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Famous report of 1934 LA outbreak

Discussion in 'General ME/CFS News' started by Persimmon, Jul 22, 2013.

  1. Persimmon

    Persimmon Senior Member

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    Has anyone actually seen the report of the US Surgeon General into the 1934 Los Angeles outbreak?

    I want read this oft-cited document, but have struggled to access a copy. If anyone has access to a digital copy, or knows how to get access a physical one, please let me know.

    The full title is:
    Epidemiological study of an epidemic diagnosed as poliomyelitis occurring among the personnel of the Los Angeles County General Hospital during the summer of 1934. Public Health Bulletin No. 240, April 1938.
    Enid likes this.
  2. Mark

    Mark Acting CEO

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    merylg and Valentijn like this.
  3. Dan_USAAZ

    Dan_USAAZ

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    A couple years ago, I was interested in finding this publication. I did an online nationwide search and found three locations that had it. Fortunately for me, one of the copies was at the state university just 20 minutes’ drive from my home.
    I found the publication in the university library and was able to make a hard copy. It is 90 pages, so it took a little while to copy. The copy quality is not great. Unfortunately, I do not have a digital copy, so not sure how I could share it with anyone.

    One of the interesting pieces of information I gleaned from the study was how many people were affected. We often hear a number of something like 212 (from memory). That number is just the number of hospital employees that were studied. The actual number of people (patients) that came through the hospital that were diagnosed was in the thousands and that was just one hospital.
  4. Forbin

    Forbin Forbin

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    FOUND IT!

    I've looked for this without success a couple of times, but I looked again today and found it here:

    http://hdl.handle.net/2027/mdp.39015022082260?urlappend=%3Bseq=617

    This appears to be 90 pages long and is the sole subject of issue 240 of "The Public Health Bulletin" published by the Public Health Service, a division of the U.S. Treasury Department, in 1938.

    It's at the very end of a compilation of volumes 231-240 spanning 1936-1938. It appears to be in the archives of the University of Michigan.

    The interface is not very speedy, at least not on my computer.
    merylg, Persimmon, Valentijn and 3 others like this.
  5. Sea

    Sea Senior Member

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    Could you download it Forbin? I only had the option to read it online
    Sean likes this.
  6. Forbin

    Forbin Forbin

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    No, unfortunately, I can't download it either.

    Looks like you have to belong to a "partner institution" (one of several universities) in order to download the whole thing - which would include 9 other bulletins and would be pretty large, I'm guessing. The source archive is the Hathi Trust Digital Library.

    It does appear possible to download one page at a time as individual .pdf's, but, at 90 pages, that will take a while. [See the lefthand pane and look under "Get this Book" - "Dowload This Page (PDF)"].

    If you try to download the whole thing and click on "login," you'll see a drop down menu listing all of the "partner institutions."
  7. Persimmon

    Persimmon Senior Member

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    Fantastic - You guys have made me happy:)
    Many thanks, especially to Forbin
  8. Valentijn

    Valentijn Activity Level: 3

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    I'm downloading the pages, and am pretty sure I can shove them into a single .pdf. It might be too big to upload to PR though.
    Sea likes this.
  9. Mark

    Mark Acting CEO

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    Nice one Valentijn. Contact wdb if it's too big to upload and I'm sure he can find a way for PR to host this - this paper ought to be easily available in the public domain - and I expect there are other hard-to-access and out-of-copyright papers out there that we could make available in a similar way.
    alex3619 and Valentijn like this.
  10. Valentijn

    Valentijn Activity Level: 3

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    I do have it in one paper now, but it's much too big for me to upload (17MB). Dividing it into two or four parts didn't help either :p I'll ask wdb to see what can be done! Thanks :)
  11. Valentijn

    Valentijn Activity Level: 3

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  12. taniaaust1

    taniaaust1 Senior Member

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    I wish I could find the Australian/New Zealand ME journal which was bein published in the 1970s or 1980s (before the cheney outbreak I think it was). Ive never been able to find a copy of this ME journal (its the only ME journal Ive ever heard about) and the research in it (I may not have the name quite correct but i do remember it was "ME" and "Australia" and "New Zealand" and it was a "ME" (not CFS) journal.

