Black November: The 1918 Influenza Pandemic in New Zealand (review)

The first edition of the present work was published in 1988. This edition has been expanded to include chapters that place New Zealand's worst natural disaster and worst public-health crisis within the context of World War I and the history of influenza both before and after 1918. It includes the latest (as of 2005) on the bird flu (the avian H5N1 strain), which seems to be inexorably spreading but still only from bird to bird. Birds have occasionally infected humans (with devastating results), but the virus has not (so far as we know) developed the means of spreading from human to human. Many experts, however, fear that birds have a only a precarious monopoly on a virus that will sooner, rather that later, jump the species barrier to become a disease of humans, thus triggering the next influenza pandemic.

The epidemic that killed more than 8,000 isolated New Zealanders in November 1918 wiped out an estimated 50 million people worldwide before it burned out. Such a number, although staggering, represents a low-case fatality rate because most people then alive got sick. Ominously, however, the case fatality rate inflicted by the H5N1 strain on the relatively few humans infected has been around 70 percent. Hence, Rice suggests the gloomy possibility that between one-third and one-half of New Zealand's 4 million people could die in an H5N1 pandemic (280). Such a calculation expanded for the world means that the death toll produced by this influenza strain could be counted in billions rather than millions.

New Zealand's experience in 1918 indicates the appalling circumstances surrounding such a catastrophe: governmental miscalculations, inefficiency, ineptitude; wrangling between the central government and local directors; the demand for hospital beds, forcing the conversion of schools and other public buildings into hospitals; untrained volunteers replacing regular health professionals out with the flu; ineffective medications and quack remedies; profiteering by physicians, pharmacists, and undertakers; children waiting for parents dead in bed to wake up; food shortages; and businesses, even whole towns, closing.

Rice has ingeniously utilized death certificates to track the 1918 epidemic geographically. It began in New Zealand about the time of Armistice, although many of the country's soldiers abroad and on troopships had already acquired firsthand knowledge of the disease. It did the greatest damage in the North Island, especially in Auckland, the country's most populous city, and relatively less in the South Island. The flu was especially virulent among the Maori, killing them at a rate 7 times greater than it killed those of European descent, for reasons that seem to have been environmental but may also have had an immunological component.

Black November is a beautiful book, featuring glossy pages and containing more than 50 contemporary, vignette-like accounts by survivors and more than 200 photographs of buildings, people, ships, medical equipment (just about anything connected with the epidemic), as well as newspaper clippings and cartoons.

The work is both fine local history and medical history, though it lacks an analytical index, and its index of names and places makes the book difficult to navigate, at least for an insider. Other scholarly apparatuses are in place, however; the endnotes and bibliography reflect the book's exhaustive research.