The Richmond palladium and sun-telegram. [volume] (Richmond, Ind.) 1907-1939, 1919-09-17

WASHINGTON, Sept. 16.-Experts
of the United States Public Health
Service are agreed that a recurrence
Of the influenza epidemic of last year
is not unlikely and in the face of the
known facts. the service bulletin says
it would be wise to be prepared. more
with a view of being on the safe side
than actually anticipating danger.
Did Not Come from Abroad.
Contrary to the opinion expressed
frequently during the early weeks of
last years pandemic by number of
observers, the studies of the United
States Public Health Service indicate
that the epidemic was not fresh i'm
portation from abroad. Careful study
of the mortality statistics of the
United States shows that there were
number of extensive though mild fore
runners of the pandemic in the previ-
Gus three or four years. The epidemic
was generally of a mild type and has
since been almost forgotten. 1t oCcaS
toned, however, noticeable increase
in the recorded death rate from pneu-
monia.
In the spring of 1918 there was an
other sharp rise in the mortality rate
from pneumonia. In the larger cities
of the Atlantis ceaboard these in
creases occurred during January, Feb
ruary, and March. In the rest of the
country, especially the Central and
Western states, the increases occurred
in April month in which pneumonia
is generally on the decline. This in
crease was sufficient to indicate a
strong departure from the normal.
The increased mortality rate extended
Sr,to No n in
longer.
Leads to Pneumonia.
This occurrence has, it is believed. a
definite significance in relation to the
influenza epidemic. In the United
States in the spring of 1918, a number
! of definite local outbreaks of influenza
were observed: thus in Fort Ogle-
thorpe, near Chattanooga, Tenn, in
| March, in Chicago during March; in
| San Quentin Prison, California, in
April October and November. AT
| Camp Funston recurrent outbreaks of
pneumonia were observed in March,
April and May of 1918 and were defin-
itely associated with coincident cpl;
denies of mild type of influenza.
The rise in mortality from pneu
monia, this very similar type of dis
ease, in the spring of 1918, is sc
sudden, so marked and so general
throughout the United States as tc
point out very clearly to a definite re
| lation. Everything indicates that the
increased mortality from pneumonia
in March and April of 1918 was the
consequence of a beginning anc
largely unnoticed epidemic of infiu
enza, the beginning in this country oil
the pandemic which developed in the
autumn of that year.
Epidemics in a Series of Three.
In the British cities the epidemic
manifested three distinct waves-tht
first and slightest in point of mortal
ity occurred in June and July, the sec
ond and most severe in November
third in February and March. Data
which need not be cited here in de
tail indicate that the course of the
| epidemic in Western Europe gener
ally was similar. In cities of India
the sequence was similar but the
| mortality far greater. In the United
States the epidemic developed more
largely in a single wave during Sep
TENDER. October and November. II
however, the epidemic already men
toned as occurring in the spring, be
considered the first phase and the
explosive outbreak in the autumn the
second, a third phase of recrudescenc'
Is quite evident in many areas. II
general, this winter recrudescenct
was less marked in those cities which
suffered most severely in the autumn
epidemic.
The prevalence Of a serious cpl
demic of influenza was first recog
nized in and around Boston in Septem
Der Of 1918. Within about two week!
it was general in the Atlantic sea
board, developing a little later among
cities further west. Rural districts