Third plague pandemic

Last updated
Plague patient being injected by a doctor 1897 in Karachi. Man being injected by doctor, during the outbreak of bubonic Wellcome V0029287.jpg
Plague patient being injected by a doctor 1897 in Karachi.
Picture of Manchurian plague victims in 1910-1911 Picture of Manchurian Plague victims in 1910 -1911.jpg
Picture of Manchurian plague victims in 1910–1911

The third plague pandemic was a major bubonic plague pandemic that began in Yunnan, China, in 1855 during the fifth year of the Xianfeng Emperor of the Qing dynasty. [1] This episode of bubonic plague spread to all inhabited continents, and ultimately led to more than 12 million (perhaps 15 million) deaths in India and China, with about 10 million killed in India alone, making it one of the deadliest pandemics in history. [2] [3] [4] According to the World Health Organization, the pandemic was considered active until 1960, when worldwide casualties dropped to 200 per year. [5] Plague deaths have continued at a lower level for every year since.


The name [6] refers to this pandemic being the third major bubonic plague outbreak to affect European society. The first began with the Plague of Justinian, which ravaged the Byzantine Empire and surrounding areas in 541 and 542; the pandemic persisted in successive waves until the middle of the 8th century. The second began with the Black Death, which killed at least one third of Europe's population in a series of expanding waves of infection from 1346 to 1353; this pandemic recurred regularly until the 19th century.

Casualty patterns indicate that waves of this late-19th-century/early-20th-century pandemic may have come from two different sources. The first was primarily bubonic and was carried around the world through ocean-going trade, through transporting infected persons, rats, and cargoes harboring fleas. 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 and Mongolia.


The bubonic plague was endemic in populations of infected ground rodents in central Asia and was a known cause of death among the migrant and established human populations in that region for centuries. An influx of new people because of political conflicts and global trade led to the spread of the disease throughout the world.[ citation needed ]

A natural reservoir or nidus for plague is in western Yunnan and is still an ongoing health risk. The third pandemic of plague originated in the area after a rapid influx of Han Chinese to exploit the demand for minerals, primarily copper, in the second half of the 19th century. [7] By 1850, the population had exploded to over 7 million people. Increasing transportation throughout the region brought people in contact with plague-infected fleas, the primary vector between the yellow-breasted rat (Rattus flavipectus) and humans. People brought the fleas and rats back into growing urban areas, where small outbreaks sometimes reached epidemic proportions. The plague spread further after disputes between Han Chinese and Hui Muslim miners in the early 1850s erupted into a violent uprising, known as the Panthay Rebellion, which led to further displacements by troop movements and refugee migrations. The outbreak of the plague helped recruit people into the Taiping Rebellion. The plague began to appear in Guangxi and Guangdong provinces, Hainan Island, and then the Pearl River delta, including Canton and Hong Kong. Although William McNeil and others believe the plague to have been brought from the interior to the coastal regions by troops returning from battles against the Muslim rebels, Benedict suggested evidence to favor the growing and lucrative opium trade, which began after about 1840. [7]

In the city of Canton, beginning in March 1894, the disease killed 80,000 people in a few weeks. Daily water-traffic with the nearby city of Hong Kong rapidly spread the plague. Within two months, after 100,000 deaths, the death rates dropped below epidemic rates, but the disease continued to be endemic in Hong Kong until 1929. [8]

Global distribution

The network of global shipping ensured the widespread distribution of the disease over the next few decades. [9] [10] [11] Recorded outbreaks included the following:

Each of the areas, as well as Great Britain, France, and other areas of Europe, continued to experience plague outbreaks and casualties until the 1960s. The last significant outbreak of plague associated with the pandemic occurred in Peru and Argentina in 1945.[ citation needed ]

