NZHistory, New Zealand history online - epidemic

Aftermath - 1918 influenza pandemic

Following the pandemic speculation continued over the Niagara's involvement in bringing the virus to New Zealand. The Department of Public Health was also heavily criticised. The government responded by setting up a royal commission with wide powers of investigation.

It fell to Robert Makgill, acting Chief Health Officer, to implement the Commission's recommendations. One of the recommendations, which Makgill had argued for, was for a new Health Act ‘to consolidate and simplify the existing legislation'. Historian Geoffrey Rice describes the resulting Health Act 1920 as ‘the most useful legacy of the 1918 influenza pandemic'. The legislation:

... was so well drafted that it survived with only minor amendments until the 1956 Health Act, which itself still followed the general pattern of the 1920 Act. At the time it was widely recognised as a model piece of health legislation, said to be the best of its kind in the English language.

Remembering the pandemic

As the government took steps towards improving the health system people began to return to their ordinary lives – often without parents, husbands, wives or other family members.

Considering the number of lives lost during pandemic it is surprising that the event has not had greater 'prominence in national histories and public monuments'. Geoffrey Rice suggests that its 'mark on the collective memory may have been more distinct' had it struck during peacetime.

Memorial to Dr Margaret Cruickshank

The pandemic was certainly remembered by those that lived through it. Visit our media gallery to read and hear some of their recollections. These are taken from a 1967 radio documentary produced by Jim Henderson and entitled The great plague. None of the interviewees are named in the documentary.

Two statues erected in Canterbury to honour doctors who died during the epidemic, Dr Little at Waikari and Dr Margaret Cruickshank (New Zealand's first woman doctor) at Waimate, are among the few public monuments to the victims of the pandemic.

Response to the influenza pandemic

There were consistencies in New Zealand's response to the influenza pandemic. Many of these arose out of a circular telegram the Health Minister, George Russell, issued to all borough councils and town boards. This ‘laid out a practical and comprehensive scheme of relief organisation in clear and concise language, and gave full initiative to the local authorities'. Many of the features of the scheme – such as the establishment of a central committee to coordinate relief and the division of areas into blocks or districts, each with its own ‘depot or bureau', were Auckland initiatives. Some towns and cities, such as Dunedin, had already taken steps to coordinate relief efforts, but Russell's circular undoubtedly prompted others to take action.

Cures and treatments

One action taken in many town and cities was to set up inhalation sprayers to disperse a solution of zinc sulphate to the public. Though ‘medically useless', this was the only approved preventative for influenza known to New Zealand's public health department. Most sprayers were set up in public buildings. They were made even more accessible in Christchurch after someone observed that the compressed-air braking units on trams ‘could be adapted to operate a sprayer by reconnecting a few hoses'. Eventually 14 trams were converted and ‘stationed on loops at the end of all major routes, handily placed to serve the outlying districts'. Some local authorities also disinfected streets and public buildings during the pandemic.

Armistice Day

Another response in many towns and cities was to close or restrict opening hours for public facilities and businesses, and cancel or postpone public events and gatherings. In many cases these actions were initiated by those in charge of relief efforts. For example, as soon as influenza was declared an infectious disease – giving local authorities greater ability ‘to check or prevent the spread of disease' – Auckland's district health officer, Dr Joseph Frengley, ordered the closure of ‘all public halls, places of entertainment, billiard rooms and shooting galleries for at least a week'. In some cases individual businesses chose to close because of depleted staff numbers, or to free employees to nurse those in their households or to volunteer to assist relief efforts.

The medical workforce

Doctors, nurses, chemists, and voluntary organisations such as the Red Cross, St John Ambulance and district nursing associations all played crucial roles during the pandemic. But they were spread very thinly across the country, particularly in smaller towns, which meant relief efforts relied heavily on volunteers. Some women, free of employment when schools or shops closed, became lay nurses. Both men and women served on block committees, answering phones or checking on those reported to be ill. Still more people helped their families, friends and neighbours as best they could, particularly where there were young children that needed care. People with any sort of vehicle found themselves in particular demand: to take food or medicine to stricken families, to transport the sick or to take away the dead.

