Third Pandemic
Encyclopedia
Third Pandemic is the designation of a major Bubonic plague
Bubonic plague
Plague is a deadly infectious disease that is caused by the enterobacteria Yersinia pestis, named after the French-Swiss bacteriologist Alexandre Yersin. Primarily carried by rodents and spread to humans via fleas, the disease is notorious throughout history, due to the unrivaled scale of death...

 pandemic
Pandemic
A pandemic is an epidemic of infectious disease that is spreading through human populations across a large region; for instance multiple continents, or even worldwide. A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic...

 that began in the Yunnan
Yunnan
Yunnan is a province of the People's Republic of China, located in the far southwest of the country spanning approximately and with a population of 45.7 million . The capital of the province is Kunming. The province borders Burma, Laos, and Vietnam.Yunnan is situated in a mountainous area, with...

 province
Province (China)
A province, in the context of Chinese government, is a translation of sheng formally provincial level divisions, which is an administrative division. Provinces, municipalities, autonomous regions, and the special administrative regions, make up the four types of province of administrative division...

 in China
China
Chinese civilization may refer to:* China for more general discussion of the country.* Chinese culture* Greater China, the transnational community of ethnic Chinese.* History of China* Sinosphere, the area historically affected by Chinese culture...

 in 1855. This episode of bubonic plague spread to all inhabited continents, and ultimately killed more than 12 million people in India
India
India , officially the Republic of India , is a country in South Asia. It is the seventh-largest country by geographical area, the second-most populous country with over 1.2 billion people, and the most populous democracy in the world...

 and China alone. According to the World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

, the pandemic was considered active until 1959, when worldwide casualties dropped to 200 per year.

Bubonic plague
Bubonic plague
Plague is a deadly infectious disease that is caused by the enterobacteria Yersinia pestis, named after the French-Swiss bacteriologist Alexandre Yersin. Primarily carried by rodents and spread to humans via fleas, the disease is notorious throughout history, due to the unrivaled scale of death...

 is an infectious disease that is widely thought to have caused several epidemic
Epidemic
In epidemiology, an epidemic , occurs when new cases of a certain disease, in a given human population, and during a given period, substantially exceed what is expected based on recent experience...

s or pandemic
Pandemic
A pandemic is an epidemic of infectious disease that is spreading through human populations across a large region; for instance multiple continents, or even worldwide. A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic...

s throughout history, including two previous pandemics commonly designated as the Plague of Justinian
Plague of Justinian
The Plague of Justinian was a pandemic that afflicted the Eastern Roman Empire , including its capital Constantinople, in 541–542 AD. It was one of the greatest plagues in history. The most commonly accepted cause of the pandemic is bubonic plague, which later became infamous for either causing or...

 and the Black Death
Black Death
The Black Death was one of the most devastating pandemics in human history, peaking in Europe between 1348 and 1350. Of several competing theories, the dominant explanation for the Black Death is the plague theory, which attributes the outbreak to the bacterium Yersinia pestis. Thought to have...

.

Casualty patterns indicate that waves of this late-19th-century/early-20th-century pandemic may have been from two different sources. The first was primarily bubonic and was carried around the world through ocean-going trade, through transporting infected persons, rat
Rat
Rats are various medium-sized, long-tailed rodents of the superfamily Muroidea. "True rats" are members of the genus Rattus, the most important of which to humans are the black rat, Rattus rattus, and the brown rat, Rattus norvegicus...

s, and cargoes harboring flea
Flea
Flea is the common name for insects of the order Siphonaptera which are wingless insects with mouthparts adapted for piercing skin and sucking blood...

s. 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
Manchuria
Manchuria is a historical name given to a large geographic region in northeast Asia. Depending on the definition of its extent, Manchuria usually falls entirely within the People's Republic of China, or is sometimes divided between China and Russia. The region is commonly referred to as Northeast...

 and Mongolia
Mongolia
Mongolia is a landlocked country in East and Central Asia. It is bordered by Russia to the north and China to the south, east and west. Although Mongolia does not share a border with Kazakhstan, its western-most point is only from Kazakhstan's eastern tip. Ulan Bator, the capital and largest...

.