1894 Hong Kong plague

The 1894 Hong Kong plague was a major outbreak of the third global pandemic from the late 19th century to the early 20th century. The first case, discovered in May 1894, was a hospital clerk who had just returned from Canton. The hardest hit was the mountainous area in Sheung Wan, the most densely-populated area in Hong Kong, characterised by Chinese-style buildings. From May to October 1894, the plague killed more than 6,000 people, leading to the exodus of one third of the population. In the 30 years starting in 1926[ dubious ], the plague occurred in Hong Kong almost every year and killed more than 20,000 people. Through maritime traffic, the epidemic spread to the rest of the country after 1894 and eventually to the whole world. [8]

There were several reasons for the rapid outbreak and spread of the plague. Firstly, in the early days, Sheung Wan was a Chinese settlement. Houses — in the mountains — had no drainage channels, toilets, or running water. The houses were small and the floors were not paved. Secondly, during the Ching Ming Festival in 1894, many Chinese living in Hong Kong returned to the countryside to tend to family graves, which coincided with the outbreak of the epidemic in Canton and the introduction of bacteria into Hong Kong. Thirdly, in the first four months of 1894, rainfall decreased and soil dried up, accelerating the spread of the plague. [22]

The main preventive measures were setting up plague hospitals and deploying medical staff to treat and isolate plague patients; conducting house-to-house search operations, discovering and transferring plague patients, and cleaning and disinfecting infected houses and areas; and setting up designated cemeteries and assigning a person responsible for transporting and burying the plague dead. [23]

Disease research

Y. pestis isolated by Ricardo Jorge during the 1899 Porto plague outbreak Preparacoes de Ricardo Jorge do bacilo da peste bubonica no Porto (1899) - fotografias de Antonio Placido da Costa (Museu de Historia da Medicina Maximiano Lemos, FMUP).png
Y. pestis isolated by Ricardo Jorge during the 1899 Porto plague outbreak

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 isolated the responsible bacterium ( Yersinia pestis , named for Yersin) and determined the common mode of transmission. His discoveries led in time to modern treatment methods, including insecticides, the use of antibiotics and eventually plague vaccines. In 1898, French researcher Paul-Louis Simond demonstrated the role of fleas as a vector.[ citation needed ]

The disease is caused by a bacterium usually transmitted by the bite of fleas from an infected host, often a black rat. The bacteria are transferred from the blood of infected rats to the rat flea ( Xenopsylla cheopis ). 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.[ citation needed ]

The British colonial government in India pressed medical researcher Waldemar Haffkine 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) in Bombay. [24]

Medical procedures implemented by New International Health Communities

In the early 1900s despite the increasing knowledge of germ theory and the rapid growth of scientific communities around the prevention of major disease, there was little the international communities could do other then create standard protocols for how to deal with an outbreak of the plague. [25] In 1897 and 1903, two conventions were held known as International Sanitary Conferences; the first in Venice and the second in Paris, to help deal with threat of the new outbreaks of the bubonic plague. From these conventions was formed an international disease convention supervised by the Office International D'hygiene Publique (OIHP) in Paris which would be one of the major predecessors of the League of Nations health organization. [25] From these conventions came the standard Protocols used in dealing with the bubonic plague throughout the early 1900s. [25] These protocols were often old fashioned and were generally summarized as the 3 "I's": Isolation, Incineration, and Inoculation. Isolation is a standard protocol of many modern disease outbreaks, but the usage of incineration was a protocol of disease control used most uniquely for dealing with the bubonic plague. [25] Burning was used often to deal with the Plague as it was believed to the be most effective way to eliminate strains of the disease from places inhabited by the infected. [25] But it was also a problematic technique as it led to the creation of many out of control fires that devastated communities the most notable being the great fire in Honolulu which devastated the Chinatown community there. [25] Inoculation was the usage of plague vaccines of which many were invented and some even proved to be extremely effective in their use in India being recorded to have over a 50% efficacy. [26]