There were other consistencies throughout the country, as the same rumours circulated widely. Some claimed that bodies were being cremated or buried in mass graves. None of these rumours turned out to be true. Some graves were left unmarked, but only in situations where the body could not be identified.

One alarming detail relating to victims' bodies that turned out to be true was that some of them turned black. But it was pneumonia, rather than the virus itself, that caused this. Pneumonia can lead to a condition known cyanosis, where ‘the amount of oxygen exchanged into the bloodstream is drastically reduced, and the skin loses its normal health pink hue, turning a dusky purple'. Historian Geoffrey Rice has described pneumonia as ‘the real killer in 1918'.

However deadly and disruptive the influenza epidemic was, it was also over quickly. By late November the epidemic had peaked or decreased in most parts of the country, and by early December it was effectively over.

Uneven rates of death - 1918 influenza pandemic

It is clear that no matter how the second wave developed in New Zealand, it was many times more deadly than any previous influenza outbreaks. No other event has killed so many New Zealanders in so short a space of time. While the First World War claimed the lives of more than 18,000 New Zealand soldiers over a four-year period, the second wave of the 1918 influenza epidemic killed almost 8600 people in less than two months.

Influenza in institutions

Death did not occur evenly throughout the country. Some communities were decimated; others escaped largely unscathed.

Maori suffered heavily: their overall rate of death was 42.3 per thousand people, seven times that of Europeans. In one community, Mangatawhiri in the Waikato, about 50 out of 200 local Maori died. Whina Cooper recalled similar suffering at Panguru, Hokianga:

Everyone was sick, no one to help, they were dying one after the other. My father was very, very sick then. He was the first to die. I couldn't do anything for him. I remember we put him in a coffin, like a box. There were many others, you could see them on the roads, on the sledges, the ones that are able to drag them away, dragged them away to the cemetery. No time for tangis.

Influenza among Maori

But there was an exception. Mortality amongst Maori on the East Coast of the North Island was, according to historian Geoffrey Rice, ‘much less than expected in comparison with other North Island districts’. This may have been because they had received partial immunity from the first wave which was reportedly widespread in the district during August and September.

The overall rate of death for Europeans was 5.8 per thousand people. But in some communities it was well above the national average.

Featherston military camp

The most striking of these was in the isolated coalmining district of Nightcaps and Wairio in Western Southland. Its rate of 45.9 deaths per thousand people rivalled that of many Maori communities.

Geoffrey Rice notes that ‘the only places where the mortality showed any uniformity were the military camps’. He describes them as ‘by far the most dangerous places to be in 1918’. At the Featherston and Trentham camps the rates were 22.6 and 23.5 deaths per thousand people respectively.

Rice comments that even the best answers of the variations in mortality rates ‘must remain to some extent speculative’, but concludes that:

The underlying cause of extreme variations in deaths was almost certainly the quirky nature of the patterns of partial immunity left by the mild first wave, together with the unpredictable behaviour of a virulent and rapidly mutating virus.

See also: death rates in suburbs and counties of the North Island and South Island

The pandemic begins abroad

The first wave

When the ‘new pandemic flu’ first appeared in 1918 there was no immediate cause for alarm. The disease was different to other strains experienced in the past – for example, it was unusually prevalent amongst young healthy adults. But most people affected by what would turn out to be ‘the first wave’ of the pandemic recovered.

The Spanish flu

The 1918 influenza pandemic was commonly referred to as ‘the Spanish flu’ but it did not originate in Spain. It was given the popular name by journalists when the Spanish King, Alfonso XIII, fell seriously ill with a form of influenza in May that year.

Evidence suggests that this ‘mild’ first wave originated in North America. Influenza was present in many countries in late 1917 and early 1918. According to influenza historian Geoffrey Rice, author of Black November, only a ‘well-documented’ outbreak in Haskell County, Kansas, in January–February 1918 bore all ‘the characteristics of a new pandemic flu – high attack rate, higher morbidity rate and greater mortality than is usual for influenza’.

