So far, the geographical foci of our regional–thematic examination of the linkages between war and disease have been the great continental land masses of the Americas, Europe, Asia, and Africa. We now turn our attention to a different stage for the geographical spread of war epidemics—oceanic islands. As well as the particular interest which attaches to islands as natural laboratories for the study of epidemiological processes (Cliff et al., 1981, 2000), island epidemics also hold a special place in war history. For example, we saw in Chapter 2 how the islands of the Caribbean became staging posts for the spread of wave upon wave of Old World ‘eruptive fevers’ (especially measles, plague, smallpox, and typhus) brought by the Spanish conquistadores to the Americas during the sixteenth century. Much later, the mysterious fever that broke out on the island of Walcheren in 1809 ranks as one of the greatest medical disasters to have befallen the British Army. In this chapter, we examine the theme of island epidemics with special reference to the military engagements of Australia, New Zealand, and the neighbouring islands of the South Pacific since 1850. Figure 11.1 serves as a location map for the discussion, while sample conflicts—exclusive of tribal feuds, skirmishes, and other minor events for which little or no documentary evidence exists—are listed in Table 11.1. Our analysis begins in Section 11.2. There we provide a brief review of the initial introduction and spread of some of the Old World diseases which occurred in association with South Pacific colonization and conflicts during the last half of the nineteenth century. In Sections 11.3 and 11.4, we move on to the twentieth century. In the Great War, Australia and New Zealand made a relatively larger contribution to military manpower than any other allied country. At the end of the conflict, the return of many tens of thousands of antipodean troops from the battlefields of Europe fuelled the extension of the 1918–19 ‘Spanish’ influenza pandemic into the South Pacific region (Cumpston, 1919). In Section 11.3, we examine the spread of influenza on board returning troopships and subsequently within Australia, New Zealand, and the neighbouring islands of the region.