The Bemidji daily pioneer. [volume] (Bemidji, Minn.) 1904-1971, 1919-10-10

detail, indicate that the course Of the
epidemic in western Europe generally
was similar. In the United States the
epidemic developed more largely in
a single wave during September, DC.
tober and November.
The prevalence of a serious epideI1-
ic Of influenza was first recognized In
and around Boston In September OF
1913 Within about two weeks it was
general in the Atlantic seaboard, de-
veloping little later among cities fur
Their west. Rural districts were usu-
ally attacked somewhat later than
large interests in the same sections.
In the cities east of the line of the
Appalachians the excess mortality
from pneumonia and Influenza during
the weeks ended September IA, 1918,
to March l, 1919, was approximately
Sc per 1000; in cities between the
Rocky mountains and the Appalachi-
ans 4.35; and in those of the Pacific
Coast $50 per 1000.
Concerning the important question
of immunity conferred by an attack
Of Influenza, the evidence is not con-
elusive, but there is reason to believe
that an attack during the earlier
stages of the epidemic confers a con-
siderable. but not absolute immunity
in the later outbreaks.
Transmitted by Contact.
In general the pandemic Of influenza
was largely similar to that of 1S89-9O
in it's development, first a mild form,
later on severe worldwide epidemic,
in the rapidity Of it's spread and its
high case incidence. 1t has however
been notably different in a much high
er mortality, especially among young
adults Such evidence as has been
gathered confirms the conclusion pre-
viously reached that 1t is transmitted
directly and Indirectly by contact. 1t
appears, probable. however, that the
Infection was already widely dissem-
mated in this country sometime be-
fore a serious epidemic was recog-
nized.
Despite the fact that there is still
some uncertainty as to the nature Of
the micro-organism causing pandem-
ic influenza, one thing is certain, that
the disease is communicable from per-
son to person. Moreover, judging
from experience in other diseases, it
is probable that the germ, whatever
it's nature, is carried about not only
by those who are i'll with Influenza,
but by persons who may be entirely
WELL Everything which increases per
sonal contact, therefore, should be re-
garded as a factor in spreading influ-
enza.
Much was heard last winter Of the
use of face masks. Though the use Of
suitably constructed masks will reduce
the interchange of respiratory germs
through inhalation, it must be remem-
bered that there are many other paths
by which such germs are transmitted
from person to person. Soiled hands,
common drinking cups, improperly
cleaned eating and drinking utensils
in restaurants, soda fountains, etc..
roller towels, infected food-these are
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
the use Of face masks has not been
attended with the success predicted
for them. If we would be more sue
cessful IN combating influenza great
er attention must be paid to the fac
tors just enumerated.
The question of most practical and
immediate interest is the probability
Of recurrence in the near future. Re-
currences are characteristic of influ-
enza epidemics; and the history Of the
last pandemic and previous ones
would seem to point to the conclusion
that this one has not yet run its full
course. On the other hand this cpl
demic has already shown three more
or less distinct phases and has been
more severe, at least in mortality, than
the three-year epidemic Of 1889-02,
facts which Justify the hope, though
not the conclusion, that 1t has run its
course already.
Recurrence 10 Likely.
It seems probable, however, that We
may expect at least local occurrences
In the near future, with an increase
over the normal mortality from pneu-
monia for perhaps several years; and
certainly we should be, As far as pos
sible, prepared to meet them by pre-
vious organization Of forces and meas
ures for attempted prevention: treat
ment, and scientific investigation.
There should be no repetition Of the
extensive suffering and distress which