The disease spread among recruits who entered Camp Funston in Kansas, then to camps in Georgia and South Carolina, and then rapidly across the Midwest.

American soldiers are also credited with bringing the disease to Europe, where the first cases appeared near the huge American transit camps at Brest and Bordeaux in early April. By June the first wave had spread across most civilian populations in Europe.

The first wave followed normal diffusion patterns and struck the southern hemisphere a few months later, becoming prevalent in New Zealand in September. By this time it had run its course in Europe and cases related to the more severe second wave were emerging.

The second wave

Second wave deaths

The first New Zealanders affected by the second wave of the 1918 influenza pandemic were soldiers of the 40th Reinforcement on board the troopship Tahiti. On 22 August their convoy – which had called at Cape Town, South Africa, en route to Plymouth, England – refuelled at Sierra Leone, West Africa. None of the crew or soldiers went ashore as fever was reported to be raging. But locals came on board to coal the ship, and within days over half of the men on board fell ill. The final death toll exceeded 80.

The first cases of a more severe form of influenza emerged amongst British and French troops serving on the Western Front early in July 1918. By mid-August the second wave, ‘a highly infectious flu, with sudden onset and an alarming propensity for pneumonic complications’, was spreading rapidly in France.

This time Europe would be responsible for infecting North America. By late September the second wave was well established in most of major cities.

The second wave did not follow normal diffusion patterns, instead striking the southern hemisphere while the disease was still raging in the northern hemisphere.

In October, for example, the flu was at its worst in countries as far apart as South Africa, Japan, China, Peru, Greece and Italy. It is now thought that the worldwide death toll was as high as 50 million.

According to historian Geoffrey Rice, the puzzle of the simultaneous outbreaks in both hemispheres may be resolved:

When one follows the very rapid diffusion from a July epicentre in eastern France: the second wave did not peak everywhere at the same time but was spread over four months, allowing ample time for diffusion by sea and rail.

Through the systematic analysis of individual death certificates, Rice calculated that New Zealand's peak of mortality occurred on 23 November 1918. This date has proved useful in dispelling the belief that the RMS Niagara was responsible for bringing a deadly new influenza virus to New Zealand.

Further information - the 1918 flu pandemic

This web feature was written by Imelda Bargas and produced by the NZHistory.net.nz team. We are grateful to Geoffrey Rice for his assistance and to Karen Cameron for information about the pandemic in Samoa.

Books

Geoffrey Rice, Black November: the 1918 influenza pandemic in New Zealand, Canterbury University Press, Christchurch, 2005. Find out more about this publication on the CUP website.

Feeling overwhelmed - the 1918 flu pandemic

Sound file

(Click on arrow to play 240kb)

This clip requires Flash Player 7 or higher. Download latest version of Flash Player.

Transcript

[Woman speaking] It just got so that if you wanted help - if you didn't feel so well - you opened your window and you put a white rag out the window and you unlocked you front door and left a white rag on the handle of the door you see so that anybody could come in and when these people who were going around on motorbikes in cars saw them you see they got out to investigate because it was beyond, you couldn't deal with it. You just couldn't deal with it at all. It was beyond anything.

[Woman speaking] I lived in Wellington at the time and was working in a chemist shop. People started to pour in with prescriptions of all descriptions and people were collapsing on the road and being picked up and taken to hospital until the hospitals were full and then it began that we could hardly deal with them for the simple reason they came in so thick and fast. I gave prescriptions. I was working in the shop and the chemist was working flat out and the doctors finally put the prescription in the paper and so they copied it out and copied this and gave it in bulk form.

Sound Archives / Nga Taonga Korero
Reference: TCDR562
This sound file may not be reused without permission from Sound Archives / Nga Taonga Korero.

del.icio.us Twitter Facebook Google StumbleUpon

RMS Niagara - the 1918 influenza pandemic

The Union Steam Ship Company's trans-Pacific liner Niagara in Auckland. This famous ship would later be sunk by a German mine off the Northland Coast in 1940.

