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Name: Queensland Past and Present: 100 Years of Statistics,
1896–1996
Section name: Chapter 8, Health, Section 4
Pages: 254–263
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 The State of Queensland 2009
QUEENSLAND PAST AND PRESENT
was not completed until the 1960s.
In unsewered areas fly-proofing of
earth closets was essential. In the
1980s and 1990s treatment of sewage
has become an important issue in the
prevention of pollution of creeks,
rivers and the ocean.
Specialist health workers
Tooth extraction by the Flying Doctor, c. 1930.
A range of specialist providers in
the health area emerged in the
postwar period. Legislation was
subsequently introduced to regulate these professions, including
procedures for registration to
practise and the setting down of
significant penalties for practising
without due authorisation. Health
professions regulated by State
legislation include physiotherapists
(from 1964), podiatrists (1969),
optometrists (1974), pharmacists
(1976), psychologists (1977), chiropractors and oesteopaths (1979),
occupational therapists (1979),
speech pathologists (1979) and
dental technicians and dental
prothetists (1991).47
In 1972-73 the adviser in social welfare from the Queensland Department of Health was
appointed to a university committee to review professional education of social workers. A
new course in social work commenced in the 1974 academic year. Changes have also occurred
in the nursing profession. In 1989-90 student nurses were transferred from hospital-based
schools of nursing to the higher education sector where various degree courses are now offered
in nursing.48
NOTIFIABLE DISEASES
The Health Act 1900 included provision for the compulsory notification of certain infectious
diseases. Other diseases were added later such as tuberculosis (known as phthisis) and venereal
disease. Regulations such as the Infectious Diseases Regulations of 1901 were aimed at the
management of diseases such as plague, smallpox, cholera, scarlet fever and typhoid. The
Tuberculosis Regulations of 1904 were expanded under subsequent health legislation, as were
the provisions relating to sewerage, drains, dwellings and offensive trades. As the Queensland
Year Book, 1996 notes, 'the compulsory notification of communicable diseases can provide
254
HEALTH
authorities with information that can enable quick and effective action to be taken to contain
an outbreak of an infectious disease'.49 Nonetheless, the recording of such diseases was beset
by shortcomings.
Table 8.6 shows the number of cases of notifiable diseases in Queensland from 1901 to 1996. It
traces the impact of infectious diseases prevalent at the turn of the century, for example,
tuberculosis, typhoid fever and diphtheria. While the reporting of notifiable diseases may not
be accurate due to possible wrong diagnosis and incomplete reporting by the doctor and to
people not seeking treatment, fluctuations in the figures are an indicator of the presence or
absence of epidemics. Most diseases were checked by improved sanitation rather than by
medical science.
Tuberculosis
Tuberculosis, or the white plague, was the leading cause of death at the beginning of the
twentieth century. However, it was not immediately declared a notifiable disease. In October
1900 the Queensland Government established the Jubilee Sanatorium at Dalby for the
treatment of tuberculosis patients in the curable stages of the disease. The Diamantina Hospital
for Chronic Diseases opened at South Brisbane in August 1901 and mainly housed tuberculosis
cases.50 Many tuberculosis sufferers lived in the general community. Patients who did not have
well-ventilated rooms were urged to sleep on verandas, especially where they shared bedrooms
with other family members.
Local authorities posted 'No expectorating' notices, and fined those who contravened the
notices and spat in public places. 51 The Commonwealth Government, through the
Tuberculosis Act 1948, entered into an agreement with the States to provide funding. Powers
Early nursing in Queensland, probably Brisbane, c. 1900.
255
QUEENSLAND PAST AND PRESENT
Table 8.6 Cases notified (a) by notifiable disease, Queensland, 1901-1996
1909Notifiable disease
1901
Amoebiasis
Diphtheria
Dysentery (bacillary)
Hansen's disease (leprosy)
Hepatitis (infective and
serum) (b)
Hookworm
Leptospirosis (c)
Malaria
Meningitis, cerebro-spinal
Poliomyelitis, acute
anterior
Puerperal infections
Q-fever
Rubella
Tetanus
Tuberculosis
Typhoid fever (d)
Typhus fever
Venereal disease (e)
Other (0
Total (g)
. . not notifiable
n.a. not available
252
n.a.
