Jean Ross: Valuable lessons from other epidemic outbreaks

Thousands of schoolchildren were vaccinated against polio in the 1950s. Photo / Herald file

Opinion

The infection first appeared in Auckland. There were sick children and their families kept at home in isolation, lessons through the mailbox and affected people and their contacts "blamed" for bringing the disease into the community.

There were sensationalised accounts about how the disease was passed on. No, not 2009 and swine flu but 1947 and the last time the whole country was put on red alert to quarantine a possibly deadly disease.

Polio epidemics were the great fear of the first half of last century. In 1916, 1924, 1937, 1947-48 and several times in the 1950s, polio affected thousands of people.

Most recovered completely, some died, many were left permanently disabled. In a time when to be "crippled" condemned a person to being a third-class citizen, this was feared as much as death.

When the first cases of polio began to appear in November 1947, the health authorities were quick to swing into action. They had had plenty of practice. Various degrees of quarantine had been imposed during the previous epidemics, and lessons learnt during the 1919 influenza epidemic.

Within days of the first cases being notified in Auckland, North Island schools were closed. On December 8, South Island schools closed. Children were banned from motor camps, Sunday schools were closed and inter-island travel for schoolchildren banned.

All home contacts for patients under 16 were quarantined for 14 days, as were all adult family contacts if they handled food or looked after children. Beaches were deserted when the health department warned about the dangers of acquiring infection there and swimming pools were closed. A few stayed open for adults as long as they were chlorinated.

University entrance and scholarship exams went ahead, but schoolchildren were sternly warned about congregating especially "in tramcars and other public conveyances". A Christmas parade in Hamilton was allowed to go ahead, providing the children stood at least 1.8m apart.

The post-war years were a time of severe housing shortages, and many families lived permanently in motor camps, so the ban on children in camps was difficult to enforce. Grocery delivery boys, who were usually under 16, could not be admitted and boxes of groceries had to be left at the camp gates. Later in January holidaying families, banned from the grounds, were simply camping outside the gates in conditions far less hygienic than inside.

The Christchurch Star-Sun urged that quarantine precautions be introduced before any cases appeared, while the West Coast town of Blackball wanted to ban visitors until the epidemic was over.

But with no signs of the epidemic abating, the government announced in January 1948 that all schools would be closed until Easter, and that children would be taught at home. The Correspondence School prepared lessons to be sent to every home and broadcast lessons began shortly after.

These lessons were to be supervised of course by their at-home mothers. In some areas schools reopened in March but in Auckland and some other places schools remained closed until mid-April. This caused great confusion where children attended school outside their area. There was also the anomaly that workers under 16 (the school leaving age was 15) could go to work, and night classes and commercial classes continued to operate.

There were other anomalies too. Cinemas were closed but eating places stayed open. Sick people congregated in doctors' surgeries.

As well, newspapers were publishing details of new cases, which enabled them to be identified and as a result the entire household were being treated like lepers.

A "very, tired, worn-out mother" spoke for many when she wrote to the Minister of Health begging for schools to be reopened. Others worried about the work that children were missing.

At then end of Summer 1948, the regulations were re-evaluated. Primary and secondary schools reopened but kindergartens remained closed. Patients were still isolated for three weeks, and their families kept in quarantine for 14 days, but they were allowed outside.

Essential shopping was permitted, but not visitors or visiting. The bread-winner was encouraged to take annual leave, but if that was not possible they were allowed to go to work providing they worked on their own, and took their own sandwiches.

Cinemas, swimming pools and motor camps were gradually reopened to everyone but quarantined persons.

As the epidemic waned towards the end of summer in 1949, the quarantine policy was re-evaluated. Out of more than 1300 notified cases, only three could be traced to a possible school contact. Not only was the quarantine policy unsuccessful, the public became less accepting of such draconian measures.

With a better understanding of how polio was transmitted, the whole public health policy towards the disease changed. In the next epidemic of 1952-53 patients and their contacts were still isolated for 14 days, but other restrictions were abandoned.

Instead a campaign for personal hygiene, particularly among food handlers, was launched. Children were asked to bring a clean hand-towel to school each week and teachers were asked to emphasise the importance of hand-washing.

This campaign highlighted problems in the schools - many had woeful hand-washing facilities. One school had 16 hand-basins for 600 pupils; another eight for 800.

New Zealand experienced one more major polio epidemic in 1955-56 before the advent of the Salk and then the Sabin vaccines stopped the disease in its tracks. New Zealand health authorities and the public of New Zealand could cross off one of the epidemics that regularly threatened their lives. For anyone who experienced those times, the preparations to deal with Sars, bird flu, and swine flu have a familiar ring.

* Jean Ross, a pharmacist living in Taumarunui, has done extensive research into polio in New Zealand.