Was the Niagara to blame?

Many people believed that a deadly new influenza virus came to New Zealand aboard the Royal Mail liner Niagara, which arrived in Auckland from Vancouver and San Francisco on 12 October 1918. This is now no longer believed to be the case.

Among the ship's passengers were Prime Minister William Massey and his deputy Joseph Ward, who were returning from a war conference. False rumours circulated that Massey had personally rebuffed quarantine measures; in fact, he insisted that he and Ward be treated the same as other passengers. Twenty-nine Niagara crew members and several passengers were hospitalised in Auckland, but doctors reported that their cases were no more severe than others already seen in the city. Indeed, six people had died of the flu in Auckland in the three days before the Niagara arrived. And the great upsurge in severe cases in the city occurred two weeks later, well outside the 48-hour incubation period. Although no one knows exactly how or when the flu reached New Zealand, it is misleading to blame the Niagara, which was only one of dozens of ships (many of them carrying returning soldiers and war invalids) to arrive from Europe and North America in October 1918.

Alexander Turnbull Library
Reference: 1/4-018386
Further information and copies of this image may be obtained from the Library through its 'Timeframes' website, http://timeframes.natlib.govt.nz
Permission of the Alexander Turnbull Library, National Library of New Zealand, Te Puna Matauranga o Aotearoa, must be obtained before any reuse of this image.

del.icio.us Twitter Facebook Google StumbleUpon

tags:

influenza

epidemic

shipping

Maori influenza pandemic memorial

This carved wooden Maori cenotaph was erected at Te Koura marae in memory of those who died in the 1918 influenza pandemic. The cenotaph was designed and carved by Tene Waitere of Ngati Tarawhai. He also created a similar cenotaph at Te Ihingarangi marae, Waimiha. This photograph was taken in 1920 by Albert Percy Godber.

Historian Geoffrey Rice suggests that higher death rates among Maori (about seven times that of Pakeha) may be attributed to their isolation from ‘the normal circulation of colds and minor respiratory ailments’, as Maori were then a largely rural population. He also suggests that ‘lower standards of housing, clothing and nourishment’ amongst Maori communities put them at greater risk.

Alexander Turnbull Library
A P Godber Collection
Reference: APG-0786-1/2-G
Further information and copies of this image may be obtained from the Library through its 'Timeframes' website, http://timeframes.natlib.govt.nz
Permission of the Alexander Turnbull Library, National Library of New Zealand, Te Puna Matauranga o Aotearoa, must be obtained before any reuse of this image.

del.icio.us Twitter Facebook Google StumbleUpon

tags:

Influenza pandemic depot, 1918

Central Medicine Depot, Cathedral Square, Christchurch, 4 December 1918. This photo shows the former Patriotic Bazaar converted by the Health Department to dispense 'the Government Standard Influenza Medicine'.

The sign on the right says 'Simulants for Patients. Small Bottles of Whisky, Brandy or Stout will be sold at the Central Medicine Depot'. The partly obscured sign at left reads: 'Medicine Supplied Only to Poor People with actual bad cases in the house'.

Read about dispensing alcohol in Wellington

Alexander Turnbull Library
Reference: 1/1-008542-G
Further information and copies of this image may be obtained from the Library through its 'Timeframes' website, http://timeframes.natlib.govt.nz
Permission of the Alexander Turnbull Library, National Library of New Zealand, Te Puna Matauranga o Aotearoa, must be obtained before any reuse of this image.

del.icio.us Twitter Facebook Google StumbleUpon

tags:

influenza

health

epidemic

South Island influenza death rates

These figures are taken from Geoffrey Rice, Black November: the 1918 influenza pandemic, University of Canterbury Press, 2005. The population figures are those of the 1916 Census. Death rate is per 1,000 of population. Maori populations for counties are inclusive of interior boroughs. Only registered Maori deaths are listed, and these are not available for some districts.

