Plague in South-East Asia

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Abstract
The paper presents a historical background and a summary of the situation of plague in South-East Asia. South-East Asia contributes at present over 90% of the total world incidence of plague. Two small outbreaks in Nepal can be considered as accidental in a wild plague focus due to intimate sharing of habitat by both man and rodents. No cases of human plague occurred in Thailand in the last 17 years (Fig. 6). In Indonesia the disease has been active again in a previously infected area after a silent period of 7 years (Fig. 5). In Burma and South Viet-Nam it continued to be active since its introduction almost 70 years ago (Figs. 7, 8, 9 and 10). Occasional increases in incidence due to new entrants in the areas in which zootic maintenance of plague is possible, and intermittent silent periods, are less evident in those two countries. The question whether the foci are “true” or not is rather academic if large numbers of cases in humans are observed year after year for 70 years. The facility with which it has spread in Viet-Nam in the last few years due to the state of war and consequent profound disturbances of the human and zootic habitats, should not obscure the fact that plague is neither new nor unexpected and that in 7 provinces (out of which 5 are coastal) the disease in humans occurred with perseverance and regularity. In others, quiescent periods are not unusual. The dispersal beyond the as yet not precisely defined “plague areas” might be temporary and plague might again retract to more limited areas*

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