Influenza outbreaks remembered - 100 years on

2019 marks the centenary of the outbreak of Influenza in North Queensland in 1919. It was the same illness that had been sweeping the globe since the end of the First World War and would ultimately go on to claim the lives of somewhere between 50 million and 100 million people worldwide. The virulent form of pneumonic influenza - known as "Spanish Influenza" - reached Australia in early 1919, coinciding with the return of the soldiers of the AIF to Australia. 

SS Morialta. Photo: State Library of South Australia B-61166.

In May 1919, cases of Influenza were reported in Townsville. Passengers aboard the steamship Morialta were thought to be the source of infection.^[1] Free inoculation against the disease was offered and 6,000 locals took up the offer. Dr Walter Nisbet, Townsville's Medical Officer of Health, estimated that somewhere between 6,000 and 7,000 of Townsville's citizens (or 25 per cent of the population) contracted the illness in some form.^[2] Eighteen people died in the outbreak, ten of those in hospital and eight in private homes. 

As in other cities throughout Australia, strict rules were imposed on Townsville's population to try and curb transmission of the illness. Public meetings were banned, picture theatres and schools were closed and the main city streets were sprayed with disinfectant. Townsville North State School (now Belgian Gardens State School) was requisitioned for use as an isolation hospital. The Army supplied and erected tents in the school grounds. Over a period of ten weeks, a total of 195 patients were treated at the makeshift hospital. A second isolation hospital was opened at St. Anne's School in June and remained in use for one month and three days. During that time, 108 patients were treated there.^[3]

In a letter to the Mayor of Townsville dated 15th August 1919, Dr Nisbet praised the efforts of the Matron in charge of the isolation hospital at Townsville North State School - Hannah Sarah Pengelly. He wrote: 

"The ideal and harmonious working of this hospital, chiefly with a band of young untrained workers, shows what women can do in an emergency. A large share of praise is also due to the tactful and untiring energies of the matron – Nurse Pengelly."^[4]

Matron Pengelly is buried in the West End Cemetery in Townsville.

Headstone of Hannah Sarah Pengelly, died 6 December 1940. Photo: T. Fielding

In Cairns, the outbreak began in June 1919. Again, the carrier was from a steamship in port, though this time it was the ship's Captain, not a passenger, that had the virus. Captain Tyree, of the SS Allinga, was not diagnosed with Influenza until after he had spent a full day in the city, and within just days, twenty cases had been reported.^[5]

SS Allinga. Photo: State Library of South Australia PRG 1324788

An isolation hospital, set up in the Girls State School, began taking in patients on 11 June.^[6] Matron Mary Gliddon, who had recently moved to Cairns after having left the Mareeba Hospital, volunteered her services as matron of the isolation hospital. She was assisted by Sister Middleton, of the Cairns District Hospital, with Dr Elliott the doctor in charge. By early July, both Matron Gliddon and Dr Elliott (along with four volunteer nurses) had contracted the illness, and were too ill to carry out their duties.^[7] This prompted an urgent call for women in the district to volunteer for nursing and domestic duties at the isolation hospital. A report in the Cairns Post on 4 July 1919 implored women, particularly women with no family or domestic responsibilities, to come forward, remarking that:

"the work of the authorities, however comprehensive, cannot be brought to fruition without the special skill that women's effort alone can supplement it with."^[8]

By late July, 60 people were being treated for Influenza in the isolation hospital.^[9] According to historian Patrick Hodgson, in the three months that Cairns battled the epidemic, there were (officially) 1007 cases of Influenza, resulting in ten deaths.^[10]

The isolation hospital at the Girls School was closed in late September 1919. Matron Gliddon went on to run her own private hospital - St. Anthony's Private Hospital - in Cairns, with the help of her mother, Nurse Margaret Gliddon.

---

^[1] Townsville Daily Bulletin, 26 May 1919, p. 4
^[2] Townsville Museum collection
^[3] Townsville Daily Bulletin, 16 July 1919, p. 6
^[4] Townsville City Libraries Local History Collection
^[5] Hodgson, Patrick, 'Flu, society and the state: the political, social and economic implications of the 1918-1920 influenza pandemic in Queensland', unpublished PhD thesis, 2017, James Cook University, p. 217.
^[6] Cairns Post 12 June 1919, p. 4.
^[7] Cairns Post 4 July 1919, p. 4.
^[8] Cairns Post 4 July 1919, p. 5.
^[9] Northern Herald 30 July 1919, p. 10.
^[10] Hodgson, Patrick, 'Flu, society and the state', p. 18

The ever-present threat of deadly disease

The threat of deadly infectious diseases prompted early twentieth-century governments to take steps to ensure the safety of its citizens. In Queensland, the Health Act 1884 was introduced after an outbreak of typhoid fever and dysentery, and the Health Act 1900 after an outbreak of bubonic plague. 

A child being immunised against Diphtheria, 1920s.
Photo: State Library of Queensland.

Introduced at a time when public anxiety over health matters was high, the main issues that concerned the general public included the adulteration of food, sanitation problems and frequent outbreaks of epidemic disease.

Most local government authorities employed a health officer who reported on the general health and sanitary state of the city on an annual basis. In Townsville, Dr Walter Nisbet was the city’s Medical Officer of Health from 1898 until his death in 1920.

Dr Nisbet reported on everything from birth and death rates, the prevalence of infectious diseases, population trends, sanitation issues and even on the number of empty houses in the city. He also reported on the state of boarding houses, butcher shops and bakeries, as well as local dairies. Dairymen could be fined if they were found to have watered down their milk and regular checks were made as to the fat content of the milk being supplied to locals.

Epidemics of measles, diphtheria, scarlet fever and dengue fever, among others, came and went with alarming seasonal regularity.

Typhoid fever proved to be a recurring problem for health authorities and one that often carried a high mortality. In his report for the year 1906, Dr Nisbet stated that 49 cases of typhoid fever had occurred in Townsville, with ten deaths - a mortality rate of just over 20 per cent.

Houses in Walker Street, Townsville, 1903. Top photo shows an open drain with a small child standing beside the drain. Bottom photo shows the drain's contents flowing underneath nearby houses.
Both photos: CityLibraries Townsville Local History Collection.

In 1915, typhoid fever again reached epidemic proportions in Townsville, with most cases located in North Ward, although there were isolated cases in other parts of the town. In this outbreak, 87 people contracted the disease.

During this outbreak Dr James King-Patrick, Medical Inspector of Health for North Queensland, was interviewed by the Townsville Daily Bulletin about his thoughts on the disease. He had prepared a leaflet with instructions to householders that outlined basic steps to take to avoid potential infection, which centered on many general principles of cleanliness that are taken for granted today.

“The strong point in the instructions to be observed by householders, is that relating to flies,” Dr King-Patrick said.

“People must get it into their heads to look after the sanitary arrangements of their premises, and keep foodstuffs covered,” he said.

“Flies carry filth to food and convey typhoid and other diseases. The fly-road from closet-pan to dinner table is very short.”

In 1918 Dr Nisbet reported that overall, Townsville’s infectious disease record was “fair”, but echoed Dr King-Patrick’s opinion, stating that he felt that the public were not doing enough to protect themselves from possible causes of infection.

Early the following year, the Spanish Influenza pandemic hit Australia and by May, cases were being reported in Townsville. Free inoculation against the disease was offered and 6,000 locals took up the offer.

Dr Nisbet estimated that between 6,000 and 7,000 (25 per cent) of Townsville’s population contracted the illness in either a mild or serious form.  Eighteen people died during the outbreak, ten of those in hospital and eight in private homes.