10
191920
552 2,841
n.a.
n.a.
1930
1,686
4
8
172
244
1
1
6
47
65
2
1
713 1,000
18
82
105
57
30
6
10
9
32
17
9
3
4
10
5
44
10
11
26
40
152
19
n.a.
n.a.
n.a.
793
760
731
n.a.
n.a.
2,848
n.a.
n.a.
n.a.
n.a.
343
130
n.a.
1,714
622
n.a.
525
53
33
1,258
283
n.a.
n.a.
n.a.
n.a.
5
1970
598
19
30
62
55
24
44
106
1
10
1940
1950
1960
— number —
55
2
50
71
101
1980
1990
1996
—
23
1
3
131
—
5
—
203 2,634
—
—
—
—
4,310
—
22
453
65
—
109
389
82
66
16
207
65
29
9
3
255
229
106 271
177
12
72
6
95
198
948
n.a.
42
4
3
594
844 291 308
139
145
2
1
1
9
7
9
2
53
13
577 1,146 1,788 <1,027 5,303 4,595
572 282 316 4,214 12,857
665
3,083 2,631
3,968 3,847 i5,741 13,261 23,621
—either no longer notifiable or no cases reported.
(a) Subject to revision as some diseases have an incubation period.
(b) For 1990 comprises 194 cases of Hepatitis A, 1,709 cases of Hepatitis B, 727 cases of Hepatitis C and 4 cases of Hepatitis E;
for 1996 comprises 416 cases of Hepatitis A, 1,001 cases of Hepatitis B, 2,884 cases of Hepatitis C, 8 cases of Hepatitis D and 1
case of Hepatitis E.
(c) Includes Weil's disease, paraweil disease and seven-day fever.
(d) Includes para-typhoid fever.
(e) The figure in the 1930 column is for 1929-30.
(f) For 1990 and 1996 includes AIDS, Barmah Forest virus, camplyobacter enteritis, dengue fever, epidemic polyarthritis, HIV,
measles, pertussis, salmonellosis(see table 8.7).
(g) For 1940 and 1950 excludes tetanus cases.
Source: ABS, Queensland Year Bonk 1982; Queensland Department of Health, unpublished data.
were granted under the Health Act for compulsory X-rays for all persons aged 14 years and
over. Notifications of tuberculosis declined from 844 cases in 1960 to 291 in 1970 and 145 in
1996 (table 8.6).
Typhoid fever
Typhoid fever, transmitted by flies, was one of the major infectious diseases that killed many
people in towns and mining camps and later among railway construction gangs. In the seven
years to 1889 typhoid fever caused 137 deaths at Charters Towers due to contamination of
creeks from cesspits on their banks. Conditions generally improved from 1897 with the
introduction of the cold bath treatment at Brisbane General Hospital and a laboratory test,
the Widal test, that identified typhoid fever. Typhoid became a notifiable disease under the
Health Act 1900. In 1901,793 cases were notified (table 8.6) and in the first six months of 1903
there were nearly 1,400 cases.52 The number of cases notified declined from 731 in 1919-20 to
130 in 1930 due largely to improved sanitation.
256
HEALTH
Dysentery
The term 'dysentery' was used to cover several intestinal infections. Dysentery caused 900
deaths in Queensland in 1884 compared with 400 for typhoid. In 1893,85% of diarrhoea deaths
occurred in children aged under five years. Dysentery remained a problem for young children
for much of the twentieth century.
Plague
In Queensland in 1900 there were 136 cases of plague, an ancient and dreaded disease spread
by rats, resulting in 57 deaths. Queensland suffered plague epidemics every year from 1900 to
1909. By 1907, 461 cases had been reported. Plague reappeared in 1921 when there were 116
cases and 63 deaths. The last reported case was in 1922.53
Influenza
In May 1919 'Spanish' influenza which had killed thousands of people in the northern
hemisphere entered Australia through Sydney, prompting authorities to make it a notifiable
disease. The Queensland Government closed its borders and established quarantine camps
along its southern boundary. The main camps were at Wallangarra and Coolangatta. Travellers
were required to remain in the camps for seven days before being allowed to enter the State.
