The pandemic to end all pandemics: influenza in 1919

We are rapidly approaching the 100 year anniversary of the outbreak of influenza that wreaked havoc in Australia in 1919.

 Six months before the end of the First World War a new and deadly form of influenza emerged and swept the world. Popularly referred to as Spanish Flu the disease probably affected between 25 and 35 percent of the world’s population and killed more than 40 million.

As pandemics stand the 1918-19 influenza outbreak was without doubt the deadliest and most destructive in recorded human history. In just a handful of months it swept around the world affecting communities with a virulence not seen before.

Australia managed to avoid the outbreak until early in 1919. On the morning of January 25^th 1919 Sydney residents awoke to read in the newspaper of a suspected case of influenza in the city. A returned serviceman was placed in the Military Hospital. Within a couple of days three hospital staff who had looked after him developed influenza symptoms.

In late 1918, Australia experienced a stream of ships arriving with a history of influenza cases on the voyage. In the three months after October 1918 more than 320 people from these ships were placed in quarantine at the North Head Quarantine Station. Despite this the Commonwealth Government remained largely indifferent to the potential threat of a major influenza outbreak believing that isolation, distance, time and quarantine offered security.

All this changed as the death toll continued to mount in the Northern Hemisphere and influenza continued to spread around the world.

Nearby in New Zealand, influenza swept the country in November and December carrying away more than 8,000 people in only six weeks. By the latter part of 1919, however, at least 15,000 Australians had died from influenza and possibly 1.5 million had caught the disease.

The most striking feature of the outbreak and where it differed from previous influenza outbreaks is that it mainly targeted young healthy adults, particularly those aged between 25 and 39.

In parts of Australia the pandemic took a heavy toll. In Sydney, for example, approximately 27 percent of the population were aged between 25 and 39 in 1919 yet this age group contributed almost half the total flu deaths, For a country that had just witnessed the sacrifice of many of its young men during the war, this was a devastating blow.

Influenza would affect all aspects of Australian life. Marriages were torn apart and many children found themselves without a father or mother. Fear of infection also caused many to put off getting married.

There is no official data on the number of people who caught influenza in Australia in 1919 In Sydney it is quite likely that between 37 and 40 percent or 300,000 of all Sydneysiders caught flu in 1919.

Generally the medical profession were unprepared and ill-equipped to deal with the pandemic. Little was known about viral infections and most believed that they were simply confronting a bacterial disease. Antibiotics were at least 30 years away and without any medical tools to confront influenza the medical profession was forced to rely on measures such as quarantine, isolation, sprays and disinfectants, masks, the banning of public meetings and simply telling people to go to bed for at least four days.

In late 1918 a vaccine had been prepared by culturing the sputum of influenza patients at the NSW Quarantine Station for use against what doctors believed was a bacterial infection. Free inoculation was offered to all people in NSW but such was the public response that supplies were soon overwhelmed. Tens of thousands in Sydney fought for a place in the queue and almost 450,000 inoculations were performed in the first five months of 1919.

There still remains some doubt as to how effective this was in preventing influenza. A survey of patients in Sydney public hospitals suggested that of those inoculated 10.6 percent caught influenza compared to 16.5 percent of those not inoculated.

At the outset of the pandemic all States and Territories possessed only a small number of hospital beds. To cope with the pandemic many schools, sports buildings and warehouses were converted into temporary hospitals.

So how did the Commonwealth Government respond to this pandemic threat?

 In late 1918 it decided to quarantine all ships arriving in Australia when there was a history of influenza on the voyage out. In addition, all ships arriving from New Zealand and South Africa were placed in quarantine for seven days.

The Commonwealth also convened a meeting of all States and Territories to lay down a set of formal instructions governing notification and quarantine. All States and Territories had to notify the Commonwealth immediately they discovered a case of influenza in their jurisdiction and once that was done institute border restrictions. While all agreed to this in 1918 when influenza threated the agreement broke down.

In early 1919, NSW accused Victoria of failing to report cases of influenza and Tasmania and Western Australia took affront at restrictions governing shipping and train travel. Within days the Commonwealth agreement was in tatters and each State going its own way with respect to border controls and local quarantine. It was a political roundabout.

During the pandemic hysteria, fear and panic had a field day. People avoided public transport, declined to attend churches or sporting events, and avoided the pub and crowds. Many people tried to flee from Sydney and the Central Railway station was crowded with people anxious to get away. Influenza swept through Australia’s towns and cities. Neighbours avoided neighbours, people barricaded themselves in their homes, avoided shops and street contact.

So many people were ill with influenza or fearful of catching it that businesses, schools and government offices struggled to exist. Faith in the medical profession quickly evaporated and people sought help from popular cures such as Dr Morse’s Indian Root Pills, Clements Tonic and Bonnington Irish Moss, while large department stores instituted fumigating sprays.

The 1919 influenza pandemic stands as the greatest social and health disaster in Australian history. Overall millions succumbed to flu during the first six months of 1919 and at least 15,000 died. The pace of the spread of the disease took Australia by surprise and totally overwhelmed the measures advanced to contain it.