    .If somoone dont find a copy of it and get it online soon, all the info in this journal (probably the only ME journal ever published) is at risk of being forever lost as those who may hold the last copies of this age (surely some old retired or near retired ME specialist has it sitting in his bookshelf or something)

    anyway.. Im looking forward to reading about that outbreak.. thanks those those who found this and got it to the site
  13. taniaaust1

    taniaaust1 Senior Member

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    is this link still working?

    Its coming up with a message from my Adobe reader saying "The root object is missing or invalid."
  14. lansbergen

    lansbergen Senior Member

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    It works on my computer.
    taniaaust1 likes this.
  15. Valentijn

    Valentijn Activity Level: 3

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    Maybe your adobe acrobat needs updating?
    taniaaust1 likes this.
  16. Enid

    Enid Senior Member

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    Interesting Persimmon - poliomyelitis much on my Neurologist's mind (mine too paralysed muscles affecting walking to breathing and swallowing).
  17. Guido den Broeder

    Guido den Broeder *****

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    Page 69.

    "... this outbreak has no parallel in the history of poliomyelitis or in any other central nervous system infections."

    This may really have been the birth of ME.
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  18. alex3619

    alex3619 Senior Member

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    I have regarded this outbreak as the first probable ME outbreak for some years now. There is an old thread on here somewhere where a number of us were discussing this. Having an in-depth report is new and welcome, up till now I have had to read short reports.
    taniaaust1 likes this.
  19. urbantravels

    urbantravels disjecta membra

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    It's a difficult document to interpret. I haven't gone over it carefully, but from a quick read a few things are apparent. First of all, the enormous, overarching importance of polio at that time and in that place really colored the perceptions of this "mystery" illness. It was seen through the lens of polio and treated at first as if it were polio. After all, it was arising literally in the middle of a local polio epidemic, in a hospital that was admitting polio cases every day. It seems that only in retrospect did anyone realize there truly was a group of patients that had something that wasn't "typical" polio.

    The descriptions of the symptoms are baffling. I don't see a very clear correspondence with our current disease definitions for ME/CFS. There are a few similarities, but there are also some superficial similarities with Guillain–Barré syndrome, just to give one example (since distinct muscle weakness in specific muscles is so prominently described.)

    I don't know what it's possible to conclude from this. I think it's reasonable to hypothesize that there might have been an unidentified viral illness that for some reason attacked the hospital staff during this polio outbreak, and that there was subsequently a post-infectious syndrome seen in some of these patients, which might have been an autoimmune disorder triggered by the initial infection, or some other form of immune or neurological damage. Since there are a number of different known post-infective syndromes and probably many more unknown ones, I don't know why this disease as described is more likely to have been ME than anything else. But as I said, I haven't read the paper very closely yet.

    I found this also, which may be of interest with regard to the "prophylactic serum" that was given to these patients. This wasn't a vaccine (polio vaccine not being invented yet) but a sort of attempt at inoculation, commonly used at the time. But the sick staff members didn't get the serum at the same point in their illness. Some had already had it before becoming ill, some were given it immediately after getting ill, some got it later on in the course of their illness, and a few apparently never got it at all. It became evident that the serum was useless at preventing this illness and in fact may have slightly increased the chances of the recipient getting sick. I found this paper:

    http://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.24.12.1215


    Even if the serum itself wasn't particularly helpful or harmful, we might wonder about the process of manufacturing it and the presence of several species of lab animals on the hospital campus - there might have been an environment in which a novel virus could arise.
    Valentijn likes this.
  20. taniaaust1

    taniaaust1 Senior Member

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    [


    does anyone have a symptom list with its descriptions for this illness for any of us who cant look at that link or whatever reason, being too sick to go throu it all or like myself, just cant get it up) or can cut and paste them and put them here.

    im wanting to see what the symptoms were for this and how they were different to typical ME. Thanks

    ps if someone did write up for this site on this early outbreak based on the info (comparisons and all) and Mark was accepting of it, i'd love to read about it as an article.Guillain–Barré syndrome, just to give one example (since distinct muscle weakness in specific muscles is so prominently

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