Third plague pandemic

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.[1] 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.[2][3] According to the World Health Organization, the pandemic was considered active until 1960, when worldwide casualties dropped to 200 per year.[4] Plague deaths have continued at a lower level for every year since.

For another third occurrence of a pandemic, see 1846–1860 cholera pandemic.
Plague patient being injected by a doctor 1897 in Karachi.
Picture of Manchurian plague victims in 1910–1911

The name[5] refers to this pandemic being the third major bubonic plague outbreak to affect European society. The first began with the Plague of Justinian, which ravaged the Byzantine Empire and surrounding areas in 541 and 542; the pandemic persisted in successive waves until the middle of the 8th century. The second began with the Black Death, which killed at least one third of Europe's population in a series of expanding waves of infection from 1346 to 1353; this pandemic recurred regularly until the 19th century.

Casualty patterns indicate that waves of this late-19th-century/early-20th-century pandemic may have come from two different sources. The first was primarily bubonic and was carried around the world through ocean-going trade, through transporting infected persons, rats, and cargoes harboring fleas. The second, more virulent strain, was primarily pneumonic in character with a strong person-to-person contagion. This strain was largely confined to Asia, in particular Manchuria and Mongolia.

Origins

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.[6] 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.[6]

In the city of Canton, beginning in March 1894, the disease killed 80,000 people in a few weeks. Daily water-traffic with the nearby city of Hong Kong rapidly spread the plague. Within two months, after 100,000 deaths, the death rates dropped below epidemic rates, but the disease continued to be endemic in Hong Kong until 1929.[7]

Political impact in British India
Directions for searchers, Pune plague of 1897

The plague, which was brought from Hong Kong to British India, killed about one million in India.[8] 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 (now Mumbai), but later emerged in Poona (now Pune), Calcutta (now Kolkata), and Karachi (now in Pakistan). 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.

Repressive government actions to control the plague led the Pune nationalists to criticize the government publicly. On 22 June 1897, the Chapekar brothers, young Pune Hindus, shot and killed Walter Charles Rand, an Indian Civil Services officer who was acting as Pune Special Plague Committee chairman, and his military escort, Lieutenant Ayerst. The action of the Chapekars was seen as terrorism.[9] The government also found the nationalist press to be guilty of incitement. The nationalist activist Bal Gangadhar Tilak was charged with sedition for his writings as editor of the newspaper Kesari and was sentenced to eighteen months of rigorous imprisonment.

Public reaction to the health measures enacted by the British Indian government ultimately revealed the political constraints of medical intervention in the country. The experiences were formative in the development of India's modern public health services.

Global distribution

The network of global shipping ensured the widespread distribution of the disease over the next few decades.[10][11][12] Recorded outbreaks included the following:

Each of the areas, as well as Great Britain, France, and other areas of Europe, continued to experience plague outbreaks and casualties until the 1960s. The last significant outbreak of plague associated with the pandemic occurred in Peru and Argentina in 1945.

1894 Hong Kong plague

The 1894 Hong Kong plague was a major outbreak of the third pandemic in the world from the late 19th century to the early 20th century. In May 1894, the first case occurred in Hong Kong. The patient was a national hospital clerk and was discovered by Dr. Yu Xun, the dean of the National Hospital, who had just returned from Guangzhou. When the Chinese-style buildings were built, the Taiping Mountain area in Sheung Wan, the most densely-populated area in Hong Kong, became the hardest hit area of the epidemic. Controlling the epidemic naturally became the top priority of the Governor of Hong Kong. From May to October 1894, the plague in Hong Kong killed more than 6,000 people, one third of the population fled Hong Kong. In the 30 years starting in 1926, the plague occurred in Hong Kong almost every year and killed more than 20,000 people. Through the maritime traffic in Hong Kong, the plague epidemic originating in Yunnan, China, spread to all parts of the country after 1894 and eventually spread to all inhabitated continents.[7]