Pattern of the pandemic

The bubonic plague was endemic in populations of infected ground rodent
Rodent
Rodentia is an order of mammals also known as rodents, characterised by two continuously growing incisors in the upper and lower jaws which must be kept short by gnawing....

s in central Asia
Central Asia
Central Asia is a core region of the Asian continent from the Caspian Sea in the west, China in the east, Afghanistan in the south, and Russia in the north...

, and was a known cause of death among migrant and established human populations in that region for centuries; however, an influx of new people due to political conflicts and global trade led to the distribution of this disease throughout the world.

Outbreak in China

The initial outbreak was in China's Yunnan
Yunnan
Yunnan is a province of the People's Republic of China, located in the far southwest of the country spanning approximately and with a population of 45.7 million . The capital of the province is Kunming. The province borders Burma, Laos, and Vietnam.Yunnan is situated in a mountainous area, with...

 Province in the 1850s. The disease was stable within the province, but was spread due to a Muslim rebellion. The rebellion displaced local tribes, and also changed animal harvesting practices, leading to greater contact with infected animals. In addition, the rebellion meant that refugees from the conflict moved south, into regions of China with larger populations. The plague went with them, producing an increasing number of casualties. In the city of Canton
Guangzhou
Guangzhou , known historically as Canton or Kwangchow, is the capital and largest city of the Guangdong province in the People's Republic of China. Located in southern China on the Pearl River, about north-northwest of Hong Kong, Guangzhou is a key national transportation hub and trading port...

, beginning in March 1894, the disease killed 60,000 people in a few weeks. Daily water traffic with the nearby city of Hong Kong
Hong Kong
Hong Kong is one of two Special Administrative Regions of the People's Republic of China , the other being Macau. A city-state situated on China's south coast and enclosed by the Pearl River Delta and South China Sea, it is renowned for its expansive skyline and deep natural harbour...

 rapidly spread the plague. Within two months, after 100,000 deaths, the death rates dropped below epidemic rates, although the disease continued to be endemic in Hong Kong until 1929.

Political impact in Colonial India

Plague came to British India in 1896, most likely from Hong Kong where the epidemic had been festering since 1894. Over the next thirty years, the country would lose 12.5 million people to the disease. Almost all cases were bubonic
Bubonic plague
Plague is a deadly infectious disease that is caused by the enterobacteria Yersinia pestis, named after the French-Swiss bacteriologist Alexandre Yersin. Primarily carried by rodents and spread to humans via fleas, the disease is notorious throughout history, due to the unrivaled scale of death...

, with only a very small percentage changing to pneumonic plague
Pneumonic plague
Pneumonic plague, a severe type of lung infection, is one of three main forms of plague, all of which are caused by the bacterium Yersinia pestis. It is more virulent and rare than bubonic plague...

.(Orent, p. 185) The disease was initially seen in port cities, beginning with Bombay (now Mumbai
Mumbai
Mumbai , formerly known as Bombay in English, is the capital of the Indian state of Maharashtra. It is the most populous city in India, and the fourth most populous city in the world, with a total metropolitan area population of approximately 20.5 million...

), but later emerged in Pune
Pune
Pune , is the eighth largest metropolis in India, the second largest in the state of Maharashtra after Mumbai, and the largest city in the Western Ghats. Once the centre of power of the Maratha Empire, it is situated 560 metres above sea level on the Deccan plateau at the confluence of the Mula ...

, Kolkata
Kolkata
Kolkata , formerly known as Calcutta, is the capital of the Indian state of West Bengal. Located on the east bank of the Hooghly River, it was the commercial capital of East India...

, and Karachi
Karachi
Karachi is the largest city, main seaport and the main financial centre of Pakistan, as well as the capital of the province of Sindh. The city has an estimated population of 13 to 15 million, while the total metropolitan area has a population of over 18 million...

 (now in Pakistan
Pakistan
Pakistan , officially the Islamic Republic of Pakistan is a sovereign state in South Asia. It has a coastline along the Arabian Sea and the Gulf of Oman in the south and is bordered by Afghanistan and Iran in the west, India in the east and China in the far northeast. In the north, Tajikistan...

). 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—while 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, and enforced by the British military. Indians found these measures culturally intrusive and, in general, repressive and tyrannical. Government strategies of plague control underwent significant changes during 1898–1899. By that time, it was apparent that the use of force in enforcing plague regulations was proving counter-productive and, now that the plague had spread to rural areas, enforcement in larger geographic areas would be impossible. At this time, British health officials began to press for widespread vaccination using Waldemar Haffkine
Waldemar Haffkine
Waldemar Mordecai Wolff Haffkine, CIE was a Russian Jewish bacteriologist, whose career was blighted in Russia because "he refused to convert to Russian Orthodoxy." He emigrated and worked at the Pasteur Institute in Paris, where he developed an anti-cholera vaccine that he tried out successfully...

