Death in the Pacific Islands – Does History Repeat Itself?

From New Zealand History Online:

On 7 November 1918, the New Zealand passenger and cargo ship Talune arrived at Apia from Auckland. On board were people suffering from pneumonic influenza, a highly infectious disease already responsible for hundreds of thousands of deaths around the world. Although the Talune had been quarantined in Fiji, no such restrictions were imposed in Samoa. Sick passengers were allowed to disembark.

The disease spread rapidly through the islands. Samoa’s disorganised local health facilities and traumatised inhabitants were unable to cope with the magnitude of the disaster and the death toll rose with terrifying speed. Grieving families had no time to carry out traditional ceremonies for their loved ones. Bodies were wrapped in mats and collected by trucks for burial in mass graves.

The total number of deaths attributable to influenza was later estimated to have reached 8500, or 22% of the population. According to a 1947 United Nations report, it ranked as ‘one of the most disastrous epidemics recorded anywhere in the world during the present century, so far as the proportion of deaths to the population is concerned’.

Survivors blamed the New Zealand Administrator, Lieutenant-Colonel Robert Logan, for failing to quarantine Talune and for rejecting an offer of medical assistance from American Samoa. A Royal Commission called to enquire into the allegations found evidence of administrative neglect and poor judgement.

22% of all the people in Samoa died of the flu 1918. What makes this catastrophe particularly sad is that it was completely unnecessary. In nearby American Samoa, there was a different policy and a different result:

From McLeod et al. (2008)

While it was in force, the maritime quarantine used by American Samoa from November 23, 1918, appeared to exclude pandemic influenza (2). Once influenza did reach this jurisdiction in 1920, no recorded deaths were attributed to influenza (in a population of ≈8,000) (8). In contrast, influenza spread rapidly through Western Samoa (now named Samoa). The impact was amplified by a lack of medical assistance and by food shortages in the area. Western Samoa had the worst death rate for any country or territory recorded in the 1918 pandemic, losing 19%–22% of its population (2).

In the current pandemic, Director General Chan of the WHO has strongly urged that no movement restrictions be used to limit the spread of the influenza virus. This time, not one country has decided to protect itself by imposing quarantines or other movement restrictions. The results are unsurprising. The pandemic virus has spread quickly from country to country by travelers, just as it did in 1918.

I recently examined the incidence of death due to pandemic flu infection per 100,000 people in all the countries that have experienced deaths. Samoa was number 5 on this list. Because its population is small, only 179,000 people, only 2 deaths were needed to give a high incidence rate. However, I believe it would be a mistake to dismiss this finding given Samoa’s tragic history with pandemic flu. We are just at the beginning of this pandemic. Unless Samoa and other nations decide to take this virus seriously and stop people with it from entering their countries, there will be more deaths.

Perhaps, many more deaths.

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1 Comment

Filed under Outbreak, public health

One response to “Death in the Pacific Islands – Does History Repeat Itself?

  1. Peut-�tre que vous devriez faire un suivi post-message � ce sujet?

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