Region:

Marlborough
Nelson
West Coast
North Canterbury
Christchurch
Banks Peninsula and Chatham Islands
South Canterbury
Otago
Dunedin
Southland

Marlborough

Place	Deaths	Population	Death rate
Sounds County and Picton	8	2,322	3.4
Marlborough	11	6,915	1.5
Blenheim	27	3,822	7.0
Awatere	2	1,542	1.2
Kaikoura	9	1,906	4.7
TOTAL	57	16,507	3.4

Nelson

Place	Deaths	Population	Death rate
Waimea County	11	9,334	1.1
Motueka	4	1,475	2.7
Nelson	29	8,774	3.3
Takaka	3	1,858	1.6
Collingwood	–	1,253
Murchison	6	1,251	4.7
TOTAL	53	23,945	2.2

West Coast

Place	Deaths	Population	Death rate
Buller County	10	5,071	1.9
Denniston	13	702	18.5
Westport	10	4,067	2.4
Inangahua and Reefton	12	4,130	2.9
Grey County	17	7,519	2.2
Greymouth	38	4,863	7.8
Westland	14	4,578	3.0
Hokitika	20	2,091	9.5
Kumara	3	623	4.8
TOTAL	137	33,644	4.0
Maori deaths	1	81

North Canterbury

Place	Deaths	Population	Death rate
Amuri County	1	1,836	3.8
Cheviot County	9	1,224	1.3
Waipara County	11	2,058	5.3
Kowai County	7	1,444	4.8
Amberley	8	470	17.0
Ashley County	–	728	–
Rangiora County	10	2,747	3.6
Kaiapoi	11	1,560	10.8
Rangiora	9	1,808	4.9
Eyre County	9	1,806	4.9
Oxford County	10	989	10.1
Tawera County	1	847	1.1
Malvern County	6	2,757	2.1
Paparua County (excluding Christchurch)	6	2,566	2.3
Halswell County	2	1,785	1.2
Springs County	4	1,785	2.2
Ellesmere County	6	3,441	1.7
Selwyn County	7	1,423	4.9
TOTAL	129	31,117	4.1
Maori deaths	1	145

Christchurch

Place	Deaths	Population	Death rate
City East	31	5,109	6.1
City Northwest	26	4,364	6.4
City Southwest	29	3,999	7.3
Riccarton	11	2,890	3.8
New Brighton	13	2,310	5.6
Sumner	5	2,287	2.1
Lyttelton	21	3,766	5.6
Addington	10	3,045	3.3
Sydenhem	43	8,418	5.1
Waltham	7	2,218	3.2
Beckenham	5	909	5.5
Spreydon East	10	1,565	6.4
Spreydon West	4	1,645	2.4
Somerfield	6	1,079	5.5
Opawa	4	890	4.5
St Martins	1	278	3.5
Woolston	9	3,990	2.2
Linwood South	14	5,195	2.7
Linwood North	25	4,758	5.3
Avonside and Bromley	1	1,933	0.5
Richmond	16	2,696	5.9
St Albans East	22	4,775	4.6
St Albans West	33	5,665	5.8
Papanui	11	1,866	5.8
Strowan and Merivale	11	2,567	4.2
Belfast and Styx	8	1,839	4.3
Marshland	7	1,454	4.8
Fendalton	13	5,078	2.5
Sockburn and Islington	8	2,397	3.3
Heathcote	7	2,738	2.5
Harewood	3	1,050	2.8
Soldiers who died in camp	19
‘Christchurch’, no address	25
TOTAL	458	92,773	4.9

Banks Peninsula and Chatham Islands

	*European*			*Maori*
Place	Deaths	Population	Death rate	Deaths	Population	Death rate
Mt Herbert County	2	405	4.9	1	120	16.6
Akaroa County	13	1,982	6.5	–	33	–
Akaroa	4	540	7.4
Chatham Islands County	1	219	4.5	5	258	19.3
Wairewa County	2	1,036	1.9	2	75	26.6
TOTAL	22	4,182	5.2	8	486	16.4

