Epidemic or Pandemic
August 3, 2009Smallpox
The first recorded epidemic of smallpox in the Cape was in 1713 and later 1735 and 1767. However many people seem to forget the outbreak in 1755 which hit the small settlement very hard – a quarter of the White inhabitants died in the first epidemic, and nearly half the slaves. Further smallpox epidemics occurred at the Cape in 1767, 1807, 1812, 1839, 1858 and 1881. That of 1881 was the most virulent.
Typhus
In 1867 a Typhus epidemic broke out. Typhoid is a disease of unsanitation, spread by contaminated human excrement. During this time it was not unusual for people to throw sanitary waste into the streets as well as carcass remains and other unsavory remnants of human and animal waste. The only serious epidemic of this disease occurred in South Africa at the beginning of the century as a result of the disorganisation brought about by the Second Anglo-Boer War. The mortality among civilians and military personnel was severe. Fairly high incidence continues in primitive, unsanitated communities.
A Cholera epidemic broke out in 1869 not long after the Typhus one a few years prior. These epidemics still occur in Southern Africa every few years.
Poliomyeltis epidemics occur periodically in South Africa. The public tends to be gravely frightened of this disease because of the pitiful crippling of children that so often results. The total number of cases occurring has, however, been relatively small compared with the other diseases that occur in epidemic form. There were epidemics in 1918, 1948 and (the worst one) the summer of 1956-57. `Epidemics’ of some hundreds of cases occurred in 1960 and 1966. In epidemic years vast numbers of children became infected without showing any sign of the disease. Such children are naturally immunised, but this is a very risky method of acquiring immunity, as the paralytic form may so easily be triggered off; e.g. by violent exercise or trauma of any kind. Subsequent crops of babies will not acquire such immunity and will provide material for the next epidemic unless submitted to vaccination.
Influenza

Some of the entries for one day (15 Oct. 1918) at the Maitland Cemetery, Cape Town, when the influenza epidemic was at its peak.
Epidemics of influenza or grippe occur at intervals. In South Africa extensive pandemics were experienced in 1918 and in 1957, which swept through the country within two months. The 1918 epidemic caused nearly 140 000 deaths in the Union of South Africa, mostly among the Bantu and Coloured sections of the population, although the death-rate among Europeans was also unusually high. The 1957 pandemic was not nearly so severe: most patients had a relatively minor illness and there were very few deaths. Epidemic outbreaks occur frequently in Southern Africa, but do not present unusual features as compared with epidemics elsewhere, although the illness tends to be more severe in the Bantu than in persons of European descent, and complications involving the lungs tend to be more frequent.
South Africa experienced outbreaks of influenza in not only in 1918 but also 1836, 1854, 1862, 1871, 1890 and 1895. The 1918 epidemic first manifested itself in Europe, where so many German and Austrian soldiers fell ill that a German offensive was delayed until March. It spread to Spain, where 8m people were affected. The death-roll in Europe was comparatively light however, and in Spain only 700 people died. The disease was spread by carriers, and it was soon contracted by British, French and American troops in France. Outbreaks were reported as far afield as Norway, Switzerland, Hawaii, China and Sierra Leone. There is little doubt that ships brought the epidemic to South Africa. At first it affected the ports and principal towns. It was reported in Durban on 14 Sept., in Kimberley on the 23rd, and in Cape Town and Johannesburg on the 25th.
Like the earlier epidemics, the 1918 `flu’ attacked men rather than women, and all races alike. There the similarity ended, for whereas previously the very young and the old were more prone to contract influenza, now adolescence and old age seemed immune, and the special incidence fell on the group between 25 and 45 years of age. The epidemic spread rapidly, following the lines of communication: the railways and roads. Hundreds of thousands of people fell ill, and the economy of the country, including the mines, was nearly brought to a standstill. Coal was no longer being produced, and factories closed their doors. Commerce almost ceased, only food-shops remained open, and transport was more precious than gold. The railways operated a skeleton service, trams ran spasmodically, and motor-cars were short of petrol. In the towns essential foodstuffs were scarce – no bread, since the bakers were ill; no milk, since the farmers were unable to bring it to town. The greatest shortage, however, was of people – hands to nurse the sick, feet to bring essentials of life when whole families lay ill.
At first the death-rate was low – then suddenly it began to rise. Doctors, many of them ill themselves, could not cope with the flood of patients, emergency hospitals overflowed, the supply of coffins gave out, and people were sometimes buried in mass graves. Nor was there safety in the country, for refugees spread the epidemic far and wide. The Transkei, with practically no medical assistance available, was particularly hard hit. The authorities did their best to cope with the situation, but thousands died without ever seeing a doctor. Then, as suddenly as it had begun, the epidemic ceased.
| Cape | Transvaal | O.F.S. | Natal | South Africa | |
| Population | |||||
| White |
617 131 |
498 413 |
181 613 |
120 903 |
1 418 060 |
| Non-White |
1 982 588 |
1 265 650 |
352 985 |
1 095 929 |
4 697 152 |
| Total |
2 599 719 |
1 764 063 |
534 598 |
1 216 832 |
6 115 212 |
|
|
|
|
|
|
|
| Influenza cases |
|
|
|
|
|
| White |
192 007 |
140 639 |
79 532 |
42 475 |
454 653 |
| Non-white |
1 009 223 |
491 448 |
150 492 |
510 989 |
2 162 152 |
| Total |
1 201 230 |
632 087 |
230 024 |
553 464 |
2 616 805 |
| Deaths |
|
|
|
|
|
| White |
5 855 |
3 267 |
2 242 |
362 |
11 726 |
| Non-White |
81 253 |
25 397 |
7 495 |
13 600 |
127 745 |
| Total |
87 108 |
28 664 |
9 737 |
13 962 |
139 471 |





