Studies on influenza in the pandemic of 1957-1958. II. Pulmonary complications of influenza.
Studies on influenza in the pandemic of 1957-1958. II. Pulmonary complications of influenza.
复制标题
1957-1958 年流感大流行的研究。
DOI：
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发表时间：
1959
影响因子：
15.9
通讯作者：
D. E. Rogers
中科院分区：
文献类型：
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作者：
D. Louria;H. Blumenfeld;J. Ellis;E. D. Kilbourne;D. E. Rogers
流感呈现出一种悖论。对于1918年的临床医生来说，流感是一种可怕的疾病，经常伴有致命的肺部并发症。对于过去四分之一世纪研究大流行间流感的学生来说，这种疾病是一种急性的、暂时使上呼吸道丧失行为能力的感染，除了在罕见的细菌性肺炎发生的情况下，这种感染是良性的。流感表现的这种对比导致人们猜测1918年的疾病要么是一种不同的疾病实体，要么是由一种比现在遇到的流感病毒毒性更大的病原体引起的。1918- 1919年流感大流行期间积累的微生物学和病理学证据确定了大多数流感死亡的可能细菌病因。然而，有许多临床医生坚持认为，某些患者死于与已知细菌病原体无关的暴发性疾病。这种印象在Goodpasture的研究中得到了支持，他们提出了两名患者的弥漫性出血性肺炎的病理证据，这与明显存在的细菌无关(2)。1918- 1919年的大流行早于甲型流感病毒的首次发现（Smith， Andrewes和Laidlaw， 1933[3]）。因此,知识,
Influenza presents a paradox. To the clinician practicing medicine in 1918, influenza was a fearsome disease attended by frequent and often fatal pulmonary complications. To the student of interpandemic influenza in the last quarter century, the disease is an acute, temporarily incapacitating infection of the upper respiratory tract which is benign except on the rare occasion when bacterial pneumonia supervenes. This contrast in the manifestations of influenza has led to speculation that the disease of 1918 was either a different disease entity or caused by an agent of greater virulence than influenza viruses now encountered. The microbiologic and pathologic evidence accumulated during the 1918-19 pandemic established the probable bacterial etiology of most influenza fatalities. There were, however, many clinicians who insisted that certain patients died of fulminating illness unassociated with known bacterial pathogens. This impression received support in the studies of Goodpasture who presented pathologic evidence of a diffuse hemorrhagic pneumonia in two patients which was unassociated with the demonstrable presence of bacteria (2). The pandemic of 1918-19 antedated the first recognition of the influenza A virus (Smith, Andrewes and Laidlaw, 1933 [3]). Thus, knowl-