Return of an ancient killer

October 11, 1994

Health officials in India believe they have brought under control an outbreak of plague that began last month in the western city of Surat. Within days it had spread from one coast to the other.

With modern medicines and sanitary methods, India appears to have been able to limit the loss of life. But already scores of people have died and hundreds have contracted the deadly disease.

Throughout history plague has been one of the major killers of mankind, attacking in devastating epidemics that brought death and terror to millions. The first recorded incident occurs in the biblical account of the defeat of the Israelites by the Philistines and the loss of the Ark of the Covenant. Shortly afterward, the victors were attacked by a fatal epidemic characterized by swellings around the groin. At the same time, thousands of rats and other small rodents appeared all over the country.

Subsequent outbreaks have been equally devastating. The great plague pandemic of the 14th century in Europe killed 20 million people, or about 25 percent of the population. It originated in Central Asia and had spread westward to the shores of the Black Sea by the year 1346. From there it swept the entire continent within five years.

Plague continued to smolder throughout Europe until the 17th century, when it recurred with great violence. In England, it climaxed in the great epidemic of 1665. The continent was also ravaged: In 1629 half the population of Lyons died, and the following year plague killed 86,000 in Milan and 500,000 in Venice. In the 18th century, another epidemic killed 300,000 people in Austria, 215,000 in Brandenburg and 60,000 in Moscow.

The last major outbreak began in China in 1894. It spread westward to India, Egypt and Europe. In 1900 plague was diagnosed for the first time in the United States -- in San Francisco.

By the end of the 19th century scientists had discovered that plague was carried by rats and transmitted to humans by fleas. Prevention concentrates mainly on controlling rat populations in urban areas, a task easier said than done in Third World nations. Other measures include rat-proofing harbors and warehouse buildings, suppressing fleas with powerful insecticides and antibiotic treatments, which are most effective against the type plague that ravaged India. All these steps are well within the means of health officials there. Yet the latest outbreak is a grim reminder of how vulnerable humans still are to this ancient killer.

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