EPIDEMIC COMMISSION.

New Zealand Herald, Volume LVI, Issue 17097, 28 February 1919, Page 7

EPIDEMIC COMMISSION.

'HEALTH OFFICER'S ACTION.

EVIDENCE BY OR. FRENGLEY

POSITION DEEMED SERIOUS.

QUARANTINING THE MAKURA.

When the Epidemic Commission regained its inquiries yesterday, under the chairmanship of Sir John Denniston, evidence was given by Dr. J. P. Frengley, deputy chief health officer, m respect to earlv events following upon his arrival in Auckland last November to deal with the outbreak of the disease here. Ho also made a detailed statement in regard to the arrival of the Makura on November 30. Dr. Frengley ;said that when he arrived in Auckland he impressed upon the Citizens' Committee the inadvisability of crowding cases unto the hospital Ho had hopes that casos could bo dealt with in their own homes with the assistance of special doctors and voluntary aid. The Citizens' Committee- arranged for the division of the city into 22 blocks, with sub-committees to supervise the work of riving assistance in each area. He informed the chairman of the Hospital Board that it should be the duty of the board to provide and equip ail temporary hospitals. After dealing with the installation of inhalation apparatus in Auckland, Dr. Frengley said that at first the administration of "the secial medical service was from the offices of the Health Department. This was found to be unsatisfactory. He then arranged with the chairman of the Hospital Board for this service, and that all nursing aid matters should also bo administered from the board, offices. Ho placed Dr. Hughes in charge of the medical side, and Miss Bagley, assistant inspector of hospitals, continued to control the nursing aid work. Dr. Hughes informed him on November 2 that he had advised the Education Board to close the schools, and this was done as from November 4. Warning to Southern Officials. Dr. Frengley said thai, in view of the general rumour that bubonic plaguo was the true nature of the disease, he went into the question of Ihe bacteriology of the illness with Dr. Hughes and the late Dr. O'Sollivan. The latter produced slides tftat clearly demonstrated the absence of plague Dr. Hughes and Dr. O'Sullrvan informed him that they had no difficulty in demonstrating that influenza bacillus was present in the cases examined. Dr. CSnllivan prepared specimens from a pneumonic case, and these were sent to Professor Champtelonp, of Dunedin. Dr. 'Frengley said he had no doubt that the influenza bacillus ■was the primary enemy, and that associated with it were other organisms responsible for the fatal pneumonia and septicaemia. As the result of further inquiries, on November 5 he sent the following telegram to the district health officers at Wellington, Christchurch, and Dunedin:—" Be warned that the type of influenza here is pneumonic and septicaemic in character. The number of deaths is very great. I can assure you that it is most unwise to regard the epidemic here as in any way exaggerated." He informed another district health officer that the epidemic in Auckland was worse than pestilence. Generally, his communications to Departmental officers impressed on them the need for taking effective steps.

When the Minister for Public Health came to Auckland on November 5 he handed witness a list of deaths notified in Auckland. He told the Minister that the position was very serious, and advised him to make influenza notifiable as a dangerous infectious disease. This course was followed on the following day by a Gazette Extraordinary being published. Dr. Irengley said he made a graph of (the frit 77 deaths taken successively off the • registrars' list, and found that 51 were males and 26 females. Of the males, 29 died st ages between 31 and 51, and eight at ages between 21 and 30. The aged and school children did not appear to be particularly susceptible. Dr. Frengley said that he had prepared a chart in respect to 1564 deaths registered. It snowed that 35 was the worst age in respect to males, (the total numbe' of deaths «t this age being 44. In regard to females, the' worst age was 28, the number of deaths being 24. ' Absence of Outside Information.

No information was available early in the period of the epidemio as to the precautions taken in England and America to combat the epidemic. It became necessary, therefore, to invent precautions. He knew nothing of the precautions taken in England in 1890-93, having been a student in those years. The whole position wast a new one to him. Nevertheless, it was gratifying to know that such precautions as were originated in Auckland had the support of the practice established simultaneously elsewhere, or subsequently in Australia. Dr. Frengley outlined the steps be took to prevent crowding in public places, and the various decisions which were arrived at from time to time by Cabinet, the Minister and himself. He also detailed the applications he made to various authorities for medical and nursing assistance. He said that 15 doctors were secured from the Defence > Department, and two lady doctors were lent by tEe Education Department. At first, the ■ services of those available— contracted" the diseasewere used in and around Auckland City. Later, as the outlying districts required aid, the services of five were used, more especially for work among Maoris. The very greatest difficulty was found in getting nursing aid in outlying districts. By constant striving, however, all needs were filled as promptly as possible.

Makura Oases Fully Discussed. Regarding the case of the Makura, which arrived at Auckland from Vancouver on November 30, Dr. Frengley said that on the previous day, November 29, he suggested that Motuihi Island should be evacuated by the German prioners of war, and this was agreed to by the Minis- . ter for Defence. He gave evidence as to his examination of the crew and passengers on the vessel's arrival. Dr. Hughes and Dr. Russell reported that one of the sick cases examined was definitely similar influenza to that experienced in Auckland; that a second case presented some doubt, but the doctors decided in favour of influenza, and that another case due for re-examination was deemed to be influenza. The latter case died on Motuihi Island. When witness left the ship he asked the port health officer to acquaint the captain with the fact that the ship was quarantined until further orders, and ittls was duly done. An inhalation apparatus was left on the ship. Witness said he saw no reason to he more definite at this stage. He had to consider quite a new aspect of influenza infection against anticipated measles infection. Un the way back to Auckland he dipthe whole position with his colognes. Vore particularly he discussed wh Dr. Hughes the question of remotfjDg the sick from the ship, and as to how ' lon g it was likely to be before the Makura could he declared clean. , witness came to the conclusion that the «ew had been infected at Suvf.. He : *<|s not worried about the passengers. these he found had been exposed to in««ion in various parts of America, and \ Alh. ♦ Ada and had passed . tnrou K h !§?«; Mrta and Vancouver, where influenza yfc ™as rife. He concluded that the passen§9| |f r ? In general might be regarded as :•: t v; already _ adequately possessed of natural "acquired immunity. He regarded the outbreak among the' crew with especial ■ J*oness. He could not find that they '-. W been exposed to influenza. He anti'':•>''Ja""i therefore, from the experience J*** gained in Auckland, that the • spread, no matter what gops, ware taken, and however quickly. « ! no cases occurred, he anticipated being

