Abstract
For years efforts were made to settle the question of immunity to influenza by enumeration during an epidemic of the frequency of illness in members of a population who had suffered from influenza in earlier epidemics. The accumulated data were in most instances not susceptible to accurate analysis and highly contradictory opinions were derived. Difficulties have been constantly exaggerated by the lack of uniformity in clinical criteria for diagnosis of influenza and by the lack of diagnostic tests for confirmation or denial of the clinical impression. One conclusion was that influenza gave rise to no subsequent immunity but rather, rendered the subject more prone to attack. The frequent relapses were considered to be reinfections; the supposed second attacks in the same epidemic, infection of the same persons during different waves of the same pandemic, or the actual recurrence of epidemic waves were indicative of a lack of resistance. On the other hand, evidence of resistance is observed in the fact that during an epidemic, even with intimate exposure, a high proportion of the population escapes disease; in the observation made in stable populations, especially military units in 1918, indicating that persons affected during the mild spring wave escaped illness during the severe autumnal epidemic, or that those who took sick in the second wave were men who had joined the unit after the first wave; in the fact that the incidence of influenza is highest in children and lowest in the older ages. The lower incidence at older ages in 1918 was in reality considered by some to indicate a resistance carried over from influenza in 1889–90.
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Francis, T. (1950). Immunity and Vaccination in Influenza. In: Doerr, R., et al. Handbuch der Virusforschung. Springer, Vienna. https://doi.org/10.1007/978-3-7091-5688-9_5
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