Social Implications of the Third Plague Pandemic

Much historical evidence shows that the Third Plague Pandemic has many world wide cases of revealing or creating major social issues and racial Inequalities. [25] Many of the Ports Infected during the plague were at the time British held colonies, this meant that in these colonies the British Empire was responsible for most of the actions used to prevent the disease. [27] Due to this the British often ended up enforcing western hygiene and medical practices and radical quarantine measures in countries and provinces such as India, South Africa and Hong Kong. Many of these imposed western sanitary measures were new to these areas and caused natives fear and apprehension of the British government. In India harsh quarantines were initially implemented by the British governments leading to Indian resentment of quarantine measures. [27] In South Africa when the plague broke out in Cape Colony the British government made a radical decision to move a large group of native South Africans out of a supposed slum into areas on the outskirts of the city which many historians argue was a move by white south Africans to segregate African born south Africans to other parts of the city for racial reasons. [28] In Hong Kong the British enforced many odd medical practices such as floating plague victims out on boats onto the water and cooling plague victims with ice which scared many Chinese residents of Hong Kong and lead to them migrating back to mainland China where the Plague was hitting even worse. [29] Another notable area of social issues caused by the plague is the great fire of Honolulu which caused the Chinatown in Honolulu to be destroyed and over 7,000 Chinese and Japanese residents homeless. [25] In America when the plague reached San Francisco there was a major social conflict in the factor of the medical board of the city implementing a strict quarantine of the entire Chinatown district after only discovering one case of the plague causing many to question whether this was because of a racial bias that the medical professionals believed Chinatown to be unsanitary and therefore full of the plague already. [30]

See also

Related Research Articles

Black Death 1346–1353 pandemic in Eurasia and North Africa

The Black Death was a bubonic plague pandemic occurring in Afro-Eurasia from 1346 to 1353. It is the most fatal pandemic recorded in human history, causing the death of 75–200 million people in Eurasia and North Africa, peaking in Europe from 1347 to 1351. Bubonic plague is caused by the bacterium Yersinia pestis, but it may also cause septicaemic or pneumonic plagues.

Plague (disease) Specific contagious and frequently fatal human disease caused by Yersinia pestis

Plague is an infectious disease caused by the bacterium Yersinia pestis. Symptoms include fever, weakness and headache. Usually this begins one to seven days after exposure. In the bubonic form there is also swelling of lymph nodes, while in the septicemic form tissues may turn black and die, and in the pneumonic form shortness of breath, cough and chest pain may occur.

Pandemic Global epidemic of infectious disease

A pandemic is an epidemic of an infectious disease that has spread across a large region, for instance multiple continents or worldwide, affecting a substantial number of people. A widespread endemic disease with a stable number of infected people is not a pandemic. Widespread endemic diseases with a stable number of infected people such as recurrences of seasonal influenza are generally excluded as they occur simultaneously in large regions of the globe rather than being spread worldwide.

<i>Yersinia pestis</i> Species of bacteria, cause of plague

Yersinia pestis is a gram-negative, non-motile, rod-shaped, coccobacillus bacterium, without spores. It is a facultative anaerobic organism that can infect humans via the Oriental rat flea. It causes the disease plague, which takes three main forms: pneumonic, septicemic, and bubonic. There may be evidence suggesting Y. pestis originated in Europe in the Cucuteni–Trypillia culture and not in Asia as is more commonly believed.

Hong Kong flu 1968-9 flu pandemic

The Hong Kong flu, also known as the 1968 flu pandemic, was a flu pandemic whose outbreak in 1968 and 1969 killed between one and four million people globally. It is among the deadliest pandemics in history, and was caused by an H3N2 strain of the influenza A virus. The virus was descended from H2N2 through antigenic shift—a genetic process in which genes from multiple subtypes are reassorted to form a new virus.

Waldemar Haffkine Ukrainian-French microbiologist (1860–1930)

Waldemar Mordechai Wolff Haffkine was a bacteriologist from the Russian Empire who later became a French citizen. He emigrated to France and worked at the Pasteur Institute in Paris, where he developed an anti-cholera vaccine that he tried out successfully in India. He is recognized as the first microbiologist who developed and used vaccines against cholera and bubonic plague. He tested the vaccines on himself. Lord Joseph Lister named him "a saviour of humanity".