There were several reasons for the rapid outbreak and rapid spread of the plague. Firstly, in the early days of Kailuan, Sheung Wan was a Chinese settlement. The design of the houses there, in the mountains, included no drainage channels, toilets, or running water. The small buildings and the lack of floor tiles were other weaknesses in the design. Secondly, during the Ching Ming Festival in 1894, many Chinese living in Hong Kong returned to the countryside to sweep the graves, which coincided with the outbreak of the epidemic in Canton and the introduction of bacteria into Hong Kong. Thirdly, in the first four months of 1894, rainfall decreased and soil dried up, accelerating the spread of the plague.[20]

The main preventive measures were setting up plague hospitals and deploying medical staff to treat and isolate plague patients; conducting house-to-house search operations, discovering and transferring plague patients, and cleaning and disinfecting infected houses and areas; and setting up designated cemeteries and assigning a person responsible for transporting and burying the plague dead.[21]

Disease research
Y. pestis isolated by Ricardo Jorge during the 1899 Porto plague outbreak

Researchers working in Asia during the "Third Pandemic" identified plague vectors and the plague bacillus. In 1894, in Hong Kong, Swiss-born French bacteriologist Alexandre Yersin isolated the responsible bacterium (Yersinia pestis, named for Yersin) and determined the common mode of transmission. His discoveries led in time to modern treatment methods, including insecticides, the use of antibiotics and eventually plague vaccines. In 1898, French researcher Paul-Louis Simond demonstrated the role of fleas as a vector.

The disease is caused by a bacterium usually transmitted by the bite of fleas from an infected host, often a black rat. The bacteria are transferred from the blood of infected rats to the rat flea (Xenopsylla cheopis). The bacillus multiplies in the stomach of the flea, blocking it. When the flea next bites a mammal, the consumed blood is regurgitated along with the bacillus into the bloodstream of the bitten animal. Any serious outbreak of plague in humans is preceded by an outbreak in the rodent population. During the outbreak, infected fleas that have lost their normal rodent hosts seek other sources of blood.

The British colonial government in India pressed medical researcher Waldemar Haffkine to develop a plague vaccine. After three months of persistent work with a limited staff, a form for human trials was ready. On January 10, 1897 Haffkine tested it on himself. After the initial test was reported to the authorities, volunteers at the Byculla jail were used in a control test, all inoculated prisoners survived the epidemics, while seven inmates of the control group died. By the turn of the century, the number of inoculees in India alone reached four million. Haffkine was appointed the Director of the Plague Laboratory (now called Haffkine Institute) in Bombay.[22]

gollark: It seems really weird that nobody is making cheaper insulin, considering that patents on it have probably expired by now. Are there difficult regulatory hurdles?
gollark: Possibly. Arguably it doesn't inherently have one but is just assigned one by humans.
gollark: I wouldn't say the virus has a goal any more than a computer program does or something. The difference is that if you set an intelligent thing a goal, it can reason about the best way to accomplish it.
gollark: Also, large-scale competition burns a ton of resources which would ideally not be used up.
gollark: I say this because you said> do you really want a second rate species succeeding?but it isn't a given that because something won at competition it's actually *better*.

