H.—3la
24
Dr. Grant, the Officer in Charge of the Hospital, was himself attacked. He was not able to attend the Commission. There was one death on the " Niagara " the night before arriving in Auckland, two deaths at the Auckland Hospital, and one death on the " Niagara " the night before she left Auckland. is obvious that the condition of the " Niagara " patients on the morning of the 12th could not by any reasonable imagination be properly described as " pure influenza," especially as defined by the Minister in his telegram, to which Dr. Hughes's was an answer, as " presenting same indications as that which has prevailed in Dominion for some time past." It does not, however, follow that they were cases of the, epidemic influenza, which has been popularly called " Spanish influenza." There have been several sporadic cases deposed to before us as occurring at times and places inconsistent with foreign infection which are practically identical with these just cited — the same expression being used, "drowned in their own secretions." It has been suggested —it seems to us reasonably —that these patients had contracted ordinary influenza in the usual way, and that the pneumonic complications were due to some condition or weakness in the patients themselves rendering them more liable than others to complications. The three most serious of the " Niagara " cases appear to have been of this class. Twenty-five of the cases had been reported by the wireless message as serious. The explosive outbreak of the epidemic influenza seems to have begun at a time which would practically synchronize with the admission of the " Niagara " patients—twenty-eight on the 12th October, six on the 13th, one on the 17th, two nurses on the-2lst. We have already cited Dr. Maguire as giving the arrival of the " Niagara " as, in his opinion, the date when the outbreak spread over the community. From the 12th October till the 14th December there were 845 admissions to the Auckland Hospital and 188 deaths. Two nurses who nursed the ' Niagara " patients died of the epidemic influenza. Out of a staff of 180 nurses 140 were affected by the epidemic at one time and 160 altogether. Wharf labourers and others had been occupied in unloading and working the steamer from the 12th onward. We have no satisfactory evidence of the extent or character of the isolation of the remaining patients. There had been influenza among the passengers who had landed, and were potential " carriers," although on this point we should mention that no instance of illness of any passenger after landing, or any attack referable to contact with any such patient, has been found, notwithstanding careful inquiries having been made. We have now to consider on this question if there is evidence of other sources from which, prior to or contemporaneous with the arrival of the " Niagara," the epidemic could reasonably be said to have been introduced. We have had the evidence of several medical men practising in Auckland of the existence antecedent to the arrival of the " Niagara " of cases in which, amongst the ordinary sporadic cases of influenza, were found bronchial or pneumonic complications. We are not satisfied that any of these have been shown to be cases of the epidemic form of the disease. On the other hand, we have the opinion in a resolution by the Auckland Branch of the New Zealand Division of the British Medical Association, which is stated to comprise practically the whole of the Auckland medical profession, that in their experience the influenza cases prior to the " Niagara " were not of that type. We have already considered the other sporadic cases of a virulent character in other parts of the Dominion. Another suggested source is the military camps, particularly at Narrow Neck Camp, about three miles distant from Auckland. On this matter also we have been provided with a number of full, able, and carefully prepared reports, statistics, and graphs. The relevant evidence of Dr. Andrew on the point is, — The only evidence I can give you is with regard to the outbreak at Narrow Neck. The first case of influenza was noticed about the 30th September. Between that and the 10th October 169 cases were reported, of whom thirty-nine were recorded as being fairly severe. Then there seems to have, been a break in the disease till the 19th October, when fresh cases arose, increasing in number until the height of the epidemic. Do you know anything about the pneumonic form ? -Yes. It appeared first of all between the 30th September and the, 10th October. There were three cases of influenza, which we sent to the annexe. That was in the pre " Niagara " days, and they were among the 169 cases. In the
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