Bombay plague epidemic

The Bombay plague epidemic was a bubonic plague epidemic that struck the city of Bombay in the late nineteenth century. The plague killed thousands, and many fled the city leading to a drastic fall in the population of the city.

John Ashburton Thompson was a British-Australian physician and an international authority on plague and leprosy.

Globalization, the flow of information, goods, capital, and people across political and geographic boundaries, allows infectious diseases to rapidly spread around the world, while also allowing the alleviation of factors such as hunger and poverty, which are key determinants of global health. The spread of diseases across wide geographic scales has increased through history. Early diseases that spread from Asia to Europe were bubonic plague, influenza of various types, and similar infectious diseases.

Bubonic plague Human and animal disease

Bubonic plague is one of three types of plague caused by the plague bacterium. One to seven days after exposure to the bacteria, flu-like symptoms develop. These symptoms include fever, headaches, and vomiting, as well as swollen and painful lymph nodes occur in the area closest to where the bacteria entered the skin. Occasionally, the swollen lymph nodes, known as "buboes" pictured to the right, may break open.

1817–1824 cholera pandemic Health disaster

The first cholera pandemic (1817–1824), also known as the first Asiatic cholera pandemic or Asiatic cholera, began near the city of Calcutta and spread throughout South and Southeast Asia to the Middle East, eastern Africa and the Mediterranean coast. While cholera had spread across India many times previously, this outbreak went further; it reached as far as China and the Mediterranean Sea before subsiding. Hundreds of thousands of people died as a result of this pandemic, including many British soldiers, which attracted European attention. This was the first of several cholera pandemics to sweep through Asia and Europe during the 19th and 20th centuries. This first pandemic spread over an unprecedented range of territory, affecting almost every country in Asia.

Chinatown, Honolulu Historic neighborhood of Honolulu, Hawaii

The Chinatown Historic District is a neighborhood of Honolulu, Hawaii, known for its Chinese American community. It is one of the oldest Chinatowns in the United States.

Joseph J. Kinyoun

Joseph James Kinyoun was an American physician and the founder of the United States' Hygienic Laboratory, the predecessor of the National Institutes of Health.

The second plague pandemic was a major series of epidemics of plague that started with the Black Death, which reached Europe in 1348 and killed up to a half of the population of Eurasia in the next four years. Although the plague died out in most places, it became endemic and recurred regularly. A series of major epidemics occurred in the late 17th century, and the disease recurred in some places until the late 18th century or the early 19th century. After this, a new strain of the bacterium gave rise to the third plague pandemic which started in Asia around the mid-19th century.

The San Francisco plague of 1900–1904 was an epidemic of bubonic plague centered on San Francisco's Chinatown. It was the first plague epidemic in the continental United States. The epidemic was recognized by medical authorities in March 1900, but its existence was denied for more than two years by California's Governor Henry Gage. His denial was based on business reasons, to protect the reputations of San Francisco and California and to prevent the loss of revenue due to quarantine. The failure to act quickly may have allowed the disease to establish itself among local animal populations. Federal authorities worked to prove that there was a major health problem, and they isolated the affected area; this undermined the credibility of Gage, and he lost the governorship in the 1902 elections. The new Governor George Pardee implemented a medical solution and the epidemic was stopped in 1904. There were 121 cases identified, including 119 deaths.

Diseases and epidemics of the 19th century Diseases and epidemics of the 19th century reached epidemic proportions in the case of cholera

Diseases and epidemics of the 19th century included long-standing epidemic threats such as smallpox, typhus, yellow fever, and scarlet fever. In addition, cholera emerged as an epidemic threat and spread worldwide in six pandemics in the nineteenth century. The third plague pandemic emerged in China in the mid-nineteenth century and spread worldwide in the 1890s.

