Pandemic Influenza In Korea With Special Reference To Its Etiology
Frank W. Schofield, D.V.Sc. And H. C. Cynn, M.B.
The great influenza pandemic made its appearance in Korea during the month of September, 1918. There seems to be no doubt that the infection came from Europe, via Siberia. The disease spread from north to south along the line of the Southern Manchurian Railway. The first cases seen by us in Seoul, the capital, were during the latter part of September. Before the middle of October the epidemic was at its height. The insanitary conditions of oriental life greatly enhanced the spread of the infection. At present it is impossible to estimate either the number of cases or deaths, as accurate information has not been received from the Japanese authorities. From one quarter to one half of the population must have been affected. Most of the schools were closed, owing to the high incidence among the scholars and teachers. As elsewhere the serious nature of the outbreak was due to the frequent sequelae, bronchitis, bronchopneumonia and heart failure. The symptoms were those of ordinary influenza, but of a more exaggerated type. Headache, and pains and aches in the limbs, with a rapid rise of temperature to 104 or 105 were common Symptoms. The dropped temperature usually to slightly above normal within twenty-four hours if the case was uncomplicated. There was also frequent evidence of respiratory infection, which varied from a mild coryza to pneumonia in severity. In some cases there was vomiting and nausea, while in some very acute cases the patient became delirious at the climax of the infection. The symptoms in general corresponded with those reported from other countries.
With regard to transmission of the disease, everything would point to droplet infection as being of paramount importance. Numbers of mild carrier cases, a population of susceptible people, and a disease infecting the upper respiratory passages, causing a prolific secretion of infectious material, produce a combination which must result in a pandemic or widely spread epidemic.