Hawthorne Street, Woolloongabba, where the first case of bubonic plague occurred in
Brisbane in 1900. James Drevesen aged 21 who lived in the house on the left was Brisbane's
first patient. He was a van driver employed in removing goods from the wharves where dead
and plague-infected rats were subsequently found. Photo appeared in The Queenslander,
5 May 1900, p. 840.
257
QUEENSLAND PAST AND PRESENT
Specially made overalls and respirators worn by Dr Burnett Ham and his medical and nursing
staff for the treatment of plague victims, c. 1905.
Accommodation for plague cases at Maryborough, c. 1906.
258
HEALTH
Strict inspection of all ships entering Queensland was carried out. But the epidemic spread
throughout the State and defied all attempts to control it, including isolation of the population,
closure of places of public assemblage such as theatres and churches, and inoculation. Hospitals
overflowed and 400 temporary beds were set up in huts at the Brisbane Exhibition Grounds.
St Laurence's Christian Brothers School in South Brisbane catered for the overflow from the
Mater Misericordiae Hospital, while shire and church halls provided temporary accommodation
throughout Queensland.
In 1918-19 there were 9,570 influenza cases reported in Brisbane and 11,099 in other parts of
Queensland. In 1919-20 cases reported in Brisbane declined to 1,483 but increased to 17,319
in the rest of the State. Unlike previous outbreaks of influenza, many of the 830 deaths from
the disease in Queensland in 1919 were young adults. The epidemic caused 69 deaths among
the 596 residents of the Barambah Aboriginal Settlement.54
There were later outbreaks of influenza in Queensland. In 1957-58 'Asian' influenza struck,
resulting in 166 deaths in 1957 and 175 in 1958. The victims of these outbreaks were mainly
young or aged.55
Diphtheria
Diphtheria became a notifiable disease under the Health Act 1900. In 1895 Dr Jefferis Turner
had introduced the diphtheria antitoxin at the Hospital for Sick Children, which resulted in a
marked reduction in the mortality rate for cases admitted to the hospital. However, there was
a resurgence of the disease between 1911 and 1913.56 While there were 2,841 diphtheria cases
in 1919-20, the number was negligible by the 1960s due largely to mass immunisation campaigns
(table 8.6).
Poliomyelitis
Unlike other diseases the incidence of poliomyelitis (infantile paralysis) gained momentum
during the first half of the twentieth century. The first epidemic occurred in 1904 and 1905 and
affected 108 patients, 75% of whom were children aged under five years. Epidemics occurred
from 1914 to 1962, generally at intervals of 3-5 years, the most serious in 1950-1952 when
more than 1,200 patients including many adults had the disease. Improvements in sanitary
conditions which favoured the decline of other diseases contributed to an increase in the number
of polio cases. A higher standard of sanitation reduced the opportunity for children to develop
a natural immunity to the disease from an early age.57 Unregistered nurse Elizabeth Kenny
successfully treated victims in a 'backyard' clinic in Townsville from 1932 by keeping paralysed
parts of sufferers mobile.58 The introduction of the Salk vaccine in 1956 and the Sabin vaccine
in 1967 significantly reduced the incidence of the disease.59
Dengue fever
Dengue fever, also known as break-bone fever from the pain caused to backs and muscles, was
first reported in 1885 in Rockhampton although it may have been present earlier. An outbreak
in northern Queensland in 1897 became a major epidemic throughout the colony. Further
outbreaks, generally statewide, occurred at irregular intervals. Two epidemics of dengue fever
swept unchecked down the coast in 1926 and 1941-1943, the latter including among its victims
members of the Australian and American armed forces.
259
QUEENSLAND PAST AND PRESENT
Wallangarra quarantine camp established during the influenza epidemic, 1919.
Control of mosquitoes, which carried the fever, started in 1916. After World War II the
Queensland Government paid a 50% subsidy to local authorities for approved drainage works,
and the Queensland National Mosquito Control Committee was formed. Despite the program
of mosquito eradication, about 15,000 of Townsville's 40,000 inhabitants suffered from an
outbreak of dengue fever in 1953-54.60 In 1992 and 1993 Queensland had 999 reported cases of
dengue fever (table 8.7).