21st century Madagascar plague outbreaks Outbreaks of plague in Madagascar during the 21st century

Madagascar has experienced several outbreaks of bubonic and pneumonic plague in the 21st century. In the outbreak beginning in 2014, 71 died; in 2017, 202 died. Smaller outbreaks occurred in January 2008, and December 2013.

Globally about 600 cases of plague are reported a year. In 2017 and November 2019 the countries with the most cases include the Democratic Republic of the Congo, Madagascar, and Peru.

1899 Porto plague outbreak Late 19th-century epidemic in Portugal

The 1899 Porto plague outbreak was an epidemic of bubonic plague centered in the city of Porto, in the north of Portugal.

1894 Hong Kong plague

The 1894 Hong Kong plague, part of the third plague pandemic, was a major outbreak of the bubonic plague in Hong Kong. While the plague was harshest in 1894, it returned annually between 1895 and 1929, and killed over 20,000 in total, with a fatality rate of more than 93%. The plague was a major turning point in the history of colonial Hong Kong, as it forced the colonial government to reexamine its policy towards the Chinese community, and invest in the wellbeing of the Chinese.


  1. Cohn, Samuel K. (2003). The Black Death Transformed: Disease and Culture in Early Renaissance Europe. A Hodder Arnold. p.  336. ISBN   0-340-70646-5.
  2. Stenseth, Nils Chr (2008-08-08). "Plague Through History". Science. 321 (5890): 773–774. doi:10.1126/science.1161496. ISSN   0036-8075.
  3. Frith, John. "The History of Plague – Part 1. The Three Great Pandemics". Journal of Military and Veterans' Health. 20 (2).
  4. Sanburn, Josh (2010-10-26). "Top 10 Terrible Epidemics: The Third Plague Pandemic". Time. ISSN   0040-781X . Retrieved 2021-01-01.
  5. Frater, Jamie (2009). The Ultimate Book of Top Ten Lists: A Mind-Boggling Collection of Fun, Fascinating and Bizarre Facts on Movies, Music, Sports, Crime, Ce. Ulysses Press. p. 175. ISBN   978-1-56975-800-7.
  6. Nicholas Wade (October 31, 2010). "Europe's Plagues Came From China, Study Finds". The New York Times . Retrieved 2010-11-01. The great waves of plague that twice devastated Europe and changed the course of history had their origins in China, a team of medical geneticists reported Sunday, as did a third plague outbreak that struck less harmfully in the 19th century.
  7. 1 2 Benedict, Carol (1996). Bubonic plague in eighteenth-century China. Stanford, CA: Stanford Univ. Press. pp.  47, 70. ISBN   978-0804726610.
  8. 1 2 Pryor, E.G. (1975). "The Great Plague of Hong Kong" (PDF). Journal of the Hong Kong Branch of the Royal Asiatic Society. 15: 61–70. PMID   11614750.
  9. Low, Bruce (1899). "Report upon the Progress and Diffusion of Bubonic Plague from 1879 to 1898". Reports of the Medical Officer of the Privy Council and Local Government Board, Annual Report, 1898–99. London: Darling & Son, Ltd. on behalf of His Majesty's Stationery Office: 199–258. Retrieved 17 October 2010.
  10. Low, Bruce (1902). "Summary of the Progress and Diffusion of the Plague in 1900". Reports of the Medical Officer of the Privy Council and Local Government Board, Annual Report, 1900–01. London: Darling & Son, Ltd. on behalf of His Majesty's Stationery Office: 264–282. Retrieved 17 October 2010.
  11. Eager, J.M. (1908). "The Present Pandemic of Plague". Public Health Bulletin. Washington: Government Printing Office: 436–443. Retrieved 17 October 2010.
