Saturday, March 9, 2002
M A I N   F E A T U R E

The killer continues to stalk silently


PLAGUE has been one of the major scourges in history. It decimated large segments of population and affected the lives of all sections of society. A pandemic of plague, known as the Black Death, broke out in 1348 in Europe and claimed one-third of the total population. One of the early outbreaks in medieval India dates back to 1550. This was followed by outbreaks in 1575 in Gaur, 1616 in the Punjab, 1702-04 in the Deccan and 1838-39 in Rajasthan. We do not have an account of the exact number of deaths; still it can be inferred from stray references that the mortality rate was high. Ikbal Nama-i Jahangiri mentions that at least 15 persons died at Lahore from the disease in an hour. Writing about the severity of the disease in Kashmir, the author mentions that a darvesh who performed the ritual of washing the body of a friend also contracted the disease and died the next day.

Under the colonial rule, plague claimed ten million lives in the subcontinent. During the spread of the epidemic, from 1897 to 1947, the Punjab was the worst-affected province. Its bubonic variant claimed 30 lakh victims or 29 per cent of the population in India. In 1906-07 almost seven lakh people lost their lives. Writing about the havoc caused by plague, the papers reported that in Patiala, the hired carriers of corpses made rounds in the streets with their calls ‘murda chukwalo.’ The ‘state doli’ waited at the fort chowk to carry the victims to the hospital. The Tribune mentioned that there were a large number of houses in Delhi itself in which no family member survived.



The first case of this disease was discovered in Khatkar Kalan village in Jalandhar district on October 17, 1897. By March 1898, the disease had spread to 24 villages in Jalandhar district and four in Hoshiarpur district. In its initial stages, it was confined to Jalandhar and Hoshiarpur districts but by 1904, it engulfed 26 districts and some native states.

It took the authorities long to understand the etiology and transmission of the infection. The ignorance regarding the cause and mode of transmission of the disease continued well into the British period till the early twentieth century. Human body was believed to be the principal agency for the spread of the infection. Clothes, bedding and other articles associated with the human beings were considered the infecting agents. A change in the general understanding regarding the role of rats in spreading and keeping alive the disease became evident in 1905. It was then recognised that rats spread plague, rat fleas acted as a vehicle of contagion between ‘rat and rat’ and ‘rat and men’ and that the life of the plague germ in soil, floors and walls of the houses was of short duration. Furthermore, the linkage between atmospheric humidity and the severity and diffusibility of the outbreak of the plague was demonstrated in 1908 by the Plague Research Commission of the Government of India. The commission also established that humidity in excess of the normal at a certain temperature was beneficial to the growth of the rat flea.

Plague was treated as an emergency situation and comprehensive measures were taken to combat it. For this, the existing administrative framework was put into service with some modifications and additions. Also, the services of the routine medical staff along with the police personnel were requisitioned. In addition to this, the co-operation of the common people and ‘leading men’ was sought.

The administrators were strict in enforcing isolation and segregation of the unfortunate ones falling prey to the disease. The infected village was cordoned off to prevent any communication with the as-yet uninfected areas. The infected cases were removed to isolation camps, while their families were kept in segregation camps. Even the suspected cases were detained and kept under observation in the camps. The inspection of the corpses of those who succumbed to the disease was carried out only at a few selected points much to the chagrin of the people. Post-mortems were ordinarily not carried out, but were performed if the police wanted it. The work of the disposal of the dead in the villages was handled by the police.

In the infected village, the people were forced to vacate their houses and move to camps with their belongings and provisions for two months, following which their houses were disinfected. The floors of the houses were dug and washed with phenol as these were believed to contain the plague carriers. Household articles and other personal belongings were burnt or destroyed. Holes were made in the roofs for exposure to sunlight; this was followed by white washing. This measure of disinfecting resulted in spreading the plague from one locality to another as rats moved out of the infected houses to other localities, carrying the infection with them.

One of the most humiliating and discriminating measures adopted was the medical ‘inspection’ of rail passengers. Passengers travelling in third class were ‘inspected’ on platforms with severity. The poor and those belonging to lower castes were considered potential carriers of the disease, for it was assumed that they did not live in hygienic conditions.

