Plague! INDIA, AFRICA CONFRONT THE ULTIMATE ANIMAL CONTROL NIGHTMARE; Tight urban budgets gave rat-catching and trash collection a low priority

From ANIMAL PEOPLE, November 1994:

SURAT, India––Inadequate animal control service was largely responsible, authorities say, for the most deadly
outbreak of plague worldwide in 28 years at Surat, India. More than 400,000 residents fled the city as the outbreak became
known, creating risk the disease would spread to nearby communities, including Bombay, 160 miles to the north.
Remembering plague outbreaks that killed thousands during the 1940s and 1950s, 950 million Indians feared the worst.
Quarantines, inexpensive prophylactic tetracycline treatments, and fast information-sharing by electronic mail were

credited with holding the official death toll to 57 and the offi-
cial number of human plague victims to 693, but the uncon-
firmed death toll may have been much higher. More than
6,000 people were treated for plague symptoms at government
clinics. Post mortems found that 84% of the fatalities were
both male and HIV-positive, whereas only 4.7% of those hos-
pitalized were HIV-positive––a strong indication that despite
the panic, the strains of plague involved were not usually
deadly to people with healthy immune systems who got
prompt treatment.
Apparently related outbreaks during early October
killed 11 people and afflicted 26 more in southwestern
Zimbabwe, which has a large ethnic Indian population. Three
cases of bubonic plague detected among Mozambiquan
refugees in southern Malawi on October 12 were believed to
have been unrelated.
Coming on much like a common cold in most cases,
for which reason most Indian officals initially didn’t recog-
nize the disease, plague is caused by the Yersinia pestis bac-
terium, and may take either of two forms: bubonic and pneu-
monic. Bubonic plague is carried by infected fleas, who in
turn are usually brought into proximity with people by rats
and mice, although more than 200 mammal species are
known to get the disease. Pneumonic plague is spread by
sneezing. Bubonic plague appeared in Maharashtra state,
east of Bombay, in early September, but claimed no
known fatalities. Pneumonic plague then hit in Surat,
which had been free of plague since 1951. Eventually eight
Indian states were afflicted.
“Experts blame a devastating earthquake that
killed more than 10,000 people in the region last year for
allowing rats to multiply and spread the pestilence,” report-
ed Nelson Graves of Reuter. The earthquake disrupted all
government services, and as in the U.S. when resources are
scarce, animal control––which in India is essentially pest
control–– received a low priority.
Although the cities of Chicago and New York
maintain special rat-catching task forces, rat-catching has
long since ceased to be a major function––or any func-
tion––of most U.S. animal control departments. In the
Third World however, including India, the village rat-
catcher is as familiar a figure as the dogcatcher is in our
Saturday morning cartoons. Rat-catching is the primary
duty of animal control departments, followed by killing
suspected rabid dogs. Cats generally aren’t part of the
Indian animal control beat; feral cats are considered the
front line of defense against rats and mice, whom Hindus
rarely kill. Indeed, although rats are blamed for eating or
spoiling more than 4.5 million tons of food per year in a
nation which rarely has any food surplus, rats are wor-
shipped because a rat was the ever-present loyal companion
of the elephant god, Ganesh––and the center of rat worship
is the Karni Mata temple in Rajastan state, within the
afflicted region. Thousands of pilgrims from all parts of
India participated in the annual festival of Ganesh, which
concluded in Surat on September 18, just a week before the
deaths began.
To avoid offending Ganesh and the devout, rat-
catchers traditionally transport the animals beyond city or
village limits, and let them go, yet another avenue by
which plague might have spread.
“This nonsense has to stop,” retired government
official Kolomesh Chandra Dev told Dilip Ganguly of
Associated Press. “The time has come for people to realize
it is either us or the rat.” Dev, of New Delhi, organized a
private rat-killing campaign, while the city government
struggled to get enough of a 590-vehicle motor pool into
adequate repair to catch up on refuse removal, to reduce
the food supply for rats. New Delhi rat-catchers set 5,000
traps nightly.
Bombay responded, meanwhile, by adding a
night shift to the work schedule of its 4,000 refuse
removers; dispatched 2,500 paramedics on a house-to-
house search for refugees and other visitors from Surat;
and hired extra rat-catchers, with instructions to poison rats
rather than just remove them. The preference for poisoning
rather than dispatching by quicker, more humane means
was apparently because setting out poison technically
means the rats kill themselves by eating it, and is therefore
less offensive to Hindu religious sensibilities even though it
means the rats suffer more. The poison squads claimed to
have killed 2,000 rats a day throughout early October.
Similar measures were taken in Surat, where
approximately 6,000 tons of trash were removed during the
two weeks following the first deaths––after officials per-
suaded city sanitation workers to return to their jobs, which
many had abandoned from fear of contacting flea-ridden
rats. The deadliest trash piles were believed to be heaps of
cattle, dogs, and cats who were drowned during August in
heavy monsoon flooding.
Plague in the U.S.
While the U.S. has never had a major outbreak of
plague, the disease is known here, especially in the west.
A national plague tracking system was begun in 1944.
During the next decade, cases appeared only in California,
Arizona, and New Mexico. Circa 1950, plague spread into
the Rocky Mountain region. Of the 362 human cases
recorded since national tracking began, 336 occurred in the
Rockies––244 of them after 1981. Beginning in 1984,
plague between moving north as far as Montana and east-
ward into Texas, but according to acting plague section
director Kenneth Gage of the Centers for Disease Control
