In Maharashtra State, Plague surveillance unit is established in
the year 1953. Since establishment, regular Plague survey is carried
out in Plague prone areas. But till 1987, no confirmed case of
plague was detected and hence the plague unit was abolished from
1th December 1987.
During August and September 1994, there was suspected outbreak of
Plague in village Mamla of District Beed. Total 634 serologically
positive cases from all over State were reported. Therefor, Plague
Surveillance Unit is reestablished from 3rd October 1994 and is
functioning under Joint Director Of Health Services, (M&F),
Pune till to date. Infrastructure of State and staffing pattern
of Plague Surveillance Unit is given in Annexure I & II respectively.
Ancient Disease:
Plague is an ancient disease that is not likely to disappear; its
continued outbreaks throughout the world attest to its tenacious
presence. Since the first descriptions, many studies have examined
the transmission, epidemiology and pathogenesis of the disease
(Gage, 1998). Plague is a bacterial infection of small mammals
transmitted from animal to animal by the bite of infected fleas.
Plague cycles naturally in its enzootic foci, circulating between
small mammals and fleas without human involvement. The quiescent
periods, during which few or no human cases are detected, may last
for years, leading to mistaken declarations of plague eradication.
However long the silent periods last, plague may suddenly reappear.
The combination of false assurance of its eradication, and the
failure of public health vigilance, sets the stage for the panic
that may ensue when enzootic plague spills over from its natural
cycle into the peridomestic and commensal rodent populations (and
their fleas), bringing plague into closer human contact. Poor sanitation,
overcrowding and high numbers of rodents are conditions that enhance
urban plague transmission. Thus, a plague outbreak has come to
represent an indictment of social, environmental and political
changes in the modern world.
Perspective and history:
Plague has a remarkable place in history. For centuries, plague
represented disaster for those living in Asia, Africa and Europe,
where, it has been said, populations were so affected that sometimes
there were not enough people left alive to bury the dead (Gross,
1995). Because the cause of plague was unknown, plague outbreaks
contributed to massive panic in cities and countries where it appeared.
The disease was believed to be delivered upon the people by the
displeasure of the gods, by other supernatural powers or, by heavenly
disturbance. Innocent groups of people were blamed for spreading
plague and were persecuted by the panicked masses. Numerous references
in art, literature and monuments attest to the horrors and devastation
of past plague epidemics. So imprinted in our minds is the fear
of plague that, even now, entering into the 21st century, a suspected
plague outbreak can incite mass panic and bring much of the world's
economy to a temporary standstill. The number of human plague infections
is low when compared to diseases caused by other agents, yet plague
invokes an intense, irrational fear, disproportionate to its transmission
potential in the post-antibiotic/vaccination era.
