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1918 influenza pandemic in the South Pacific

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  • 1918 influenza pandemic in the South Pacific

    * http://influenza.sph.unimelb.edu.au/MOH_TOC.php

    7/02/07/1918-pandemic-in-polynesia-and-fiji-small-island-developing-states/

    REPORTS ON PUBLIC HEALTH AND MEDICAL SUBJECTS. No. 4. REPORT ON THE PANDEMIC OF INFLUENZA, I918-I9. MINISTRY OF HEALTH. LONDON: PUBLISHED BY HIS MAJESTY?S STATIONERY OFFICE. 1920. Price 10s. Net.

    page 358 F I J I .
    In a report dated the 18th January 1919, the Chief Medical Officer of Fiji states that it is a matter of uncertainty, or even impossibility, to define the manner in which the epidemic of influenza first gained admission to the Colony, especially in view that (I) there was undoubtedly influenza (which in some cases was of a severe type and complicated by pneumonia) in widely separated districts of Fiji for some months before the epidemic ; (2) all incoming vessels arrived with clean bills of health until the disease was raging all through the Colony,

    page 359 In Suva there were some cases of influenza of moderate severity during October, and reports were received of localised outbreaks in Taveuni, Labasa, Navua, and Kadavu, but the main epidemic in Fiji burst out about the middle of November.

    The earliest fatal cases in Suva occurred on 17th November, and thereafter the reports of burials for influenza fatalities on certain dates were as follows : [tables]

    It was not found possible to keep records of the number of persons attacked, but the Chief Medical Officer considered that it would not be an exaggerated estimate to say that 85 to 90 per cent of the whole population of Suva and district were affected at some time or another during the course of the epidemic?.

    The decline of the epidemic was said to be rapid from the middle of December. By the 24th of that month all four temporary hospitals which had been established in Suva were

    page 360 closed, and after the 28 th no more notifications of genuine cases were received.

    Measures.? Owing to the absence of many officers on War service, to local shipping difficulties, and to the dislocation of the steamship service from Australia and New Zealand, the Colony was ill-prepared to deal with so serious an epidemic.

    In November the disease was made notifiable under the Public Health Ordinance of 1911, and circulars were sent to all medical officers, native medical practitioners, and native officials, calling attention to the epidemic, suggesting methods of treatment, advising that food be stored in all villages, and authorising the use of plantation hospitals for the treatment of cases. Temporary hospitals were equipped and maintained in Suva, Levuka, and other centres. Depots were also established from which soup, arrowroot, sago, and other food and medical comforts were distributed to the homes of natives who were too ill to help themselves. In this work the medical officers and other officials in the Colony were assisted by a large number of voluntary workers. A relief party of 4 medical officers, 1 lady doctor, 4 nurses, 3 senior students, and 24 orderlies was sent by the New Zealand Government to assist in dealing with the epidemic, and arrived at Suva on the 17th December. The complete cessation of steamship communication with Sydney prevented the arrival of a relief party which had been asked for from Australia, but the services of two medical officers and some medical orderlies, who were members of the relief party sent by Australia to deal with the epidemic in Samoa, were obtained.

    The expenditure incurred in relief measures in connection with the epidemic was estimated to be approximately 10,000?.

    page 360 T H E S A M O A I S L A N D S.
    A Commission appointed by the Governor-General of New Zealand to inquire into the circumstances and causes of the introduction of epidemic influenza into the Islands of Western Samoa reported that in their opinion there was no doubt whatever that epidemic pneumonic influenza was introduced into Western Samoa by the S.S. ? Talune? on the 7th November 1918. This ship left Auckland (where influenza was seriously prevalent) on the 30th October, and influenza broke out among the passengers and crew during the voyage to Samoa. Within seven days after her arrival, pneumonic influenza was epidemic in Upolu. It spread with great rapidity throughout this island and later throughout Savaii, the other island of Western Samoa.

    It was calculated that up to the 31st December 1918, out of a population of 30,738 in Western Samoa, 7,542 persons had died either directly from influenza or in consequence of its prevalence.

    page 361 The Commission reported that American Samoa (Pago Pago) had entirely escaped the ravages of influenza, and it appears, from their report, that from the 20th November, to avoid the risk of introduction from Apia, the United States Governor at Pago Pago imposed on all ships arriving at this port five days absolute quarantine before discharging or taking on board any mail or cargo.

    P O L Y N E S I A.
    Dr. Cumpston, Director of Quarantine for the Commonwealth of Australia, has drawn attention to the relative incidence of influenza in certain of the Pacific Islands. He notes that the Tonga and Samoan Islands are based upon New Zealand, from which they receive all supplies. Both these groups of islands were very heavily infected and suffered a high mortality.

    On the other hand, the Gilbert and Ellice Islands, New Hebrides, Norfolk Island, Solomon Islands, British and German New Guinea and New Caledonia all are based on Australia, with which alone they have communication. This group of islands entirely escaped influenza infection, a result which is ascribed by the French Authorities and by the local British Administration to the strict outward quarantine precautions which were taken by the Australian Quarantine Service in respect of all vessels leaving Australia for these island groups.

  • #2
    Re: 1918 pandemic in Polynesia and Fiji (small island developing states)

    It was calculated that up to the 31st December 1918, out of a population of 30,738 in Western Samoa, 7,542 persons had died either directly from influenza or in consequence of its prevalence.
    Assuming a 90% attack rate for Western Samoa (extrapolating from information from Fiji), the CFR for the 1918 pandemic in Western Samoa would have been about 27%.
    http://novel-infectious-diseases.blogspot.com/

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    • #3
      Re: 1918 pandemic in Polynesia and Fiji (small island developing states)

      From Tonga Pandemic Plan http://www.spc.int/phs/PPHSN/Outbrea...demic_Plan.PDF

      Historical background of influenza pandemic in the Pacific:


      There were three influenza pandemics in the last century: 1918, 1958 and in 1969. The ?Spanish flu? of the 1918 greatly affected some of the Pacific island countries and territories (PICTs), and was claimed as the ?worst affected? worldwide where up to 25% of total population of Samoa and French Polynesia were wiped out; 16% of total population of Tonga, 6% and 5% of total population of Fiji and Samoa respectively were claimed by the pandemic viruses (1,2).

      The killer virus of the 1918 pandemic was introduced into the Pacific following the wake of the SS Talune, a regular steamship that serviced mostly the South Pacific from New Zealand that had influenza stricken individuals on board. The ship could not be quarantined (7) because influenza was not a notifiable disease. Other countries like Solomon Is., Tuvalu, Kiribati and Vanuatu were spared because the Australian vessels that serviced them followed the strict maritime quarantine policy to both incoming and outgoing vessels.

      American Samoa was totally spared secondary to the ?commendable foresight, inspired guesswork and individual initiative? (1,2) of its governor Poyer, who instituted strict border control with maritime quarantine policy.

      The 1st pandemic wave [May to July 1918] and the third wave [February to April 1919] from the Spanish flu of 1918 did not claim as many lives as during the 2nd wave [September to December 1918]. The most recent estimation ?put mortality from the 1918 pandemic at between 50-100 million? worldwide (3).

      REFERENCE
      1 Tomkins, S.M., The Influenza Epidemic of 1918 -1919 in Western Samoa. The Journal of Pacific History, 27:2, 1992 p.181-197.
      2 ?Influenza guidelines and Influenza pandemic preparedness guidelines?. PPHSN/SPC 2004.
      3 Ministry of Health, New Zealand. ?New Zealand Influenza Pandemic Action Plan ? Version 14. Draft. November 2005.
      7 Republic of Palau Pandemic Influenza Response Plan, 2005.

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