EPIDEMIC COMMISSION.

Timaru Herald, Volume CVIII, Issue 16800, 2 April 1919, Page 8

EPIDEMIC COMMISSION.

% - ■■; i i'. • v,The,;Epidemic, Commission'-sat": afc j f Blimqdin yestqnlny. ..." •"''. Vvf'* ."'"""! ~:| •■'■: Dr 'Ban-is', District' .Health,' Officer; ~■ \ stated .that-during the x months' precedingr.thW epidemic, i there -We're , riiunprous of influenza in Dtfiii ''. bdin,: but : jch'o..rafiter. .Ho* know .',., of" jripnia; ogewedv«)iia complication; Hp <had also^^en^j>M6rnied.; by f ii pi-acv titiohci r of|two eases which caino under * ..'■ bis»no.tico.LSfc :, Septißmbej'r 2; whicb, in tho light owpresent] e.xpOi-ionce} lie* considered to;bo pfrepldoniie type! He at- .',. tributed th&< spread" "Hi '"' this- ,: ,district- to' the* ChVifitihureh carnival week, com- ' .mdnojtift'on.November 4, and the Winton races, on November 13 and 14. Some contracted disease immediately on, reaching: "Clhristcliurcli, ,nnd returning : nt. oijc<j"tp: thoii? homes" in Otngo and Southland-spread the infection. Tho population , of the Otago Health Dis-' trict ,wiV 100.8(i.j Eiiropean and 208 Maoris; ,w/rjie total deaths during the last- three --mouths of the year-wore: —

'America, •; whilst wozkors. in Australia were finding similar conditions.: In the light of present-day knowledge we could expect very little help in preventing f*** ure epidemics from protective inoculation.by means of bacteriological vaccine£ made from ..the micro. organisms found to bo most frequently present in l the of Severe cases. Ho was'ofi , opinion that protective, inoculation gave, in any of those inoculated, a very brief and., slight degree of 'protection, but sudciorit in some cases toihake all -the difference between a. mild attack on the one hand and a severe or, fatal attack on tho other. . An.idealicondition would lie to administer • Vaccine before the epidemic appeared, for there was a. certain amount of risk in giving lot to» persona jvho might .be incubating the disease. For this reason and" by I 'reason 'of-.the protection afforded being problematic, lie. did not recommend wholesale During the last epidemic there were two classes of peoi pie, however, for whom vaccine should ; be /available as soon as an epidemic was likely, viz, doctors, nurses arid voluntary workers, and those .who, for any reason, had an unusual dread of. tho disease. To ■.these- people inoculation I would give confidence, apart from specific protection, and there could be no doubt fright contributed to deaths. Speaking on improvements in tho health service, he considered that the health and hospital services were now too much for one man. ■ Ho suggested a director-general, with a deputy chief health officor and a deputy-iri-spec tor-general of .hospitals. The four central districts should be divided, and junior medical officers stationed in suitable sub-centres. In the most violent type of the disease germs othor, than pure influenza were found in great number in the earlier stage. He thought the disease wo had in New. Zealand before the Niagara arrived would in time have reached the same violence.

Ofitobftf'' (i,,'.';Novembcr 470,' December 428; tlHnl 004. Ho considered that . nmnmnspcctorH were required. . . W'.Chiunptiilouj), Professor of Bac- , torlolday Hnd Public'.Health, said that ' the world's leading authorities held views, on the disease. Expert opinipii, at present was divided on two lines;' one believing that 'the ' ' bacillus was the primary cause'and the •other.'micro, organisms were 'secondary invadcrw, after tbo way bad beun prepared for thorn. .Other experts believed that the roal cause was a, filter-passing * virus, too smnll to bo recognised by tli,e microscope, and that the influenza bioilluH and other micro-organisms were nil secondary invaders. At present experimental evidence in support of the second view was needed. Dr Cluvmptnloup handed in a report from tho Medical School on the scientific aspects of the epidemic, presenting | the clinical, pathological and bac- . terological aspects. The result, Tory closely with those obtained in i ... " 1