Malaria
Malaria was first reported by the Queensland Registrar-General in 1885, but had been diagnosed
as an acute remittent or intermittent fever for many years before that. Australian soldiers in
World War I returned after contracting the disease in New Guinea, Egypt and Palestine. They
were treated with courses of quinine. In 1942, 700 civilian cases of malaria were reported in
Cairns. This epidemic helped identify the subspecies of the carrier mosquito. Control measures
required affected servicemen to take Atebrin tablets daily.61 An increased number of cases
have been reported in the 1980s and 1990s (table 8.6).
Coastal fevers
Other fevers causing considerable illness in northern Queensland were commonly referred to
as 'coastal fevers'. In 1910 the Commonwealth Government established the Australian Institute
of Tropical Medicine in Townsville, the first institute of medical research in Australia. By the
1950s the different fevers were clearly identified. Principal among these was Q-fever.62 There
were 255 cases of Q-fever notified in 1960 and 177 in 1996 (table 8.6). Other northern
Queensland coastal diseases include leptospirosis and scrub typhus.
260
HEALTH
Venereal disease
Syphilis contributed to a high number of stillbirths and was a cause of crippling. Compulsory
notification of venereal disease was required from 1913, but medical practitioners observed
the legal obligation of notification less stringently than for other diseases. During both world
wars there was a rise in notifications of venereal disease.63 The number of notified cases declined
from 2,848 in 1919-20 to 577 in 1950 (table 8.6) due largely to penicillin. While syphilis
notifications in Queensland fell, the gonorrhoea organism developed a resistance to penicillin.
An increase in venereal disease since the 1950s has coincided with the introduction of the Pill
and other birth control methods and the trend towards a more promiscuous society.
Other diseases
Notifications of hepatitis (infective and serum) increased markedly from 713 in 1960 to 4,310
in 1996 (table 8.6). About two-thirds (2,884) of notifications in 1996 were due to hepatitis C.
There were also 1,001 cases of hepatitis B (acute, chronic and unspecified), 416 cases of hepatitis
A, eight cases of hepatitis D and one case of hepatitis E. The incidence of 'new' diseases—
acquired immunodeficiency syndrome (AIDS) and its precursor, the human immunodeficiency
virus (HIV)—has plateaued in recent years (table 8.7). In 1996 there were 3,031 and 2,010
»•«•••«•
f •••
«• ••
. ••••
Petrolisation of a salt marsh at New Farm. The marsh was subsequently filled in, to inhibit
mosquito breeding, c. 1915.
261
QUEENSLAND PAST AND PRESENT
Table 8.7 Cases notified (a) by selected notifiable diseases, Queensland, 1985-1996
Notifiable disease
1985
1990
1991
AIDS
Barmah Forest virus (b)
Camplyobacter enteritis (c)
Dengue fever (b)
n.a.
66
18
553
44
96
3
2,767
13
Epidemic polyarthritis (Ross River fever) (b)
HIV
Measles
Pertussis (whooping cough)
Salmonellosis (c)
479
n.a.
1,398
189
45
156
1,313
1,955
218
153
132
1,486
. . not notifiable
390
1992
1993
— number —
108
115
159
311
3,075 2,467
336
663
1994
1995
1996
120
448
2,109
3
129
456
2,094
13
98
576
3,031
11
2,386
191
819
597
1,367
3,141
226
2,483
1,937
1,450
1,687
227
251
1,416
1,579
4,936
222
93
766
2,010
4,187
219
127
210
1,474
n.a. not available
(a) Subject to revision as some diseases have an incubation period.
(b) Commonly transmitted by mosquitoes.
(c) Normally associated with food poisoning.
Source: ABS, Queensland Year Book, various years; Queensland Department of Health, unpublished data.
Table 8.8 Main causes of death, Queensland, 1896
Cause of death
Phthisis (tuberculosis)
Pneumonia
no.
