidemic,'.Ln of and Its high case Incidence. It has however beentietab.ly-different In a much hlgher mortality, especially among young adults. Such evidence aS\DXffS“been gathered confirms the conclusion previously reached that it is transmitted directly and indirectly by contact. It appears, prbbable, however, that the infection was already widely disseminated In this country sometime before a serious epidemic was recognized. Despite the fact that there is still some uncertainty as to the nature of the micro-organism causing pandemic influenza, one thing is certain, that the dis-ease is eotnmuntcable from per■akfltr** t(T"’person. Moreover, ’judging’ • from experience In other diseases, it is prolTabre'TTtaf the germ, whateverits nature, is carried about not only by those'who are 411 with influenza, but by persons who may be entirely -well. Everything whleh iricreases-per-sonal contact, therefore, should be regarded as a factor in spreading influenza. Much nas heard hist winter of the use of face masks. Though the use of suitnhly c<>nstrueted tim sks will r educe, the interchange of respiratory germs

' through Inhalation, It must be remem- | bered that there ure jnany other path* |_W <eemti are fransniltteS I from person to pension. Soiled hands, ' common drinking cups, improperly I ( leaned eating and drinking utenslla .In restaurants, soda fountains, etc M | roller towels, infected food —these are I only a-few of the common vehicles ' of germ transmission. The use of face \ masks appears to make people neglect ! these other paths of infection, and so ■ tlic use of face masks has no’ beerr I attended with the success predicted ’ for them. If we would be more suc- . eessful in cr»mbnting inflnehza greats [-er atieiitimi must be patrFtTj the TffcThe (piestion of most practical and 1 Jtnmedfate IntoresF is probability to-TEtunTEuce nx“ i curreaees are characteristic oT lnlhi-. ■ last pfimU'l'nic aml privlous (iiies [would scorn t(. taint, XQ t.he_coߣ4uslon ■ 11 mt this one ha* not yet run Jja fall ! this ‘*i»ldemlc has already shown three more or less dimmer ptm<es and has been more severe, at least in mortality, than the three-year epidemic of 1889-92. facts which justify’ the hope, though not the condusion, that it has run its course already. Recurrence Is Likely. jt seems probable, however, that we may expect at least local recurrences in the near future, with an increase over the nonnal mortality from pneumonia for perhaps several years; and certainly we should be, as far ?s possible, prepared to meet them by previous organization of forces and measures for attempted prevention, treatment. and scientific investigation. There should be no repetition of the extensive suffering and distress which accompanied last' year's pandemic. Communities should make plans now for dealing with any recurrence of the -epideniic; —The prompt recognition ofthe early cases and tiieir effective isolatlon should be auued at. In this connection. attention is called to fae fact that the cases may appear to be just orillna ry colds. A’ * recent exteneive outbreak of what were regarded as "s u mmer colfls” In I’eoria, Illlnols, proved on investigation to be an epidemic of a mild type of influenza. Experience indicates that these mild epidemics are often the starting points of more severe visitations. Hence every effort should be made to discover as early as possible any unusual prevalence of “colds.” For municipalities operating on a budget basis. It is important that all delay In providing the necessary finan?ial sxipfiort to The health authorities in dealing with a recurrence of the epidemic WavtThTeTTyDgftlng-aslde an. emergency epidemic fund. This may prove of the greatest value in carrying out important preventive measures in tiie early days of the epidemic, nt a time when their beneficial effect is greatest. The most promising way to deal with a possible recurrence of the influenza epidemic is. to sum it up in a single word, “Preparedness.” And now it is the time to prepare.