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(d) It is worthy of note that if a fatal case of pneumonia following influenza
occurred in one house, another member of the same family contracted
influenza followed by pneumonia, and in many cases both cases were fatal;
whereas, as a rule, if one case of influenza and pneumonia recovered in a
house, any second case did so—query-pointing to infection with a strain of
bacteria of some virulence. The number of cases of pneumonia was high
—in many cases the pneumonia was of a mild type, and might have passed
unsuspected without examination of chest. The present epidemic has been
of a much severer type than that earlier in the year. Where the vast majority
had no complications and were soon back at work, in nearly every case in
the present epidemic nearly all have had some bronchitis, if not pneumonia,
and patients have been in bed for several days. I should say that those who
suffered from the milder type earlier in the year obtained immunity, and that
this is the same disease, but with a much more virulent bacteria, whether
originating in this country or brought from abroad.
(e) I should like to remark that the mortality seems high, but is it any
higher proportionately to the attacks? Broncho-pneumonia following
influenza has always been a fatal disease, but as we are having an enormous
number of influenza cases, we must naturally expect more broncho-pneumonia.
(f) During the past three or four weeks (December 10th) there has been:-
1. A slight recrudescence of the more severe type of influenza,
but this is now lessening in extent.
2. When lobar pneumonia has occurred as a complication in
this recrudescence it has, in my experience, not been of such a
fatal type as that of three months ago.
3. Prevalence of the usual "Seasonal Influenzal Colds."
Regarding this latter affection (clinically, Catarrh of the Air Passages)
I have noticed this season a very marked "immediate infection"
amongst those coming much together when one of them is already
suffering from this illness.
Dr. C. Spurrell.
Medical Superintendent of the Poplar and Stepney Sick Asylum.
Began on September 12th, with the admission of six Asiatics, from the
S.S. Palma, R.A. Docks. The chef characteristics of the present outbreak
which I have noticed are the following:—
Sore throat—Almost universal, consisting of a laryngitis sometimes, but
more often of an inflammatory condition of the lower part of the pharynx
and upper part of the œsophagus, with nothing visible on ordinary examination
of the throat. Some cases, however, have had well-marked follicular
tonsilitis.