444
377
Deaths
% of total
deaths
7.9
6.7
Diarrhoea
Enteritis
Convulsions
Endocarditis, valvular disease
Premature birth
285
248
199
199
197
5.0
4.4
3.5
3.5
3.5
64
55
44
44
44
Cancer
Bronchitis
Circulatory system, other diseases of
Drowning (accident)
Typhoid or enteric fever
183
163
160
159
130
3.2
2.9
2.8
2.8
2.3
41
36
36
36
29
Dentition
Bright's disease
Dysentery
Tuberculosis, scrofula, other forms of
Sunstroke and heat apoplexy
107
92
90
88
84
1.9
1.6
1.6
1.6
1.5
24
21
20
20
19
83
82
79
65
64
1.5
1.5
1.4
1.2
1.1
19
18
18
15
14
Disease of stomach
Respiratory system, other diseases of
Tabes mesenterica
Starvation, want of breast milk
Other causes
54
53
53
50
1,857
1.0
0.9
0.9
0.9
32.9
12
12
12
11
415
Total
5,645
Inflammation of brain or its membranes
Apoplexy
Influenza, coryza, catarrh
Whooping cough
Senile decay
100.0
rate (a)
99
84
1,260
(a) Proportion per 100,000 of mean population. In 1896 the mean population was 447,885.
Source: Registrar-General, Vital Statistics: Annual Report of the Registrar-General 1896; GSO and
ABS data, in ABS, Demographic History of Queensland, Cat. no. 3104.3.
262
HEALTH
notified cases of camplyobacter enteritis and salmonellosis respectively, both of which are
associated with food poisoning. There were 4,936 cases of Ross River virus, a disease transmitted
by mosquitoes, notified in 1996. Cases of Barmah Forest virus increased from three in 1991 to
576 in 1996. Both measles and whooping cough increased sharply in 1994 with 2,483 and 1,937
reported cases respectively.
MORTALITY AND MORBIDITY
Causes of death
In 1896 the major causes of death were tuberculosis (444 deaths) and pneumonia (377 deaths)
(table 8.8). Drowning was also high on the list, with 159 deaths in 1896. Other causes of death
no longer common included 107 from dentition and 50 from starvation or want of breast milk.
The death rate from most causes declined during the twentieth century. However, death from
heart disease increased from a rate of 57 per 100,000 of mean population in 1900 to 330 in 1970
before declining to 184 in 1995 (table 8.9). The rate for malignant neoplasms (cancer) rose
from 47 in 1900 to 169 in 1995. In the 1990s priority areas for the Queensland Department of
Health are cancer, cardiovascular health, diabetes, mental health and injury.
In 1896,30.9% (1,105) of males and 44.7% (925) of females who died were aged under 5 years
whereas in 1995 less than 2% (384) of persons who died were in this age group (table 8.10).
Only 3.5% (124) of males and 5.1% (105) of females who died in 1896 were aged 75 years and
over (table 8.10). In 1995,43.5% (4,858) of males and 63.1% (6,067) of females who died were
in this age group.
In 1896 the proportion of deaths from tuberculosis was higher in the northern (9.1%) and
southern (8.0%) regions than in the central region (4.4%) (table 8.11). The proportions of deaths
Table 8.9 Death rates by selected causes of death, Queensland, 1900-1995
Cause of death
1900
1910
1920
1930
Accidents
Congenital anomalies
100
9
77
14
60
15
55
11
Diabetes mellitus
Diseases of early infancy
Heart disease (b)
Hypertensive disease
Malignant neoplasms (c)
3
48
57
n.a.
47
6
60
114
n.a.
67
9
75
139
n.a.
79
8
48
136
n.a.
82
15
42
215
n.a.
103
10
39
225
46
113
Nephritis and nephrosis
Pneunomia
Tuberculosis
Cerebrovascular disease
Other causes
38
68
108
n.a.
694
42
34
59
45
452
53
49
51
45
490
56
42
42
37
302
59
45
27
63
252
819
897
Total
1,172
970
1,065
1940 1950 1960
— rate (a) —
65
57
53
11
11
14
1970
1980
1990
1995
61
10
45
6
32
5
30
4
10
30
254
31
121
11
20
330
14
142
9
8
249
6
148
9
5
212
5
163
12
4
184
29
30
20
99
194
15
27
5
111
159
10
29
2
130
188
9
10
1
91
140
8
10
—
69
151
7
9
—
64
148
873
830
947
723
668
635
5
169
(a) Deaths per 100,000 of mean population.
(b) Only includes International Classification of Diseases codes 410-429.
(c) From 1950 includes neoplasms of lymphatic and haematopoietic issue.
Source: ABS, Queensland Year Book 1982; ABS, Australian Demographic Statistics, various editions, Cat. no. 3101.0; ABS,
unpublished mortality data.
263