See also

References
  1. Cohn, Samuel K. (2003). The Black Death Transformed: Disease and Culture in Early Renaissance Europe. A Hodder Arnold. p. 336. ISBN 0-340-70646-5.
  2. Infectious Diseases: Plague Through History, sciencemag.org
  3. "Quarantine lifted after plague scare". BBC News. 2019-05-07. Retrieved 2020-05-08.
  4. Frater, Jamie (2009). The Ultimate Book of Top Ten Lists: A Mind-Boggling Collection of Fun, Fascinating and Bizarre Facts on Movies, Music, Sports, Crime, Ce. Ulysses Press. p. 175. ISBN 978-1-56975-800-7.
  5. Nicholas Wade (October 31, 2010). "Europe's Plagues Came From China, Study Finds". The New York Times. Retrieved 2010-11-01. The great waves of plague that twice devastated Europe and changed the course of history had their origins in China, a team of medical geneticists reported Sunday, as did a third plague outbreak that struck less harmfully in the 19th century.
  6. Benedict, Carol (1996). Bubonic plague in eighteenth-century China. Stanford, CA: Stanford Univ. Press. pp. 47, 70. ISBN 978-0804726610.
  7. Pryor, E.G. (1975). "The Great Plague of Hong Kong" (PDF). Journal of the Hong Kong Branch of the Royal Asiatic Society. 15: 61–70. PMID 11614750.
  8. Infectious Diseases: Plague Through History, sciencemag.org
  9. Zaman, Rashed Uz (2013). "Bengal terrorism and the ambiguity of the Bengali Muslims". In Jussi H. Nhimaki; Bernhard Blemenau; Jussi Hanhim Ki (eds.). An International History of Terrorism: Western and Non-western Experiences. Routledge. p. 152. ISBN 978-0415635400.
  10. Low, Bruce (1899). "Report upon the Progress and Diffusion of Bubonic Plague from 1879 to 1898". Reports of the Medical Officer of the Privy Council and Local Government Board, Annual Report, 1898–99. London: Darling & Son, Ltd. on behalf of His Majesty's Stationery Office: 199–258. Retrieved 17 October 2010.
  11. Low, Bruce (1902). "Summary of the Progress and Diffusion of the Plague in 1900". Reports of the Medical Officer of the Privy Council and Local Government Board, Annual Report, 1900–01. London: Darling & Son, Ltd. on behalf of His Majesty's Stationery Office: 264–282. Retrieved 17 October 2010.
  12. Eager, J.M. (1908). "The Present Pandemic of Plague". Public Health Bulletin. Washington: Government Printing Office: 436–443. Retrieved 17 October 2010.
  13. "Plague Hospital in Porto - 1899". Apollo - University of Cambridge Repository. Retrieved 1 March 2020.
  14. "Honolulu's Battle with Bubonic Plague". Hawaiian Almanac and Annual. Honolulu: Thos. G. Thrum, Hawaiian Gazette Co.: 97–105 1900. Retrieved 17 October 2010.
  15. https://scholarsbank.uoregon.edu/xmlui/bitstream/handle/1794/7694/Bailey_Kevin_thesis2007.pdf?sequence=1
  16. MacDonald, Kenneth (2 January 2019). "Rats 'wrongly blamed' for 1900 Glasgow plague outbreak". BBC News. Retrieved 2 January 2019.
  17. "On The Plague In San Francisco". Journal of the American Medical Association. Chicago: The American Medical Association. 36 (15): 1042. April 13, 1901. doi:10.1001/jama.1901.52470150038003. Retrieved 17 October 2010.
  18. "The Plague, "American Medicine," And The "Philadelphia Medical Journal."". Occidental Medical Times. San Francisco. 15: 171–179. 1901. Retrieved 17 October 2010.
  19. "Bubonic Plague At San Francisco, Cal". Annual Report of the Supervising Surgeon General of the Marine Hospital Service of the United States for the Fiscal Year 1901. Washington: Government Printing Office: 491–. 1901. Retrieved 17 October 2010.
  20. "1894上環大鼠疫". elearning.qcobass.edu.hk. Retrieved 2019-03-06.
  21. 楊, 祥銀 (2010). "公共衛生與1894年香港鼠疫研究". 華中師範大學學報. 49: 68–75.
  22. Hanhart, Joel (2016). Waldemar Mordekhaï Haffkine (1860–1930). Biographie intellectuelle. Paris: Honore Champion.

Further reading
  • Media related to Plague, third pandemic at Wikimedia Commons
  • Advisory Committee for Plague Investigations in India (1911), Report On Plague Investigations In India, 1906–1910
  • Hazrat Mirza Ghulam Ahmad, The Promised Messiah. Noah’s Ark: An Invitation to Faith.
  • Gandhi, M. K. The Plague Panic in South Africa
  • Gregg, Charles. Plague: An Ancients Disease in the Twentieth Century. Albuquerque, University of New Mexico Press, 1985.
  • Kelly, John. The Great Mortality: An Intimate History of the Black Death, the Most Devastating Plague of All Time. New York: HarperCollins Publishers, 2005. ISBN 0-06-000692-7.
  • McNeill, William H. Plagues and People. New York: Anchor Books, 1976. ISBN 0-385-12122-9.
  • Orent, Wendy. Plague: The Mysterious Past and Terrifying Future of the World's Most Dangerous Disease. New York: Free Press, 2004. ISBN 0-7432-3685-8.
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