Pneumonic plague epidemic in Northeast China in 1910-1911: Dr. Wu Lien-Teh's epidemic preventive system for plague control / 医学前沿

Pneumonic plague that originated in Russian Siberia broke out in Northeast China in October 1910-March 1911. On the basis of field visits, autopsy, bacteriological identification, and close collaboration with local authorities and international colleagues, Dr. Wu Lien-Teh implemented a series of efficient antiplague measures, which successfully controlled the development of an extraordinary epidemic plague. In his subsequent work, Dr. Wu demonstrated the respiratory transmission of pneumonic plague and tarbagans' role in this spread. Dr.Wu's academic and cultural contributions are valuable in the medical progress in China.

The First and the Second Pneumonic Plague in Manchuria and the Preventive Measure of Japanese Colonial Authorities (1910-1921) / 의사학

During the first plague epidemic in Manchuria (1910-1911), Japanese Government-General in Korea had not reported a plague patient at all in official. This did not mean the preventive measure of colonial authorities was successful. Their prevention program and measure were operated inadequately. They focused on instigative and sometimes irrelevant aspects such as rat removal to restore order in the colony. The quarantine facility was insufficient so that some people could not be effectively isolated. The reason pneumonic plague did not spread from Manchuria to Korea was mostly because Chinese coolie did not enter Korea. The colonial government promulgated Jeonyeombyeong Yebangryeong (Preventive Regulation of Contagious Disease) in June 5, 1915. This regulation aimed at unitary control by police and was strengthened 10-day quarantine. After the March First Movement, the colonial government tried to change imperial policy to cultural policy. The military police and civilian police were bifurcated and governors took charge of health administration. However, sanitary police still played important role for preventive measure. The preventive policy of colonial government experienced important change from cholera epidemic between 1919 and 1920. The death toll of two years had exceeded 20,000 people. During the cholera outbreak of two years, quarantine and isolation were emerged as important tools to prevent disease transmission, and were well-appointed more now than before. To prevent cholera epidemic, the colonial government strengthened house-to-house inspection as well as seaport quarantine, train quarantine, passenger quarantine. House-to-house inspection detected sixty percentage of cholera patients. When the second Manchurian plague spread in Korea in 1920-1921, this plague was known to Korean people as pneumonic plague. The colonial government propagated and educated pneumonic plague, and urged to wear a mask through Heuksabyeong Yebang Simdeuk (The Notandum for Plague Prevention). The colonial government did not focused on rat removal any more. They pointed out Chinese coolie as a source of infection. Though they did not know exact information and analysis on pneumonic plague, the preventive measure of the second plague in Manchuria was successful due to the well-equipped disinfection system such as house-to-house inspection and nationwide quarantine made by cholera prevention. While the first prevention of plague in Manchuria was successful despite rubbish preventive system, the second prevention of plague in Manchuria was successful due to the well-equipped disinfection system in spite of occurring plague patients.

Detection of Enzootic Plague Foci in Peninsular India.

A Continuous serological and bacteriological surveillance in rodents was carried out in peninsular India i.e. Andhra Pradesh, Karnataka and Tamil Nadu to detect the role of different species of rodents in the maintenance of active enzootic plague foci. Live rodents were collected from wild and ruderal/peri-domestic situations by digging and trapping for sera and organ samples. During 1989 to 2007 serological evidence of plague was detected in different species of rodents in peninsular India. Plague antibodies were detected in 243 sera samples in three different rodent species. Sero-positivity (0.042 percent) amongst rodents tested were found in Tatera indica cuvieri (Hardwicke) followed by Rattus rattus and Bandicota bengalensis. Regular plague surveillance work enhanced the possibility of detecting and delimiting plague foci and helped in implementing necessary preventive anti plague measures to prevent the occurrence of human plague.

REAL TIME ESTIMATION OF REPRODUCTION NUMBERS BASED ON CASE NOTIFICATIONS-Effective reproduction number of primary pneumonic plague

To estimate the time-dependent transmission potential of primary pneumonic plague (PPP), we analyzed historical records from six outbreaks. Based on contact investigation information (source of infection information) of three outbreaks, we generalized the probability density function of the serial interval with a Gamma distribution using maximum likelihood estimations. Furthermore, we used a likelihood-based approach to estimate effective reproduction numbers at time <I>t, R<SUB>t</SUB></I>, incorporating records from the remaining three outbreaks by assuming independence within unknown contact networks. According to our estimates, the <I>R<SUB>t</SUB></I> of PPP during the initial phases of each epidemic were roughly in the order of 1.3 (95% confidence interval (CI): 0.0-4.3) in Oakland, 1.4 (0.0-4.6) in Rangoon and 6.5 (0.0-16.0) in Ecuador. The expected values of <I>R<SUB>t</SUB></I> were shown to slightly exceed unity, even in latter stages. While declining trends in <I>R<SUB>t</SUB></I> were observed in Oakland and Ecuador, no such trend was observed in Rangoon. The findings suggest that the three outbreaks investigated could have been accompanied by demographic stochasticity. The statistical usefulness of the transformation procedure, even with a small number of recorded cases available, was demonstrated, and the expected responses to bioterrorism using <I>Yersinia pestis</I> were discussed.