THE SAMOAN EPIDEMIC.

New Zealand Herald, Volume LVI, Issue 17242, 19 August 1919, Page 9

THE SAMOAN EPIDEMIC.

m REPORT OF COMMISSION. SUGGESTIONS CRITICISED. < VIEWS OF DR. R. H. MAKGILL. Certain points and recommendations in the report of the Samoan Epidemic Commission were referred to the adting-chief health officer, Dr. R. H. Makgill, yesterday for an expression of opinion. . i Regarding the statement that some notification should have been forwarded to the authorities 'in Samoa of the epidemic of influenza whioh was raging in New Zealand at the latter end of 1918, and regarding the suggestion that the Government should enter into a reciprocal arrangement with Governments in other parts of the world for immediate notification by cablegram of tTie outbreak of anv infectious disease, Dr. Makgill said the difficulty with influenza was to know ■when is, was likely to, take on a serious form. Outbreaks of influenza with increasing death rates had been going on continuously all over the world, and e\eu in New Zealand every year we had a certain number of deaths from influenza. For instance, in 1913 the numj b.r of deaths from this cause was 56, in 1914 it had increased' to 63, and in the succeeding year to 110. In 1916 the number dropped to 73, and in 1917 to 38, while in 1918 it must have increased out, of all proportion to the number in any previous year. Those deaths were almost entirely due to pneumonic complications ensuing. Obviously tho mere recurrence of deaths from pneumonic pr other complications was not a rea«on\ or adopting special quarantine or other methods. It was difficult to know when to take alarm. It was only in November. 1918, that authorities in New Zealand were able to form an opinion that tho outbreak in this country was of a quite unusual character, and of a virulence not within the experience of any living medical man. Tho outbreak, severe as it was, could not have been anticipated. With the experience of last year, however, the health authorities must now look upon influenza, especially cases with pneumonic complications, as far more serious a matter than ever before. Exceptionally Virulent Pandemic. Dr. Makgill said it was quite unlikely that there would be a renewal of a pandemic of such virulence as that which New ' Zealand experienced in 1918, because with i the return of peace the conditions leading up to, and responsible for, the outbreak ] had ceased. There was no doubt that the j aggregation of large bodies of men of susceptible age in camps in all parts of the world, and their transport overseas, had I resulted in the high virulence of the wave i of influenza and iU complicated organisms. ! The probability was that the virulence would now diminish and would not reappear in the same degree unless some other such extraordinary circumstance arose. A matter which had greatly affected our knowledge of the progress of influenza in other parts of the world was the military censorship, and because of this, information relating to disease among the troops abroad was of necessity withheld. Fortunately tho censorship had now been abolished. Commenting on the commission's statement that bills of health were procured by shipping companies without anv reference to the Public Health Department, Dr. Makgill said that as bills of health were issued by the port health officer to the shipping companies, and the port health officer was an officer of the Department, it was difficult to understand the meaning of the commission's statement. After all, a bill of health was of little use indeed. It only referred to the prominent infectious diseases in the port from which the steamer left. This might have been of some value in the old days before the day of rapid transport. A bill of health could not take cognisance of disease which might have been brought on a steamer bv passengers or crew from other ports, nor could it take cognisance of potentialities for virulence m such diseases as influenza. Our experience showed that what might one week apparently bo little more than an outbreak of feverish colds might the following week assume the proportions of a virulent outbreak. Question of Bills of Health. The»? Health Department officer in preparing a bill of health could not possibly know what potentialities for harm there might be abroad in his own port, and still less among the passengers and crew from another port who were passing through. The abolition of bills of health would bo preferable to any attempt to elaborate them, resulting pTobably upon too much weight being placed upon unreliable dateRegarding the suggestion to take the , temperatures of all people on a ship before sailing, Dr. Makgill said that during the past month an attempt had been made in New Zealand and Australia to check tho temperatures of all persons leaving tho , ports. A small amount of good might result from this system, but it was obvious that it would not reveal the existence among passengers and crew of persons in the incubation stage of a disease" only. In a disease such as measles it might be 14 days from the time the infection was re- ! ceived before the temperature rose. The only measure from which we could secure > definite protection was the strict examination of passengers and crew on arrival from i overseas. ( To do this adequately a very ■ great amount of delay must result. This would cause bitter complaining among . business people, but it was obvious that ■ lone could not " have the cake and eat it." ; I " If we are to have a full measure of proi tection against the importation of disease, , then the people of New Zealand must make up their mind to interruption of the • overseas trade." said Dr. MakgiU. I In regard to the suggestion that a , quarantine officer should be appointed for ) New Zealand and its dependencies, such , officer to have control of all matters con- [ nected with quarantine, including, inter . alia, the clearance of inward and outward , shipping and the issue of bills of health, . Dr. Makgill said it was evidently taken , from a suggestion already made by the , Department that one officer should i specialise in all matters relating to quaran- ; tinable diseases in all parts of the world. I Some specialisation was necessary, owing . to the enormous amount of research work involved, particulars of which were con- , tained in the Departmental reports of . various countries. The average medical I officer had not the time, with his other [ duties, to devote to this special work.