’s plague vaccine, although 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 gave the Pune nationalists an opportunity to berate the government publicly. On 22 June 1897
22 June 1897
22 June 1897 is a 1979 Marathi film, co-written by Shankar Nag and Nachiket Patwardhan and directed by the husband and wife team of Jayoo Patwardhan and Nachiket Patwardhan. The duo are also practising architects. It is based on the true life story of the assassination of British Government...

, the Chapekar brothers
Chapekar brothers
The Chapekar brothers alternatively spelt as Caphekar or Chaphekar , Damodar Hari, Balkrishna Hari and Vasudeo Hari belonged to Chinchwad, then a village, near the former Peshwa capital Pune, in the state of Maharashtra, India.In late 1896, Pune was hit by bubonic plague; by the end of February...

, young Pune brahmin
Brahmin
Brahmin Brahman, Brahma and Brahmin.Brahman, Brahmin and Brahma have different meanings. Brahman refers to the Supreme Self...

s, shot and killed W. C. Rand, an Indian Civil Services officer acting as Pune Special Plague Committee chairman, and his military escort, Lt. Ayerst. The action of the Chapekars has been considered the worst violence against political authority seen anywhere in the world during the third plague pandemic. The government also found the nationalist press guilty of incitement. Independence activist Bal Gangadhar Tilak
Bal Gangadhar Tilak
Lokmanya Tilak –, was an Indian nationalist, teacher, social reformer and independence fighter who was the first popular leader of the Indian Independence Movement. The British colonial authorities derogatorily called the great leader "Father of the Indian unrest"...

 was charged with sedition for his writings as editor of the Kesari newspaper. He was sentenced to eighteen months rigorous imprisonment. This punishment made him a living martyr to the struggle for India
India
India , officially the Republic of India , is a country in South Asia. It is the seventh-largest country by geographical area, the second-most populous country with over 1.2 billion people, and the most populous democracy in the world...

n independence.

Public reaction to the exceptionally intrusive health measures enacted by the British Indian state ultimately revealed the political constraints of medical intervention in the country. These 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. Recorded outbreaks include:
  • Pakhoi, China 1882.
  • Canton, China
    Guangzhou
    Guangzhou , known historically as Canton or Kwangchow, is the capital and largest city of the Guangdong province in the People's Republic of China. Located in southern China on the Pearl River, about north-northwest of Hong Kong, Guangzhou is a key national transportation hub and trading port...

      1894.
  • Hong Kong
    Hong Kong
    Hong Kong is one of two Special Administrative Regions of the People's Republic of China , the other being Macau. A city-state situated on China's south coast and enclosed by the Pearl River Delta and South China Sea, it is renowned for its expansive skyline and deep natural harbour...

     1894.
  • Formosa
    Taiwan
    Taiwan , also known, especially in the past, as Formosa , is the largest island of the same-named island group of East Asia in the western Pacific Ocean and located off the southeastern coast of mainland China. The island forms over 99% of the current territory of the Republic of China following...

    , Japan
    Empire of Japan
    The Empire of Japan is the name of the state of Japan that existed from the Meiji Restoration on 3 January 1868 to the enactment of the post-World War II Constitution of...

     1896.
  • Bombay Presidency
    Bombay Presidency
    The Bombay Presidency was a province of British India. It was established in the 17th century as a trading post for the English East India Company, but later grew to encompass much of western and central India, as well as parts of post-partition Pakistan and the Arabian Peninsula.At its greatest...

    , India 1896–1898.
  • Calcutta, India 1898.
  • Madagascar
    Madagascar
    The Republic of Madagascar is an island country located in the Indian Ocean off the southeastern coast of Africa...

    , 1898.
  • Egypt
    Egypt
    Egypt , officially the Arab Republic of Egypt, Arabic: , is a country mainly in North Africa, with the Sinai Peninsula forming a land bridge in Southwest Asia. Egypt is thus a transcontinental country, and a major power in Africa, the Mediterranean Basin, the Middle East and the Muslim world...