South Canterbury

Place	Deaths	Population	Death rate
Ashburton County	46	13,136	3.5
Ashburton	25	3,109	8.0
Geraldine County	11	5,194	2.1
Geraldine	5	869	5.7
Temuka	21	2,173	9.6
Levels County	11	4,378	2.5
Pleasant Point	4	722	5.5
Timaru	38	12,238	3.1
Mackenzie County	6	2,868	2.0
Waimate County	13	6,984	1.8
Waimate	17	1,867	9.1
TOTAL	197	53,538	3.6
Maori deaths	10	232	43.1

Otago

Place	Deaths	Population	Death rate
Waitaki County	22	9,694	2.2
Hampden	4	364	10.9
Oamaru	46	5,140	8.9
Waihemo County	6	1,446	4.1
Palmerston	5	752	6.6
Waikouaiti County	6	2,841	2.1
Waikouaiti	4	611	6.5
Seacliff*	21	1,253	16.7
Taieri County	10	5,662	1.7
Mosgiel	11	1,719	6.3
Bruce County	3	4,763	0.6
Kaitangata	4	1,681	2.3
Milton	5	1,317	3.7
Clutha County	6	6,194	0.9
Balclutha	10	1,409	7.0
Owaka district	15	707	21.2
Tuapeka County	4	4,818	0.8
Lawrence	4	837	4.7
Roxburgh	2	449	4.4
Tapanui	8	627	12.7
Maniototo County	–	2,527	–
Naseby	2	276	7.2
Vincent County	7	3,930	1.7
Alexandra	9	679	13.2
Cromwelll	4	549	7.2
Lake County	1	1,749	0.5
Arrowtown	1	307	3.2
Queenstown	3	657	4.5
TOTAL	223	62,958	3.5

* includes Seacliff Mental Hospital

Dunedin

Place	Deaths	Population	Death rate
Roslyn	22	6,300	3.4
Maori Hill	4	2,075	1.9
North East Valley	18	4,750	3.7
Central Dunedin	63	21,290	2.9
Mornington	9	4,381	2.0
St Kilda	28	5,520	5.0
South Dunedin	30	6,687	4.4
Caversham	22	6,165	3.5
Green Island	15	1,841	8.1
St Clair	–	1,797	–
Port Chalmers	20	2,615	7.6
West Harbour	1	1,631	0.6
Tainui–Andersons Bay	4	1,871	2.1
Peninsula County	1	1,793	0.5
‘Dunedin’, no address (including soldiers who died in camp)	36
TOTAL	273	68,716	3.9

Southland

	*European*			*Maori*
Place	Deaths	Population	Death rate	Deaths	Population	Death rate
Southland County	100	23,531	4.2	1	43	23.2
Campbelltown (Bluff)	8	1,823	4.3
Gore	27	3,551	7.6
Lumsden	5	570	8.7
Mataura	13	1,129	11.5
Winton	19	1,155	16.4
Wyndham	13	991	13.1
Invercargill	171	15,866	10.7
Wallace County	65	7,729	8.4	7	92	76.0
Nightcaps and Wairio	33	718	45.9
Otautau	21	837	25.0
Riverton	16	985	16.2
Fiord County	–	17	–
Stewart Island County	–	349	–	1	4	250
TOTAL	491	59,251	8.2	9	139	64.7

NZHistory, New Zealand history online - epidemic

Aftermath - 1918 influenza pandemic

Remembering the pandemic

Response to the influenza pandemic

Uneven rates of death - 1918 influenza pandemic

The pandemic begins abroad

The first wave

The Spanish flu

The second wave

Second wave deaths

Further information - the 1918 flu pandemic

Links

Books

Feeling overwhelmed - the 1918 flu pandemic

Sound file

Transcript

RMS Niagara - the 1918 influenza pandemic

Was the Niagara to blame?

Maori influenza pandemic memorial

Influenza pandemic depot, 1918

South Island influenza death rates

Marlborough

Nelson

West Coast

North Canterbury

Christchurch

Banks Peninsula and Chatham Islands

South Canterbury

Otago

Dunedin

Southland