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Respiratory Disease.pdf

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6 PORTO RICO JOURNAL OF PUBLiC HEALTH AND TROP. MEDICINE'I'he pneumosintes group of organisms consists of a large group ofquite similar, filterpnssiug, ram negative, tiny anerobie forms,which ha ve not always been found in epidemics of influenza andwhich have not produced influenza when inoculated into th e nasopharynxof presumably susceptible individuals.It is obvious that unless we can determine the etiological agentof this group of acute respiratory iuleetious, or at least to dete rmineclear-cut procedures for differential diagnosis of the group, we cannotsucceed in developing methods of prevention or control of thisgroup of very common infections,\ 'e may be dealing with an etiological agent that has not yet beendiscovered; on the other hand, the etiological agent may be one ofthe many types of orga nism found norm ally in the nasopharynx andwith which we are familiar. Infection may occur because of changesin virulence of the organism, or changes in the physiological balanceof the individual producing an " anautarcesis " , which permits invasionof the tissue by an organism which under normal conditionswould be avirulent. In either ease, we must assume that environmentalfactors play the deciding part in influencing the change ofeither increased virulence of the organism or decreased resistance oft he individual.One method of attacking this problem is to undertake a studyof the normal flora of the nasopharynx and to follow the changeswhich occur in the individual and in the environment when thesepersons already studied develop an upper r espiratory infection.Such studies have been made by J ordan, Park, Doehaz, Noble andtheir eo-workers, All this work has been done in densely populatedcenters where the persons studied are in direct conta ct with a largenum ber of other persons and subjected to a great variety of environmentalfactors which may affect the respiratory flora, In an attemptto mini mize these extraneous factors we have undertaken a fieldstudy of acute respiratory disease in isolated communities where lifeis simple, contacts relatively infrequent, and envir onmental factorsmore readily estimated and controlled.This field unit consists of a portable laborat ory with a small personnelof epidemiologist, bacteriologist, and technician. Supplementarynon-technical personnel are secured at each post. The firstare a selected for study was" Happy Hollow", Alaba ma, an isolatedsection along the Patsiliga River near the Gulf of Mexico. Here asmall group of normal people were studied over a period of foul'months. During the study an epidemic of acute respiratory diseaseoccurred which was followed throughout its cours e, In May, 1928,

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