The 1919 Influenza pandemic and its impact on Aboriginal people in South Australia Tom Gara
Introduction
This year, 2019, marks the centenary of the ‘Spanish’ Influenza pandemic reaching Australia. It is believed that the pandemic of 1918-20 killed at least 40 million people worldwide and perhaps as many as 100 million,1 easily surpassing the 20 million combatants and civilians who died during the Great War. It was the most lethal pandemic of modern times and, indeed, the most lethal since the Bubonic Plague, the Black Death, of the fourteenth century. While AIDS has caused about 35 million deaths over the last four decades, the influenza pandemic may have killed two or three times that many people in about 18 months.
It was not until the 1930s that influenza was discovered to be caused by a virus, and it was only in the 1990s that research on corpses retrieved from Arctic permafrost, and from tissue samples stored in medical museums, revealed that the 1919 Influenza was a mutation of an
avian influenza that had adapted to human hosts. Alarmingly, it was strikingly similar to the H1N1 strain of swine influenza that affected much of the world in 2009.2
Origin and spread of the pandemic
The virulent strain of influenza responsible for so many deaths is believed to have first broken out in August 1918 in military camps in western France and southern England, but there is some evidence that it may have originated in crowded military camps in the USA, before travelling with the troops across the Atlantic to France.3 The virus spread rapidly throughout the Allied and German armies, killing thousands of troops on both sides of the Western Front. It soon dispersed throughout Europe’s civilian population via the railways, roads and waterways, killing more than two million people, including about 200,000 in England and Wales, 240,000 in France and a similar number in Germany and perhaps
450,000 in Russia.4 In Spain about 260,000 people died. That country remained neutral during the war and, unlike most of the combatant nations, did not impose press censorship. News of the ravages of influenza there spread around the world; that is why it became
known as ‘Spanish flu’.5 The virus crossed the Atlantic in August and within a few months about 675,000 Americans had died, more than the USA lost in all its wars of the twentieth century.6
By the time of the Armistice in November 1918, the virus was raging across the globe, spread across the continents by trains and cars and across the oceans by ships. It is estimated that 18 million people may have died in India and perhaps 10 million in China. In Indonesia the death toll was about 1.5 million. Millions more died across South America and Africa. It is estimated that 300,000 people died in South Africa.7
Most people are familiar with influenza’s symptoms; a sore throat, severe cough, shivering fits, headaches and muscular pain, vomiting and diarrhoea. The symptoms of ‘Spanish’ Influenza were the same, only more severe. The attack commonly lasted three or four days
but it left its victims weak and debilitated for weeks afterwards. It was the pneumonial complications that developed in about 10 or 20 per cent of cases that caused many of the fatalities. In those days, prior to the discovery of antibiotics, the only treatment for pneumonia was complete bed-rest and careful nursing, but even then the mortality rate was usually about 30%.8 In those flu-sufferers who developed pneumonia, infection attacked the respiratory membranes and blood vessels in the lungs, causing the lungs to fill with blood and fluid. Fever and delirium set in and the patient usually lapsed into a coma within a day or two. The body began to darken due to greatly reduced blood oxygen levels and death usually occurred within another day or two. In particularly severe cases, a fit, healthy young man who complained of a sore throat in the morning might lapse into a coma by lunchtime and be dead by nightfall. After death the body would continue to darken and sometimes
turned completely black. For this reason the epidemic was sometimes known as the ‘Black Flu’.9 Mortality from influenza is usually confined to the very young and the elderly, but the 1919 virus caused a disproportionate number of deaths amongst those aged between 25 and 44, particularly men.10 Infection rates were relatively low for people aged over 50, possibly the result of immunity acquired through exposure to an earlier pandemic.
When news came in October 1918 from South Africa of the high death toll there, the Australian government imposed strict quarantine procedures at all ports.11 Australian troops returning home from the war, especially those aboard ships that stopped in South Africa en route, were quarantined aboard their ships in port or in isolation camps such as Torrens Island, near Port Adelaide, until it was clear that none were infected. While these measures failed to stop the pandemic reaching Australia, they delayed it significantly, by which time its virulence seems to have diminished; the virus had evidently mutated into a less virulent strain than the one that had raged around the world in late 1918.12
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