Evening star. [volume] (Washington, D.C.) 1854-1972, 1931-02-12
PHYSICIANS ALLAY
INFLUENZA SCARE
Only $4,000 Cases in u. S.
Reported, with Small Gain
in Death Rate.
BY THOMAS r. HENRY.

What is THE flu?"
There has been a popular impression
that during the past month Washing
ton-together with most of the Eastern
United States and Europ3-haS been ex-
periencing an epidemic of this disease
in a mild form. Somebody has been
sick in every other family-complain
ing of aching bones, soreness at the
roots of the hair, watering eyes, slight
fever, irritating cough and a generally
diffused mean" feeling. Victims and
their relatives describe it as THE flu
and so does the family doctor when he
is talking unprofessionally and not for
publication.
But flu" or influenza, is a reportable
disease. Here, and in most OF the
States, the attending physician is sup
posed to make a return to the health
authorities on each case among his
patients. And the official records show
nothing comparable to the popularity
assumed prevalence Of the disease. For
example, for the week ending January
81 only about 10000 cases were re-
ported to the Public Health Service
for the whole country, and if every
case popularity called FLU" had been
reported that figure hardly would have
covered the number in any single large
Eastern city.
United States Public Health Service,
lies in the vagueness of the territory
covered by the diagnosis of influenza 7"
There is no specific test to determine
the boundary between bad cold, the
old-fashioned Ia grippe" and influenza.
The physician, even where reporting
regulations are most stringent, is free
to use his own judgment as to whether
or not a case should be reported as
"fu."
Common Cold Comes First.
First, it was explained, comes the
common cold" Generally, this is
what a person has who is discharging
from the nose. coughing and feeling
miserable" but is not sick enough to
60 to bed, and remains at work There
Is no specific line where cold passes
over into la grippe" Generally 1t is
where the patient feels so badly that
he must go to bed or remain at home
The next stage is where la grippe comes
alarmingly close to the lung involve
ment of pneumonia. Here is where
most physicians would make a diagno-
sis Of FLU" But it still rests on the
Judgment of the individual doctor He
can, if he wishes, continue to call the
case grippe until pneumonia is def
initely established This is the one
point where certain diagnosis can be
made.
There are various kinds of colds .
La grippe is one of them. And grippe"
is FLU" from the mildest case to those
cases on the verge of pneumonia. OFF,
grippe" It is just a name of which
folks used to apply to that condition
which. breaking out in virulent and
pandemic form in 1918, caused an
enormous pneumonia death rate in the
United States and Europe and definite
ly affected the progress of the war
There has been grippe" everywhere
every Winter, as far back as doctors
can remember. Some years have been
worse than others. but people don't
worry about it very much. Usually
victims were on their feet in a week
or so. Once in while case devel-
oped into pneumonia and resulted
fatally, but the grippe" was not blamed.
Flu was hardly mentioned except in
technical publications.
Then came the World War epidemic
It was a virulent strain of grippe,
spreading rapidly from person to per-
son, which very frequently passed over
into pneumonia. But only in its viru-
lence did it actually differ from the old
fashioned, respectable Winter visitor of
papers began applying the technically
correct name and the public became
acutely influenza conscious.
Problem for Physicians.
That, it is explained at the Public
Health Service, is the case to-day. The
general public, remembering the piled
up cofiins Of war days, becomes almost
panic-Stricken at the word FLU" Yet
he turi xr-Iai 1la
they have been suffering from for years
and years without serious consequences,
they have nothing less than the terrible
"hu" itSen-even If none of the cases
pass beyond the status of bad colds.
But what is physician to do Com
mon sense tells him that he isn't sup
posed to report bad cold or its coun-
terpart, which he always has spoken of
as Ia grippe" in the face Of the correct
medical Technology. If he did there
would be statistically a bad influenza
epidemic every Winter. He under
stands that the intention of the law is
that he shall report cases of the viru-
lent type or strain of influenza, such as
caused the enormous death rate of 1918
but he has no way to distinguish these
from the "grippes" or bad colds"
which are common and which, with
proper care, are not likely TO cross the
AIT hIOo llle ldGal pneumonia.
80, Public Health Service officials be-
heve, the average physician uses his
own Judgment. The milder cases he
sets down on his own records under
the traditional but non-technical name
OF Ia grippe" The serious ones and
those which turn into pneumonia in a
few DAYS he reports to the authorities
as influenza" Yet he could not ac-
tually state a means of differentiating
the two, for their is no such thing.
Health Service Cautious.
Tf1is practice tends to prevent an
epidemic scare. The public takes "la
grippe" as a matter of course. Hard
ened sinners begin to pray at the
mention of the flu" After all the
resulting statistical picture may be
closer to the facts than IL everything
in the wide area between colds and
pneumonia were reported as influenza.
The death rate, it is explained, prob
ably Is better measuring stick of the
seriousness OF an influenza sweep than
the rate Of occurrence of the disease