able to declare the ship clean in three days, but he felt almost absolutely sure the cases must increase, and that, therefore, at least seven days must elapse before the Bhip could be declared clean. Dr. Frengley quoted his authority for ordering all well persons on board the; Makura, Australian passengers included, to perform quarantine on board. He said there was no provision in the Public Health Act requiring authority to bo received from the Minister before a ship was ordered into quarantine. Witness informed the chief health officer of the steps he had taken, and a reply was received, stating that action regarding the Makura was approved. In all, 36 cases—the whole of whom, with one exception, were members of the crew— removed to the island for treatment. Up to December 12, three deaths occurred on th>i island. A volunteer helper also died. Eleven cases developed on the Makura subsequent to the ship leaving Auckland for Sydney. One of these died in quarantine in Sydney.

Evidence of Overcrowding in Houses. George T. Jones, a waterside worker, said ho had been authorised by the Auckland branch of the New Zealand Labour i Representation Committee to give evidence. Until two years ago ho had been in the employ of the Auckland Gas Company. In this capacity he visited a largo number of houses in various localities in Auckland. Witness then gave evidence relating to alleged overcrowding. Fie specifically mentioned the case of a 10roomed house in the Heme Bay district, in which, he said, 17 families had teen living two years ago. Partitions had been erected between rooms, and families were living in single rooms. During the period of the epidemic, he visited a four-roomed house in which a man and his wife and seven children were living. He condemreel a large number of houses in the Bcino Bay and Ponsonby districts as being wet and damp. lie also condemned build in other quarters of the city as being nnSt Tor occupation in their present state. He contended that all bouses should he licensed, and said that if a bouse fell into disrepair the license should be withdrawn. Regarding the proposal of tho Auckland City Council to expend £250,000 in erecting workers' homes, he said that the sum named would not provide more houses than were actually immediately needed by people. The council's scheme would make no provision for the future. Position of Makura's Passengers. Robert M. Hacket, who was a passenger on the Makura, said the passengers knew very little regarding sickness on board the ship. Up to the morning of arrival they had been led to believe by the ship's doctor that there waa no sickness on board, and certainly no influenza. Later tho doctor attributed the first cases of influenza to a fog which the ship ran through on the morning of the arrival at Auckland. He said the fog came into the stokehold and caught men when they were lightly clad and overheated, and influenza resulted. When witness passed through Montreal influenza was as serious as it nad ever been in Auckland. Conditions were not quitj so bad in Vancouver. Taking these things into consideration, it was surprising there was no sickness on the voyage among the passengers. Witness detailed the proceedings subsequent to the Makura's arrival at Auckland.

Speaking in regard to the landing of the patients at Motuihi, Mr. Hacket stated that the first five were well wrapped up and great care was taken of them. Tho others walked on to the launch and had no warm coverings. Some of them went ashore as late as 8 p.m. Referring to the reported intention to land the New Zealand passengers at St. Heliensßay, the witness said that on the evening of the day the passengers were landed from the ship Dr. Valintine visited Motuihi, and in a discussion with the passengers he stated that they would probably be landed on Sunday, and that on account of the possibility of a disturbance on the part of the public if they were landed in Auckland it was intended that they should be taken to St. Heliers Bay. The passengers for Southern destinations would be driven in motor-car 6to Penrose junction, and would join the train there, and the Auckland passengers would be driven to Auckland. He protested to I Dr. Valintine regarding the proposal to ; land the passengers at St. Heliers Bay, and later that evening he went to the telephone to protest along with Mr. G. Fenwick, of Dunedin, who drew Dr. Valintine's attention to the fact that if the pas. sengers were landed at St. Heliers Bay there would be no Customs examination of their luggage or their passports. Dr. Valintine said that those were matters for other Departments. He said he would discuss the objection to the St. Heliers Bay landing when he came to the island next day. On the following morning (Sunday) Dr. Valintine went to Motuihi, and witness had no doubt that he had then abandoned the intention to land the passengers at St. Heliers Bay. Witness said he had always considered that Dr. Valinline's fears regarding a possible disturbance at Auckland were wrongly founded. Dr. Valintine said the account given by Mr. Hacket was substantially correct. He had received a telegram from the Minister suggesting that on account of the feeling in Auckland the passengers should be mobilised at St. Heliere Bay. He abandoned this intention, however.

Mr. Hacket said that the Southern passengers were actually taken to fenrose in motor-cars after landing in Auckland. This was necessitated by tie fact that the Railway Dspartment had arranged for them to entrain there.

The chairman expressed the opinion that the supposed intention to land the passengers at St. Heliers Bay was outside the scope of inquiry of the commission. The commission will resume this morning.