Although a screen was erected on the platform for the examination of women passengers, it was seldom used; the women using purdah felt outraged. The suspected cases among the natives or those considered likely to spread the disease were detained. Their bedding and clothing along with other articles were disinfected or destroyed.

People felt that such measures to combat the disease resulted in loss of dignity and honour. There were instances also of molestation of women. The ramifications of the plague extended far beyond the infected people and their kin. The plague operations like cordoning resulted in the closure of shops and manufacturing units in the rural areas. Agricultural production and marketing too were adversely affected. The crops which needed to be sold or processed immediately were the worst affected. To cap it all, the peasants’ claims for compensation or remittance of land revenue were rejected.

The fear amongst the people regarding safety of their life and property found expression in rumours. The rumours grew as a reaction against the forcible use of western medicine to combat the disease. One of the rumours which spread was that the government was poisoning the plague patients to arrest the disease. People gave credence to the belief that the authorities wanted a large number of people to die as the Queen (Queen Victoria) had died. They believed that a large number of men were impersonating as inoculators moving around the villages and carrying needles filled with the plague poison to spread the disease. Another set of rumours cast doubts about the intentions of the British.

The apprehensions of the people about the plague eradication measures resulted in concealment of the infected cases. Corpses were secretly buried in graves and even in houses. The severity with which the officials dealt with the people led to the spread of terror and panic among them. The most common response was flight from the infected areas.

Reactions of the people to the apathetic attitude of the authorities ranged from mild forms of opposition to violent attacks: there were demonstrations, threats of violence, attacks on subordinate staff and even riots. The victims of this mob fury were generally the subordinate staff on plague duty. They were often beaten up, pelted with stones and cow dung and sometimes even killed.

The Punjab plague was devastatingly and unremittingly deadly in its effects. It was an unfamiliar disease which no one fully comprehended and for which no remedies were known. The present plague epidemic carries some of the resonances of the epidemic of the early twentieth century. Although, its remedy is now fully understood, the panic and fear associated with the disease still exists in the minds of the people.

Watch out for plague

Though plague is no longer a ‘Black Death’ as it was referred to till the 19th century, it still continues to threaten large sections of population. Both cities and smaller settlements that have unattended garbage are prone to it. The urban plague in such condition is transmitted by the ‘murine rat’ to human beings. Till the 19th century, plague had killed two-thirds of Europe’s population. The Great Plague of London killed over 70,000 people; in Canton and Hong Kong, it killed 80,000 to one lakh people in a span of 20 years.

At first, say experts, cases are sporadic, but once the conditions are favourable for the rat-fleas, more and more persons are infected and the disease is transmitted from person to person by what doctors call "droplet infection."

Illness varies within the widest limits showing gradations of severity from mere indisposition to violent death. Mild infections are almost bubonic and pneumonic. Incubation period is usually 3 to 6 days but it may be also as short as 36 hours, believe the experts. It begins suddenly and is well-marked.

Three-fourths of the reported cases of plague are bubonic and it does not start from person to person contact. It starts with shivering then vomiting, headache, giddiness, intolerance to light, pain in the back and limbs, sleeplessness, apathy and delirium. Temperature rises rapidly and frequently falls by two or three degrees in the second and third day with marked prostration. Constipation is usual and diarrhoea is a grave sign. The flea from one person to another carries the bubonic bacillus. In pneumonic plague, the physical signs are those of bronchopneumonia, edema (filling with fluid) of the lungs which soon follows and death in 3 or 4 days, if untreated.

The septicemic plague is marked by prostration and brain damage and death occurs within 24 hours. It proves fatal before there is time for pneumonia to develop. The sanitary measures, say the experts, must be directed against both rodents and fleas. The sick should be isolated immediately with all precautions. Vaccination of the affected areas and homes should be done and surveillance of the contacts should be ensured. Studies have shown that blood group A is less susceptible to plague and people with this blood group can be involved in fighting the onslaught of plague.

Kuldeep Chauhan