    , 1899.
  • Manchuria
    Manchuria
    Manchuria is a historical name given to a large geographic region in northeast Asia. Depending on the definition of its extent, Manchuria usually falls entirely within the People's Republic of China, or is sometimes divided between China and Russia. The region is commonly referred to as Northeast...

    , China 1899.
  • Paraguay
    Paraguay
    Paraguay , officially the Republic of Paraguay , is a landlocked country in South America. It is bordered by Argentina to the south and southwest, Brazil to the east and northeast, and Bolivia to the northwest. Paraguay lies on both banks of the Paraguay River, which runs through the center of the...

    , 1899.
  • South Africa
    South Africa
    The Republic of South Africa is a country in southern Africa. Located at the southern tip of Africa, it is divided into nine provinces, with of coastline on the Atlantic and Indian oceans...

    , 1899–1902.
  • Republic of Hawaii
    Republic of Hawaii
    The Republic of Hawaii was the formal name of the government that controlled Hawaii from 1894 to 1898 when it was run as a republic. The republic period occurred between the administration of the Provisional Government of Hawaii which ended on July 4, 1894 and the adoption of the Newlands...

    , 1899.
  • San Francisco, United States, 1900.
  • Australia
    Australia
    Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...

    , 1900–1905.
  • Russia
    Russia
    Russia or , officially known as both Russia and the Russian Federation , is a country in northern Eurasia. It is a federal semi-presidential republic, comprising 83 federal subjects...

    /Soviet Union
    Soviet Union
    The Soviet Union , officially the Union of Soviet Socialist Republics , was a constitutionally socialist state that existed in Eurasia between 1922 and 1991....

    , 1900–1927.
  • Fukien
    Fujian
    ' , formerly romanised as Fukien or Huguing or Foukien, is a province on the southeast coast of mainland China. Fujian is bordered by Zhejiang to the north, Jiangxi to the west, and Guangdong to the south. Taiwan lies to the east, across the Taiwan Strait...

     Province, China 1901.
  • Thailand
    Thailand
    Thailand , officially the Kingdom of Thailand , formerly known as Siam , is a country located at the centre of the Indochina peninsula and Southeast Asia. It is bordered to the north by Burma and Laos, to the east by Laos and Cambodia, to the south by the Gulf of Thailand and Malaysia, and to the...

    , 1904.
  • Burma, 1905.
  • Tunisia
    Tunisia
    Tunisia , officially the Tunisian RepublicThe long name of Tunisia in other languages used in the country is: , is the northernmost country in Africa. It is a Maghreb country and is bordered by Algeria to the west, Libya to the southeast, and the Mediterranean Sea to the north and east. Its area...

    , 1907.
  • Trinidad
    Trinidad
    Trinidad is the larger and more populous of the two major islands and numerous landforms which make up the island nation of Trinidad and Tobago. It is the southernmost island in the Caribbean and lies just off the northeastern coast of Venezuela. With an area of it is also the fifth largest in...

    , Venezuela
    Venezuela
    Venezuela , officially called the Bolivarian Republic of Venezuela , is a tropical country on the northern coast of South America. It borders Colombia to the west, Guyana to the east, and Brazil to the south...

    , Peru
    Peru
    Peru , officially the Republic of Peru , is a country in western South America. It is bordered on the north by Ecuador and Colombia, on the east by Brazil, on the southeast by Bolivia, on the south by Chile, and on the west by the Pacific Ocean....

     and Ecuador
    Ecuador
    Ecuador , officially the Republic of Ecuador is a representative democratic republic in South America, bordered by Colombia on the north, Peru on the east and south, and by the Pacific Ocean to the west. It is one of only two countries in South America, along with Chile, that do not have a border...

    , 1908.
  • Bolivia
    Bolivia
    Bolivia officially known as Plurinational State of Bolivia , is a landlocked country in central South America. It is the poorest country in South America...

     and Brazil
    Brazil
    Brazil , officially the Federative Republic of Brazil , is the largest country in South America. It is the world's fifth largest country, both by geographical area and by population with over 192 million people...