drt« tol Ji da T s ' tn ?? 6 fatal f rom ten days onwards, .(m Which certain cases were more typ-.cal of lobar pneumonia, and an which- there -were frequently infections), and special cases which did not fall into these groups. In au similar micro organisms were wui J Va l aatl ??i~ in *yP es w ere probably due to difference in resistance power anpV susceptibility, amount and virulence of infection, and antecedent lesions. Investigation showed t'h« great value of-full post mortem examinations and laboratory examinations during life, and the pressing need for more adequate support of research work in medical matters in the Dominion. Besides the influenza problems , there were others equally pressing, but not so obvious to. the public, that required workers and means to work. _The. first witness to-day was Dr. Frank Fitchett, lecturer on materia medica and clinical juedicine at the Otago University. He said that as far. as his observations went he would not use the word septicaemia of any case he saw. during the epidemic. He wu-uld describe the manifestations as the .result of a toxaemia. Ordinary febrile types predominated even during tha pneumonia invasion, aud many of these cases exhibited toxaemia" wihout pneumonic" symptoms. Pneumonia appeared rather as a. complication of an 01dinary type. As early 'as September and October there was ordinary epidemic influenza about Dunedin, but) it was not tilKXovember that it appeared in virulent pandemic form, with virulent symptoms not usually met in New Zealand. He thought the virulent form must have been imported, that it eamo in its virulent form as a direct continuation of thjo English pandemic. He did not think anything had been found to suggest the presence of an additional organism to what was found in previous pandemics: It was astonishing to find how closely the observations made here accorded with the observations made a hundred years ago, so far as clinical manifestations we're Concerned.

Dr Champtaloup offered to show the Commission, a collection of pathological specimens taken from actual cases, the only collection in the Dominion. Ulic chairman said that a visit would be paid to the Medical School for that purpose .i Dr Drennan, Professor of Pathology nt Otago University, said that in cases examined in Dunedin certain types were distinguishable, those fatal in

Mr George A. Lewin, town clerk, said that while the Act of 1876 provided for local Boards of. Health, which were a distinct advantage, the Act of 1900 introduced tlie- Public Health Department more prominently; and made the Minister supreme therein. ■ He

thought the weakness lay there becauv the introduced element cf dual control sapped local authorities' desire for initial work. If the local' authority were _ entirely responsible he thought the initiative would be improved. Me advocated the creation of local .boards. Witness thought the Act of last session Was so hastily passed that it merely emphasiscd and added to the uncertainty of control. ' Dr. Colquhouit said the disea'se was conveyable by goods,, letters, postal packets, etc. The most susceptible ages, had been from 20 to 50: In preparing for a possible epidemic hospital and municipal authorities should try to get accommodation in" open sheds or. tents. The best defence was soiuul hygiene, vand 'the public have to be educated to the necessity for this. Ho condemned public inhalation and the use. oL masks. The-former congregated large numbers of uninfected and possibly infected people together. The latter, if they permitted. the passage of air, also permitted. the passage of the minute micro-organisms of. influenza, and.had the disadvantage of restricting the supply of fresh air to the wearer. He did not think the Niagara was T;o blame for the epidemic, since'severe casks occurred immediately after her ■.arrival and before the period of incubation required. A recurrence of influenza was almost, certain to take place . in New; Zealand, but it did not follow that it: would be of last year's severe, type. Hei thought a recurrence - would probably take place within the next "month..

The Rev. Mr King advodated extension of the powers -of the .:• local District Health. Officer, who had to refer too ,much to Wellington. He should have power in an emergency to nationalise the whole of the : medical arid nursing services,, and apportion any surplus,in one district to another. There should, also be power to inspect, arid' go into'houses. ' '' H ;\ ■The Commission adjourned till Wedr riesday. -' .-' ■'■'.•,■.'.' ■ -/■'■,' v ■' ,'• !:.,/■•