By Virginia Winder

Imagine a virus so deadly that in less than two years it would kill more than 40 million people in the world.

That's equivalent to wiping out the entire population of Spain right now, or all the people of Australia twice over.

This is not science fiction, or scaremongering about germ warfare. This is a true story set in 1918.

At the end of World War I, Spanish Influenza swept the world. At the time there were about one billion people in the world and about half of those caught this illness. That's the same as every single person in India coming down with the flu right now.

The World Health Organisation (WHO) says that India was hammered by the virus, which claimed the lives of 16 million its people.

The New Zealand death toll from the flu was about 8600. That's close to the number of people now living in the south Taranaki town of Hawera.

Inglewood takes hammering

In Taranaki, 322 people died of the flu. Statistics reveal that most of those deaths occurred in the last three months of 1918, with 177 males and 120 females meeting their demise. The epidemic eased in 1919, with the flu killing 11 males and 14 females.

One of the worst-hit places was Inglewood, which recorded 772 cases. The situation was so bad that the Inglewood Record was forced to cease publication. It didn't appear between 8 November and 11 December 1918.

When it returned, the newspaper printed a table of streets showing the households affected, listing cases of sick, recovering and dead. About four-fifths of the town's 260 homes were touched by the illness. The final death toll for Inglewood was 24, four of whom were visitors.

Maori hit hardest

Maori in New Zealand were hit the hardest by the vicious virus.

At Purangi, 37 kilometres east of Inglewood, there had been more than 50 Maori living in the village, according to the late William Bertrand.

In an oral history recorded in 1979, the then 85-year-old talked about the effects of the flu on the small settlement. "...it broke up over that influenza epidemic in 1919 - that cleaned them out; it only left about 10 Maoris (sic)."

In New Plymouth, medical workers were sent to the Maori Hostel on lower Morley Street, where there were some serious cases, and the Waiwakaiho Showgrounds building was opened for Maori convalescents.

In New Plymouth there were 78 deaths recorded and 17 of those were Maori.

The death toll in South Taranaki was much higher. There, 223 deaths were recorded. Of those, 103 were of European descent from an estimated population of 15,700. The remaining 120 deaths were all Maori, from a population of just 1400.

Throughout New Zealand, estimates put the number of Maori deaths at 2160 - about 42.3 per thousand deaths. But that figure could be much higher, because at that time not all Maori deaths were recorded.

Te Atiawa fall to flu

In his book, Te Puea, Michael King says that some Maori settlements were virtually annihilated. "A Pakeha visitor to the Atiawa settlement at the headwaters of the Waitara River in Taranaki counted 140 people there before the epidemic and less than 50 afterwards," he writes.

In a footnote, the late historian says that at the time of the outbreak, there were no Maori Medical Officers. "The estimated toll of the epidemic moved consciences in the Department of Health and in 1920, a Division of Maori Hygiene was created with Peter Buck (Te Rangi Hiroa) as its first director."

Virus not really Spanish

The 1918 flu and its far-reaching fallout began in the United States. The first case occurred in Kansas on 11 March, when a soldier at the Fort Riley military camp reported symptoms, including a sore throat, headache and a fever.

The "Spanish influenza" label came about because Spain was the first country in the world to publish reports of the epidemic, so it was thought the disease began there. Many of the countries fighting in World War I did not print news stories about the flu because they did not want to appear vulnerable in the face of their enemies.

Early on, the flu was serious but claimed few lives. About August that year, scientists say the virus mutated into a far more potent strain.

By this time the war was coming to an end and troops were travelling home to all parts of the globe, taking the illness with them.

Niagara gets the blame

In New Zealand, it was believed that the troopship Niagara was responsible for bringing the virus to Auckland. However, records show there were already some cases in the North Island city.

Along with the returning troops came victory celebrations. Thousands of people crowded the streets, allowing the virus to spread as viciously and effectively as an Australian forest fire.

The results were devastating, with entire countries coming to a standstill.

New Zealand was one of those. Schools, theatres, public transport and non-essential retailers were closed to prevent the flu spreading, enabling workers to focus on caring for the sick. Also, with so many ill, there weren't people to run the trains and trams.

Hospitals set up everywhere

Throughout the country, hospital wards were overflowing with highly contagious and seriously ill patients. To cope with the influx, temporary hospitals were set up in town halls, school halls and other public places.

Bug Stop: An influenza medicine depot in Christchurch, 1918.
Image: Permission of the Alexander Turnbull Library, National Library of New Zealand, Te Puna Matauranga o Aotearoa, must be obtained before any re-use of this image.

In Wellington, even an old steamship was used to house the ill.

Hester McLean, who was in charge of medical operations in the capital, wrote about the epidemic in her book, Nursing in New Zealand.

"This world sickness, which swept over the sea from country to country, was not like ordinary influenza. I think it was a form of plague, caused by all the corruption of death on the fields of war, and the deadly germs, airborne from place to place," she writes.

Viral foe hits troopship

"Perhaps one of the worst happenings was the outbreak on the Tahiti, a ship taking (New Zealand) troops to the field of war."

The men were cared for by about seven nurses, led by Sister Maxfield of Auckland Hospital. "The troops went down like flies; 70 died and the medical officers were ill. The nurses stuck to their jobs like Britons, and ill or not, managed to crawl on deck and attend to the dying men.

"All that could were brought on deck to give some air, and as the nurses said afterwards, it was a gruesome task, treading among them in the dark, and not knowing whether you would find another dead or dying."

Children become orphans

Young men in the prime of life and new-made mothers were the most vulnerable, writes Kiwi doctor Eleanor McLaglin.

"In Auckland, some children who had been playing in the street all day went to the nearby grocer and asked for food as they were hungry. They said their father and mother were in bed and would not get up or even speak to them. Both parents were found side by side in bed, dead," she says in her book, Stethoscope and Saddlebags.

During the outbreak she was working in Christchurch Hospital, where doctors felt "tragically helpless".

"Neither sulpha drugs nor antibiotics had been discovered," she says. "Doctors had no weapons with which to fight the epidemic, and they minded their helplessness dreadfully."

Scientists still on influenza trail

Those who fell to the flu actually died of pneumonia, an illness that today would be treated with drugs. However, antibiotics were a futuristic notion in 1918. They first came to light in the late 1930s, and were used to treat soldiers with infections during World War II.

In the 21st century, scientists are still studying the Spanish influenza in order to prevent an outbreak of a similar magnitude.

They have studied the virus's DNA, but have not been able to get the disease to grow in their laboratories.

Every year, new influenza strains appear and WHO provides countries with vaccines to beat them before they can take hold.

While there have been other serious flu outbreaks in 1957, 1968 and Severe Acute Respiratory Syndrome (SARS) in the 21st century, nothing has come close to the 1918 epidemic. But, like a sleeping volcano, there is always a chance that another violent eruption of a deadly virus will sweep the world.