    , 1908.
  • Cuba
    Cuba
    The Republic of Cuba is an island nation in the Caribbean. The nation of Cuba consists of the main island of Cuba, the Isla de la Juventud, and several archipelagos. Havana is the largest city in Cuba and the country's capital. Santiago de Cuba is the second largest city...

     and Puerto Rico
    Puerto Rico
    Puerto Rico , officially the Commonwealth of Puerto Rico , is an unincorporated territory of the United States, located in the northeastern Caribbean, east of the Dominican Republic and west of both the United States Virgin Islands and the British Virgin Islands.Puerto Rico comprises an...

    , 1912.

Each of these areas, as well as Great Britain
Great Britain
Great Britain or Britain is an island situated to the northwest of Continental Europe. It is the ninth largest island in the world, and the largest European island, as well as the largest of the British Isles...

, France
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...

, and other areas of Europe, continued to experience plague outbreaks and casualties until the 1950s. The last significant outbreak of plague associated with the pandemic occurred in Peru and Argentina
Argentina
Argentina , officially the Argentine Republic , is the second largest country in South America by land area, after Brazil. It is constituted as a federation of 23 provinces and an autonomous city, Buenos Aires...

 in 1945.

Disease research

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
Alexandre Yersin
Alexandre Emile Jean Yersin was a Swiss and French physician and bacteriologist. He is remembered as the co-discoverer of the bacillus responsible for the bubonic plague or pest, which was later re-named in his honour .Yersin was born in 1863 in Aubonne, Canton of Vaud, Switzerland, to a family...

 isolated the responsible bacterium (Yersinia pestis
Yersinia pestis
Yersinia pestis is a Gram-negative rod-shaped bacterium. It is a facultative anaerobe that can infect humans and other animals....

) and determined the common mode of transmission. Japanese physician and researcher Kitasato Shibasaburō
Kitasato Shibasaburō
Baron was a Japanese physician and bacteriologist. He is remembered as the co-discoverer of the infectious agent of bubonic plague in Hong Kong in 1894, almost simultaneously with Alexandre Yersin.-Biography:...

 initially mis-identified the bacterium. In 1898, French researcher Paul-Louis Simond
Paul-Louis Simond
Paul-Louis Simond was a French physician and biologist who was born in Beaufort-sur-Gervanne, on July 30, 1858. His major contribution to science was his demonstration that the intermediates in the transmission of bubonic plague from rats to humans are the fleas Xenopsylla cheopis that dwell on...

 demonstrated the role of fleas as a vector.

The disease is caused by a bacterium usually transmitted by the bite of flea
Flea
Flea is the common name for insects of the order Siphonaptera which are wingless insects with mouthparts adapted for piercing skin and sucking blood...

s from an infected host, often a black rat
Black Rat
The black rat is a common long-tailed rodent of the genus Rattus in the subfamily Murinae . The species originated in tropical Asia and spread through the Near East in Roman times before reaching Europe by the 1st century and spreading with Europeans across the world.-Taxonomy:The black rat was...

. The bacteria are transferred from the blood of infected rats to the rat flea (Xenopsylla cheopsis). 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 bacterium that causes this disease, Yersinia pestis, was named for Yersin. His discoveries led in time to modern treatment methods, including insecticide
Insecticide
An insecticide is a pesticide used against insects. They include ovicides and larvicides used against the eggs and larvae of insects respectively. Insecticides are used in agriculture, medicine, industry and the household. The use of insecticides is believed to be one of the major factors behind...

s, the use of antibiotic
Antibiotic
An antibacterial is a compound or substance that kills or slows down the growth of bacteria.The term is often used synonymously with the term antibiotic; today, however, with increased knowledge of the causative agents of various infectious diseases, antibiotic has come to denote a broader range of...

s and eventually plague vaccine
Vaccine
A vaccine is a biological preparation that improves immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism, and is often made from weakened or killed forms of the microbe or its toxins...

s.

The British colonial government in India pressed medical researcher Waldemar Haffkine
Waldemar Haffkine
Waldemar Mordecai Wolff Haffkine, CIE was a Russian Jewish bacteriologist, whose career was blighted in Russia because "he refused to convert to Russian Orthodoxy." He emigrated and worked at the Pasteur Institute in Paris, where he developed an anti-cholera vaccine that he tried out successfully...

 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
Haffkine Institute
The Haffkine Institute was established on 10, January, 1899 by Dr. Waldemar Mordecai Haffkine, an orthodox Jewish Russian scientist from the Pasteur Institute, that aasigned him to work in India, then in the throes of major plague and cholera outbreaks...

) in Bombay.

Further reading

  • 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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