HEALTH-INDIA: Plague-like Disease Kills Four, Causes Panic

By Ranjit Devraj Reprint | | Print |

Ranjit Devraj

NEW DELHI, Feb 19 2002 (IPS) - After a fourth person died of a mysterious illness that has caused panic in the northern Himalayan states of Himachal Pradesh and Uttaranchal, medical experts said the disease could be plague.

“Clinically it looks like plague but we are awaiting final identification through molecular characterisation according to World Health Organisation (WHO) criteria,” Dr S.K. Sharma, director of the Post Graduate Institute of Medical Sciences (PGIMS) at Chandigarh city, said on Monday.

The National Institute of Communicable Diseases (NICD) in New Delhi, which has been tasked with the job of identifying the disease that broke out last week in the Rhoru district of Himachal Pradesh, a known focal point for plague, has not issued its report.

The latest victim, a woman, is one of nine people currently admitted at the PGIMS, and undergoing treatment. Chandigarh, the joint capital of Punjaband Haryana states, is the nearest major city with specialist facilities for people in Himachal Pradesh state.

Earlier, union minister for health, C. P. Thakur, himself a qualified doctor, claimed that the disease was under control but admitted that it had “symptoms similar to pneumonic plague”.

Thakur will have to make an official statement on this soon, and if the disease is in fact plague, his pronouncement is expected to have an impact on industries like tourism.

The symptoms of pneumonic plague, which is spread through the air and therefore considered highly contagious, includes rapid onset of fever, chills, headaches, malaise, prostration and nausea. Victims and doctors treating them are required to wear surgical masks to prevent contagion.

Plague, caused by the bacterium Yersinia Pestis, which is carried by the rat flea, also manifests as the bubonic plague (the Black Death of mediaeval times) in which the lymph glands in the armpits, groin and neck swell, and also as septicaemic plague.

The mysterious disease has so far claimed four lives — two in Himachal Pradesh and two in Uttaranchal. In all, 15 people are now undergoing treatment for plague, including nine admitted at the PGIMS. Tablets of tetracycline, the drug of choice against plague, are being distributed in Rhoru and nearby Jhubal village.

News reports from the two remote Himalayan villages, about a 100 kms east of Shimla, a well-known tourist resort and capital of Himachal Pradesh, spoke of hundreds of panic-stricken people flocking around public health centres and small medical facilities demanding tetracycline tablets.

Memories of the 1994 outbreak of plague in the western port city of Surat in western Gujarat state, which left more than 50 people dead, and resulted in several airlines canceling flights to India have not helped the situation, observers said.

Both Rhoru and Jubbal villages have been placed under quarantine and educational institutions closed down although no new cases have been reported since Saturday.

“There is no need for panic as no new cases have been reported beyond the incubation period of the disease,” Dr Pallab Ray, associate professor at the PGIMS was quoted as telling reporters in Chandigarh.

As with the 1994 plague outbreak in Surat, fingers are now being pointed at the government and blame for what is regarded as an easily preventable mediaeval disease, laid on gross neglect of public health by authorities.

Following the Surat outbreak, local authorities carried out a massive clean-up operation, removing mounds of accumulated rubbish and anything that attracts rats, and inspiring other cities including New Delhi to follow suit. But the current outbreak seemed to indicate that the enthusiasm has faded out.

The Hindu newspaper on Monday cited unnamed public health experts who said Himachal Pradesh, a known focal point for plague, had dismantled a surveillance system for the disease some ten years ago for lack of funds.

Other focal points for plague in the country include Uttaranchal state, Latur-Beed in central Maharashtra and the tri-junction of southern Karnataka, Tamil Nadu and Andhra Pradesh states.