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Plagues of India

Fig: Quarantine area, during bubonic plague outbreak, Karachi, India. 

India has unfortunately experienced 2 large plague pandemics: The third plague pandemic and the plague pandemic of 1994.

Third plague pandemic(1855-1945)

Fig: victims of plague in manchuria

The third plague pandemic was a major bubonic plague pandemic that began in Yunnan, China, in 1855 during the fifth year of the Xianfeng Emperor of the Qing dynasty. This episode of bubonic plague spread to all inhabited continents, and ultimately led to more than 12 million deaths in India and China, with about 10 million killed in India alone. According to the World Health Organization, the pandemic was considered active until 1981, when worldwide casualties dropped to 200 per year. Plague deaths have continued at a lower level for every year since.

The bubonic plague was endemic in populations of infected ground rodents in central Asia and was a known cause of death among the migrant and established human populations in that region for centuries. An influx of new people because of political conflicts and global trade led to the distribution of the disease throughout the world.

A natural reservoir or nidus for plague is in western Yunnan and is still an ongoing health risk. The third pandemic of plague originated in the area after a rapid influx of Han Chinese to exploit the demand for minerals, primarily copper, in the second half of the 19th century. By 1850, the population had exploded to over 7 million people. Increasing transportation throughout the region brought people in contact with plague-infected fleas, the primary vector between the yellow-breasted rat (Rattus flavipectus) and humans. People brought the fleas and rats back into growing urban areas, where small outbreaks sometimes reached epidemic proportions. The plague spread further after disputes between Han Chinese and Hui Muslim miners in the early 1850s erupted into a violent uprising, known as the Panthay Rebellion, which led to further displacements by troop movements and refugee migrations. The outbreak of the plague helped recruit people into the Taiping Rebellion. The plague began to appear in Guangxi and Guangdong provinces, Hainan Island, and then the Pearl River delta, including Canton and Hong Kong. Although William McNeil and others believe the plague to have been brought from the interior to the coastal regions by troops returning from battles against the Muslim rebels, Benedict suggested evidence to favor the growing and lucrative opium trade, which began after about 1840.

Fig: A doctor injecting a patient in Karachi

The plague, which was brought from Hong Kong to British India, killed about one million in India. It later also killed another 12.5 million in the British colony India over the next thirty years. Almost all cases were bubonic, with only a very small percentage changing to pneumonic plague. (Orent, p. 185) The disease was initially seen in port cities, beginning with Bombay , but later emerged in Poona (now Pune), Calcutta , and Karachi .By 1899, the outbreak spread to smaller communities and rural areas in many regions of India. Overall, the impact of plague epidemics was greatest in western and northern India, in the provinces then designated as Bombay, Punjab, and the United Provinces; eastern and southern India were not as badly affected.

The colonial government's measures to control the disease included quarantine, isolation camps, travel restrictions, and the exclusion of India's traditional medical practices. Restrictions on the populations of the coastal cities were established by Special Plague Committees, with overreaching powers enforced by the British military. Indians found the measures culturally intrusive and generally repressive and tyrannical. The government's strategies of plague control underwent significant changes during 1898–1899. By then, the use of force in enforcing plague regulations had been shown to be counterproductive, and since the plague had spread to rural areas, enforcement in larger geographic areas would be impossible. British health officials then began to press for widespread vaccination by using Waldemar Haffkine’s plague vaccine, but the government stressed that inoculation was not compulsory. British authorities also authorized the inclusion of practitioners of indigenous systems of medicine into plague prevention programs.

Pandemic of 1994

Fig: Migration of people from Surat

The 1994 plague in India was an outbreak of bubonic and pneumonic plague in south-central and western India from 26 August to 18 October 1994. 693 suspected cases and 56 deaths were reported from the five affected Indian states as well as the Union Territory of Delhi. These cases were from Maharashtra (488 cases), Gujarat (77 cases), Karnataka (46 cases), Uttar Pradesh (10 cases), Madhya Pradesh (4 cases) and New Delhi (68 cases). There are no reports of cases being exported to other countries.

A government committee was not able to determine the source of the origin of the dissase.But other  sources identify the ultimate cause as the 1993 Latur earthquake, which caused a large number of homes to be abandoned with food grains inside. This destabilized the population of domestic and wild rats (in which the plague is endemic), leading to the transmission of the plague from wild rats to domestic rats to people. There were reports of excessive rat deaths in Malma in the Beed district of Maharashtra along with complaints of fleas. After three weeks, reports of suspected bubonic plague in Malma started to emerge, followed by other villages and districts.

Fig:A Rat

Flooding in Surat, which had open sewers, put the bodies of many dead rats on the street, which residents probably came into contact with. The Ganesh Chaturthi festival created crowds in the city shortly thereafter, promoting the spread of pneumonic plague, which was declared on 21 September. By the end of the outbreak, an estimated 78% of confirmed cases were in the slums of Surat. 

Due to the pandemic tourism was negatively affected, flights to India were cancelled, and some planes from India were fumigated at airports. Many flights from India to the nearby Gulf region were suspended. Some countries also put a hold on the imports from India. Paramilitary forces set up checkpoints to deal with people fleeing Surat. Panic buying and government-ordered closures spread to Mumbai and Delhi.

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