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Plague, a
disease of great antiquity was a major public health problem throughout India
till the mid twentieth century AD. The authenticated plague epidemic started in
the year 1895-1896 and reached its peak in 1907. During the periods there were
over 25 million deaths in India. The decennial death rate due to plague in
India per 1,00,000 population were 183.3 and 133.8 respectively. During
1949-1958, mortality rate was calculated to be 1.8 per 1,00,000 population.
Mortality rate reached zero level during 1967. The reasons for dramatic
reduction in plague incidence in India since 1948 and a sudden recrudescence in
certain areas can only remain in speculation. However, two important
anti-plague measures to combat the disease were made available immediately after
the Second World War. Streptomycin and Sulphanomides were found to be very
specific for plague treatment and universal use of DDT in rural areas in India
since 1958 intercepted plague transmission. The resurgence of plague in
peninsular India during 1959 to 1966 was due to discontinuation of DDT spray in
the area.
In India
sporadic cases of suspected human plague were reported from Himachal Pradesh
during 1966 and 1983 and Karnataka during 1984. During 1994 a bubonic plague
outbreak in Maharashtra and pneumonic plague outbreak in Surat, Gujarat were
recorded. A pneumonic plague outbreak in Himachal Pradesh in 2002 and a bubonic
plague outbreak in 2004 in Uttarakhand were also recorded.
Plague
continues to exist as a major public health problem in many countries of the
world. In several countries plague has remained quiescent for years together
before reappearing all of a sudden. According to notification received by WHO
during the period 1987 to 2009, plague affected 26 countries with 53,417 cases
and 4060 (7.6 percent) deaths. Under reporting of plague case may be attributed
to lack of diagnostic facilities for the confirmation of the cases and
cessation of plague surveillance work by number of erstwhile plague endemic
countries.
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