Suspected Smallpox Case Isolates Niue

Press, Volume XCIX, Issue 29383, 9 December 1960, Page 18

Suspected Smallpox Case Isolates Niue

[From a Special Correspondent] NIUE ISLAND, November 8. After suffering a disastrous drought and two devastating hurricanes within three years, New Zealand’s isolated little dependency, Niue Island, has now had another blow inflicted on it, this time by becoming enmeshed and nearly throttled in the coils of red tape of health regulations enforced “to the letter.” Those on the island were powerless to alter the course of events. The situation began in a very simple way. On Tuesday, November 8, two days before the monthly Tofua was expected to arrive (two days after its scheduled date), the local health authorities noticed symptoms similar to smallpox in an 18-month-old child brought in sick from one of the villages.

The case was, to say the least, surprising, if not enigmatic, because of three facts: Smallpox was unknown on the island. It was one month since there had been any contact of the island with the outside world, and such contact as there is monthly is with the Tofua plying from New Zealand. Nevertheless, certain precautions had to be taken and New Zealand health authorities and the Union Line had to be notified. Locally, the obvious steps were carried out. Some 26 persons, children and adults, who had been in closest contact with the patient, were evacuated to the prison farm where in the space of a few hours a full camp, complete with cookhouse, sleeping quarters, latrines, a small “tuckshop” and even a building to be used as a chapel, was set up. All these people, together with nursing and medical staff, were vaccinated with the small supplies of vaccine then on the island. No Landings Then the news got around that no passengers would be allowed on shore and no passengers would be allowed to go on board. Well and good, a very wise and natural precaution, although of course the latter decision meant the complete upsetting of the plans of dozens, perhaps hundreds of people for months to come, with unforeseeable complications, since the Tofua is fully booked out for months ahead. The plight of passengers intending to land (in many cases, Niueans with no reserves of money) can be imagined, since it meant that they would have to be carried on around through Samoa to Suva, and wait there for another month (at least).

Through all Wednesday, November 9, messages were exchanged between New Zealand, the Union Line and the authorities here, and as the afternoon wore on, it began to become apparent to the complete surprise and dismay of everyone on the island, that it was now doubtful whether cargo from Niue could be taken on board. In the meantime. the lighter crews and all officials had also been vaccinated, in a desperate effort to be able to get poor Niue’s hard-earned exports on board. A disastrous drought in 1957 had reduced exports in 1958 to a minimum, a hurricane in February, 1959, had stopped them entirely just when at last copra and banana exports were starting again; and a further hurricane in January of this year had dealt the final smashing blow.

Now at last, this month things were looking up. Some £3OOO worth of kumaras were waiting on the wharf, a snail shipment of bananas had been got ready, and the women of the island were proud because the Weavers’ Cooperative they had formed in February had gradually built up to a record order of £lOOO worth of baskets and other woven ware, representing tens of thousands of hours of patient and intricate weaving of pandanus and other plant fibres. All this was jeopardised, and was indeed likely to be a total loss—the kumaras and bananas obviously, and the basketware because the orders were for the Christmas trade in New Zealand, and in this humid, hot climate woven ware in any case cannot be kept indefinitely unless it is frequently exposed to sun and air. Moreover goodwill among New Zealand stores would be destroyed. No possible compensation existed, except for the bananas, which are covered by a guaranteed price fund. Everything looked gloomy, but the lighters and crews were out in the roadstead when about 6 o'clock in the morning the Tofua came into sight. Then the blow fell. Not only would no out-w-ard cargo be loaded, but no inward cargo would be landed. No contact of any sort was to be allowed. The lighters which were hovering around the Tofua were not even to touch the sides of tire vessel! It was begged that the mail should be dropped overboard. without any contact, into the lighters- No, impossible. The humble prayer was uttered that a dying man on board, being brought back to end his last days among his own people, might be lowered in slings, and the slings dropped. No. Finally, after lowering a canister of vaccine overboard, the rope being carefully also dropped overboard, the Tofua sailed away, carrying with it the mail, the meat, sugar, flour, tobacco, potatoes, rice, and general groceries for the following month. No Reserves Virtually no reserves are held of these commodities because of general tropical conditions, and so the island is now without even bread. The island’s own staple foods, taro and yams, are still in short supply because of the hurricane, and fish is never available in large catches. Moreover, work on the rehousing of the people after the humcane is brought almost to a standstill temporarily, because materials for this were also parried on. At one stage, the Union Line Indicated that the Tofua would not load for Niue even on the December run. The fortunate, saving circumstance in the whole set-up is that by the greatest of good fortune, the Moana Roa is making a special trip with building

material and is due to arrive next Monday. As she is calling at Rarotonga it is expected tha' she will bring what she can ge' from there in the way of foodstuffs such as flour, rice and sugar. After some days of uncertainty it now seems sure that she will load and unload normally, and that the Tofua will load for Niue on her next trip. Moreover, the kumaras and the basketware will doubtless get away on the Moana and should arrive perhaps in time for Christmas trade. The bananas were sold off on the wharf at half-a-crown a case. Mass Vaccination In the meantime, two flights by flying-boat from Fiji have been made, air-dropping supplies of smallpox vaccine, and the whole population of the island, some 5000 people, is being vaccinated, starting with the children. Meanwhile,, because of the "outbreak of smallpox in Niue,” mass vaccinations were started in Fiji. Let us look at this case of “smallpox.” The symptoms, as said above, became apparent one month after the last contact with the outside world, and that contact was not with any countries in which smallpox is endemic or even known at the present time. On Niue itself smallpox is similarly unknown. No further “cases” developed in the days immediately following the discovery of the suspect, nor have any occurred since. It is true that there have been rare cases in medical history where an outbreak of smallpox can be attributed to the wearing of clothes worn or touched by a smallpox victim—but where is the possible connexion in this case.

Where does the boundary of reasonable precaution lie? Why should a helpless, isloated island be treated as though bubonic plague was raging, when in fact, every circumstance ruled out the probability of a smallpox epidemic having broken out?

The local health officer did his duty in reporting a “suspected case’’ of smallpox, but all later developments lay in the decision of the New Zealand health authorities and the Union Line. Goods of all sorts come into New Zealand monthly from India and Pakistan and other countries where smallpox is endemic, yet a ship calling at a place where a highly problematic, single case of “suspected smallpox” existed is. apparently unable even to drop mail overboard, much less load cargo

November 23.—Epilogue: The “smallpox epidemic”, is now officially ended, having consisted of one case, classified for the records as “variola minor” and having apparently neither source nor issue. The child is recovered, the quarantined villagers have returned to their homes, and the Moana Roa is due this evening, bringing such stocks of commodities as it could pick up in Rarotonga. Presumably the Tofua will call on its next trip at the beginning of December and will doubtless bring with it the mail, the passengers and whatever has not perished of the cargo and commodities due to have been landed at this island nearly two months before.