  12. (:Unkn) Unknown (2018). "Plague Hospital in Porto - 1899". Apollo - University of Cambridge Repository. doi:10.17863/CAM.32180 . Retrieved 1 March 2020.
  13. "Honolulu's Battle with Bubonic Plague". Hawaiian Almanac and Annual. Honolulu: Thos. G. Thrum, Hawaiian Gazette Co.: 97–105 1900. Retrieved 17 October 2010.
  14. Kevin R. Bailey (June 2007). "Plague in paradise : a study of plague on Hawaiian sugarcane plantations" (PDF). Department of History and the Honors College of the University of Oregon. p. 3.
  15. MacDonald, Kenneth (2 January 2019). "Rats 'wrongly blamed' for 1900 Glasgow plague outbreak". BBC News. Retrieved 2 January 2019.
  16. "On The Plague In San Francisco". Journal of the American Medical Association. Chicago: The American Medical Association. 36 (15): 1042. April 13, 1901. doi:10.1001/jama.1901.52470150038003 . Retrieved 17 October 2010.
  17. "The Plague, "American Medicine," And The "Philadelphia Medical Journal."". Occidental Medical Times. San Francisco. 15: 171–179. 1901. Retrieved 17 October 2010.
  18. "Bubonic Plague At San Francisco, Cal". Annual Report of the Supervising Surgeon General of the Marine Hospital Service of the United States for the Fiscal Year 1901. Washington: Government Printing Office: 491–. 1901. Retrieved 17 October 2010.
  19. Zwanenberg, D Van (Jan 1970). "The last epidemic of plague in England? Suffolk 1906-1918". Medical History. 14 (1): 63–74. doi:10.1017/s0025727300015143. PMC   1034015 . PMID   4904731.
  20. Benedictow, Ole Jørgen (2004). The Black Death, 1346-1353: the complete history. Boydell & Brewer. p. 20. ISBN   0-85115-943-5.
  21. Shrewsbury, J. F. D. (2005). A History of Bubonic Plague in the British Isles. Cambridge University Press. pp. 509–510. ISBN   0-521-02247-9.
  22. "1894上環大鼠疫". Retrieved 2019-03-06.
  23. 楊, 祥銀 (2010). "公共衛生與1894年香港鼠疫研究". 華中師範大學學報. 49: 68–75.
  24. Hanhart, Joel (2016). Waldemar Mordekhaï Haffkine (1860–1930). Biographie intellectuelle. Paris: Honore Champion.
  25. 1 2 3 4 5 6 7 8 Echenberg, Myron (2002). "Pestis Redux: The Initial Years of the Third Bubonic Plague Pandemic, 1894-1901". Journal of World History. 13 (2): 429–449. doi:10.1353/jwh.2002.0033. ISSN   1045-6007. JSTOR   20078978. PMID   20712094.
  26. Hawgood, Barbara J (2007-02-01). "Waldemar Mordecai Haffkine, CIE (1860–1930): prophylactic vaccination against cholera and bubonic plague in British India". Journal of Medical Biography. 15 (1): 9–19. doi:10.1258/j.jmb.2007.05-59. ISSN   0967-7720. PMID   17356724.
  27. 1 2 Chatterjee, Srilata (2005). "Plague and Politics in Bengal 1896 to 1898". Proceedings of the Indian History Congress. 66: 1194–1201. ISSN   2249-1937. JSTOR   44145931.
  28. Swanson, Maynard W. (July 1977). "The Sanitation Syndrome: Bubonic Plague and Urban Native Policy in the Cape Colony, 1900–19091". The Journal of African History. 18 (3): 387–410. doi:10.1017/S0021853700027328. ISSN   1469-5138. PMID   11632219.
  29. Benedict, Carol (1988). "Bubonic Plague in Nineteenth-Century China". Modern China. 14 (2): 107–155. doi:10.1177/009770048801400201. ISSN   0097-7004. JSTOR   189268. PMID   11620272.
  30. Vavlas, Belinda A. (2010). Anti-Chinese Discrimination in Twentieth Century America: Perceptions of Chinese Americans During the Third Bubonic Plague Pandemic in San Francisco, 1900-1908 (Thesis). Youngstown State University.

Further reading