“AUSTRALIA MUST now face the fact that the scourge which has taken so heavy a toll from the rest of the world has invaded her own frontiers,” reported The Sydney Morning Herald on 28 January 1919.
Flu pandemics (epidemics of worldwide proportion) have reached our shores – in the 1890s, in 1957, 1968 and 2009 – but none has been as devastating as that of 1918–19.
That event, called the Spanish flu because it was first widely reported from Spain, began during the last year of World War I and passed through soldiers in Western Europe in ever more destructive waves.This version of the flu affected healthy young adults more than the usual targets of children, the elderly and people with a weakened immune system. In Australia, the virus became known as pneumonic influenza, because of its effect on the lungs.
It spread rapidly worldwide as soldiers returned from active service at the war’s end. Because of its remoteness from Europe, Australia had months to prepare.The first line of defence was to try to keep the virus from reaching mainland Australia.The Australian Quarantine Service implemented maritime measures on 17 October 1918 after learning of outbreaks in New Zealand and South Africa.The next day the first infected ship to enter Australian waters, the Mataram from Singapore, arrived in Darwin. During the following six months our quarantine service intercepted 174 vessels carrying the infection. Of 81,510 people checked, 1102 were infected.
The federal government’s second line of defence was to set consistent responses for handling and containing outbreaks. It was agreed the federal government be responsible for proclaiming which states were infected and organising quarantine.The states would arrange emergency hospitals, vaccination depots, ambulance services, medical staff and public awareness.
Melbourne’s Commonwealth Serum Laboratories (CSL) developed its first experimental vaccine in 1918 in anticipation of pneumonic influenza reaching mainland Australia. Researchers didn’t know what caused influenza, but the vaccine addressed potentially fatal secondary bacterial infections. From 15 October 1918 to 15 March 1919, CSL produced 3 million free doses. It later evaluated the vaccine as partially effective in preventing death.
Maritime quarantine contained the virus until its virulence lessened, and restricted the introduction of the disease into Australia to a single entry point.The first confirmed case appeared in Melbourne on 9 or 10 January 1919. Early cases were so mild there was initial confusion about whether they were Spanish flu or simply seasonal flu virus from the previous winter.
This uncertainty delayed confirmation of an outbreak, allowing it to spread to New South Wales and South Australia. NSW was the first state to proclaim an outbreak, on 27 January 1919. Victoria following suit the next day.
The influenza experience varied between locations. Sydney implemented strict measures including school closures and mandatory mask use, which slowed but didn’t stop the disease’s spread. Sydney ultimately experienced three waves of outbreak, with many deaths. In Perth, the city’s isolation and state border quarantine control ensured pneumonic influenza didn’t appear there until June 1919. A spike in infections was recorded after crowds gathered to celebrate
Peace Day on 19 July 1919. By that year’s end, the pandemic was over.
Globally, more people died from the influenza pandemic (50–100 million) than during WWI (18 million). In Australia, the estimated death toll of 15,000 was high but far less than the country’s WWI death toll of 62,000.
In fact, Australia’s overall flu death rate of 2.7 per 1000 of population was one of the lowest recorded of any country during the pandemic. Nevertheless, up to 40 per cent of the population was infected, and some Aboriginal communities recorded a mortality rate of 50 per cent.
Surgical masks were worn in an attempt to prevent the spread of influenza, seen here in Brisbane in 1919.