and Prevention, the disease is likely to stop there because
the mid-Plains area marks the eastern edge of the known
habitat for the deer mouse, rock squirrel, and prairie dog,
who have been the primary mammalian carriers.
On the other hand, Gage is sufficiently concerned
that cats could become major carriers that on April 7 of this
year he issued a special warning via national media.
“People are moving out, building new houses, or setting
up mobile homes,” he explained. “They have a junk pile or
a wood pile outside where the rodents live, right at their
house. They turn their cats out, and the cats bring infected
fleas or a dead rodent back to the house.”
Traditionally, most U.S. plague victims contract
the disease from wildlife. The first known case in
Wyoming, for instance, afflicted a trapper who got it while
gutting a rabbit in 1978. The first Wyoming fatality was
another trapper who got it while skinning a bobcat in 1992.
But, said Gage, seven of the 10 human plague cases in
1993 were infected at home; at least two were infected by
cats, rarely carriers abroad, as have been at least 13 other
people since 1977.
One victim was a 31-year-old Tucson man, who
in 1992 volunteered to rescue a cat from a crawl space
beneath friends’ home in rural Colorado. He found the cat
docile but desperately ill. Face to face with her while coax-
ing her out, he apparently contracted pnuemonic plague
from a sneeze; mistook the symptoms for stomach flu;
waited 48 hours to seek medical help; and died. His case
mirrored that of a woman from South Lake Tahoe,
California, who died after face-to-face contact with her
sick cat in 1980. That region remains a plague risk area,
as other infected cats were foundd in nearby Truckee dur-
ing 1992 and 1993. Sixteen California counties reported
plague in animals during 1993. The afflicted locales were
scattered throughout the Sierra Nevada foothills, with
other cases in San Diego, Riverside, and San Luis Obispo.
According to a veterinary bulletin issued on
September 24 by the California Division of Communicable
Disease Control, “The incubation period for plague in cats
is short, approximately two days. Bubonic plague is the
most common form seen in cats, and usually appears as
fever, anorexia, lethargy, lympthadenopathy, and/or
buboes,” or abcessed lymph nodes. “The submandibular
lymph nodes are frequently affected,” the bulletin contin-
ued. “In the less common form, pnuemonic plague, respi-
ratory signs may be seen with or without buboes, and
include sneezing, coughing, nasal discharge, oral lesions,
and/or lower respiratory signs. Exudate from buboes or
respiratory secretions and sputum are contagious to
humans,” it emphasized.
Veterinarians were advised to hospitalize and iso-
late any cat with plague symptoms, “until the signs are
completely resolved. Protect veterinary clinic personnel
from secretions and other body fluids,” the warning added,
“by using disposable surgical masks, gowns, and gloves
while handling the animal. Thoroughly disinfect or dispose
of all contaminated materials. Treat the cat for fleas with
an effective insecticide. Also instruct the owner on how to
treat the cat’s environment and other contact animals.
Owners of cats with suspected plague, the treating veteri-
narian, and the staff should consult their phsycian immedi-
ately, especially if fever or lymphadenopathy develop.”
Concluded the California advisory, “To help
prevent plague in cats, advise clients to keep their pets
confined away from rodents and teach them how to
practice effective, regular flea control.”
The advisory did not recommend any special mea-
sures to eliminate the homeless cat population, aware, per-
haps, that medieval fear and hatred of cats brought on a
purge of the species throughout much of Europe––followed
by a population explosion among rats and mice, and the
Black Death, a plague epidemic that killed a third of the
European population before it subsided.
Forty-four nations undertook special measures to
contain the Indian plague outbreak. Nearby nations gener-
ally closed their borders to Indian visitors. More distant
and more medically advanced nations variously limited air
travel from India, screened arriving passengers for symp-
toms, and discouraged residents from going to India. In-
flight fumigations of aircraft, controversial recently after
public disclosure of several cases in which passengers had
serious reactions to the insecticides, were stepped up. India
instituted screening of all departing air passengers.
The U.S. response may have been the least
alarmed, as travellers were merely told to avoid the Surat
region; to use insect repellant on legs, clothes and outer
bedding if they did visit parts of India where they might
encounter either plague or rats; and to take tetracycline or
doxycycline as a preventative treatment should they be
exposed to plague somehow, except for children under age
8, for whom sulfonamides were recommended.
The most bizarre response may have come in
Pentre, Wales, where self-appointed rat-catchers Richard
Morgan and Andy Thomas, each 24, blew up the village
sewer line while trying to burn rats out of a drain hole.
Japan, plague-free since 1926, helped bring the
Indian outbreaks under control by donating 3.3 million
antibiotic capsules to India. Informed estimates of the cost
of the outbreak to India, where the average daily wage is
under a dollar, ranged from $300 million to $10 billion.
Dr. P.V. Unnikrishnan of the Voluntary Health
Association warned October 9 that despite the attention paid
to the plague, it was actually not one of India’s most press-
ing health problems. “One Indian dies every five minutes
from tuberculosis,” he said. “One third of the population is
exposed to malaria, one third of the world’s leprosy suffer-
ers are Indian. Of 22 million Indian children born each
year, 2.5 million die before they are one, 40% of them suf-
fer from malnutrition, and 50% of children and 65% of
women are anemic. Eighty percent of the health budget is
spent on hospitals and research facilities,” he continued,
“which are always in the big cities and towns, when 70%
of the people live in the countryside.”
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