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ASIAN INFLUENZA - 1957
The following report was presented to the Port and City of London Health Committee in
December, 1957:
Influenza and other Acute Respiratory Diseases have been the concern of the Ministry of
Health over a number of years and Bulletins issued by the Ministry have stressed the importance
of increasing our knowledge of the epidemiology of respiratory infections presumably of
virus aetiology and have emphasised that the chance of recurrences of influenza pandemics and
the disruption and economic loss caused by the ordinary influenza epidemics make necessary a
national study of the disease linked to the international investigations of the World Health
Organisation.
In October 1956, the Monthly Bulletin of the Ministry contained a note on Winter Epidemics
and drew special attention to the scheme of ascertainment which had been operative in previous
winters and requested that "in the case of ports and airports, port medical officers are asked
to report immediately to the Senior Medical Officer, Med. 3, Ministry of Health the occurrence of
influenza-like disease on board ship, or among passengers or air crews arriving in this country".
No occurrences of this nature were reported during the latter part of 1956 and the early
months of 1957, but in June of that year the Ministry of Health circulated the following
memorandum:-
OUTBREAKS OF INFLUENZA
"Extensive outbreaks of influenza have occurred recently in several countries of the Far
East. Brief reports of these have been published in the Medical Press. Cases were first
observed, in mid April, at Hong Kong and Singapore where large numbers of persons have
been affected. Towards the end of April an outbreak began in Taiwan (Formosa) and it has
been estimated that more than 100,000 cases occurred there in the course of two or three
weeks. During the first half of May another large outbreak developed at Manila, in the
Phillipine Islands, and subsequent outbreaks have been reported from Japan, India, Sarawak,
North Borneo, Vietnam, Cambodia and Indonesia. Outbreaks have also been reported among
persons travelling by sea or air from the affected regions.
"Most of the cases have been described as clinically mild. A report from Singapore
refers to severe headache, generalised pains and fever (101° — 103°F.) lasting 2 or 3 days
and followed by about 4 days disability. There have been a number of deaths, but the
fatality rate has been low. The outbreaks have been explosive in character, but the epidemic
wave has passed quickly.
"Virus strains from the Singapore outbreak have been received at the World Influenza
Centre, London, where they are being extensively studied. Preliminary investigations
have shown that they belong to the influenza A group, but are markedly different from
strains isolated during past influenza outbreaks. The present strains are not neutralised
by any antiserum prepared from previous strains and it is considered that the antigenic
variation is the largest that has taken place since the appearance of the A-prime variant
in 1946.
"It is unlikely that the vaccines, which have been prepared against past influenza
strains, will protect against infection by the new variant and the possibility of preparing a
vaccine against the recently isolated strains are being actively explored. However favourably
this work might proceed there would be an inevitable delay before such a vaccine
could be produced in quantity.
"In the meanwhile it is of importance that any outbreaks of influenza which may occur in
Great Britain, should be speedily investigated, with particular reference to the identification
of the causative agent. The Monthly Bulletin of the Ministry of Health and the Public
Health Laboratory Service for October, 1956 (vol. 15, p. 226) contained, under the title
'Winter Epidemics', recommendations for the ascertainment and laboratory investigations
of outbreaks of influenza and other respiratory diseases. It is urged that these recommendations
should be applied, by Medical Officers of Health and by other persons concerned, to
the present situation and continued until further notice. Port and airport medical officers,
in particular, are asked to keep a close watch on the possible introduction of epidemic
influenza into the community and to report immediately to the Senior Medical Officer,
Med. 3, Ministry of Health, Savile Row, W.l, the occurrence of influenza-like illness on
board ships or amongst passengers or crews of aircraft arriving in this country".
Immediately on receipt of this note copies were distributed to all the Boarding Medical
Officers (including Locums) and to all the Health Inspectors together with the following
memorandum
ASIAN INFLUENZA
"You will have read accounts of this in the Press and I now enclose an official 'handout'
from the Ministry of Health.
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