Pandemi pes ketiga

Untuk peristiwa pandemi ketiga lainnya, lihat Pandemi kolera 1846–1860.

Pandemi wabah ketiga adalah sebuah pandemi yang diakibatkan oleh penyakit pes. Wabah ini mulai menyebar dari wilayah Yunnan, Tiongkok, pada tahun 1855 selama lima tahun masa pemerintahan Kaisar Xianfeng dari dinasti Qing. Wabah pes ini menyebar ke semua benua yang berpenghuni, dan pada akhirnya menyebabkan lebih dari 12 juta kematian di India dan Tiongkok, dengan sekitar 10 juta tewas diantaranya berasal dari India. Menurut Organisasi Kesehatan Dunia, pandemi ini dianggap aktif hingga tahun 1960, ketika korban di seluruh dunia turun menjadi 200 per tahun. Kematian akibat wabah terus berlanjut namun dengan tingkat yang lebih rendah setiap tahun sejak itu.

Pasien wabah disuntik oleh dokter pada tahun 1897 di Karachi.

Gambar korban Wabah manchuria pada 1910–1911

Nama mengacu pada pandemi ini sebagai wabah pes ketiga utama yang mempengaruhi masyarakat Eropa. Yang pertama dimulai dengan Wabah Justinian, yang melanda Kekaisaran Bizantium dan sekitarnya pada tahun 541 dan 542; pandemi terus berlanjut dalam gelombang yang berurutan sampai pertengahan abad ke-8. Yang kedua dimulai dengan Black Death, yang menewaskan sedikitnya sepertiga penduduk Eropa dalam serangkaian gelombang infeksi yang meluas dari tahun 1346 hingga 1353; pandemi ini terjadi berulang secara teratur hingga abad ke-19.

Pola jumlah korban jiwa menunjukkan bahwa gelombang pandemi pada akhir abad ke-19/awal abad ke-20 ini mungkin berasal dari dua sumber yang berbeda. Yang pertama terutama adalah bubonik dan dibawa ke seluruh dunia melalui perdagangan laut, melalui pengangkutan orang yang terinfeksi, tikus, dan kargo yang mengandung kutu. Strain kedua, yang lebih ganas, terutama bersifat pneumonia dengan penularan dari orang ke orang yang kuat. Peristiwa ini sebagian besar hanya terjadi di Asia, khususnya Manchuria dan Mongolia.

Origins

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 distribution of the disease throughout the world.

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. 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.

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.

Political impact in British India

Directions for searchers, Pune plague of 1897

The plague, which was brought from Hong Kong to British India, killed about one million in India. It later also killed another 12.5 million there over the next thirty years. Almost all cases were bubonic, with only a very small percentage changing to pneumonic plague. (Orent, p. 185) The disease was initially seen in port cities, beginning with Bombay (now Mumbai), but later emerged in Poona (now Pune), Calcutta (now Kolkata), and Karachi (now in Pakistan). By 1899, the outbreak spread to smaller communities and rural areas in many regions of India. Overall, the impact of plague epidemics was greatest in western and northern India, in the provinces then designated as Bombay, Punjab, and the United Provinces; eastern and southern India were not as badly affected.

The colonial government's measures to control the disease included quarantine, isolation camps, travel restrictions, and the exclusion of India's traditional medical practices. Restrictions on the populations of the coastal cities were established by Special Plague Committees, with overreaching powers enforced by the British military. Indians found the measures culturally intrusive and generally repressive and tyrannical. The government's strategies of plague control underwent significant changes during 1898–1899. By then, the use of force in enforcing plague regulations had been shown to be counterproductive, and since the plague had spread to rural areas, enforcement in larger geographic areas would be impossible. British health officials then began to press for widespread vaccination by using Waldemar Haffkine’s plague vaccine, but the government stressed that inoculation was not compulsory. British authorities also authorized the inclusion of practitioners of indigenous systems of medicine into plague prevention programs.

Repressive government actions to control the plague led the Pune nationalists to criticize the government publicly. On 22 June 1897, the Chapekar brothers, young Pune Hindus, shot and killed Walter Charles Rand, an Indian Civil Services officer who was acting as Pune Special Plague Committee chairman, and his military escort, Lieutenant Ayerst. The action of the Chapekars was seen as terrorism. The government also found the nationalist press to be guilty of incitement. The nationalist activist Bal Gangadhar Tilak was charged with sedition for his writings as editor of the newspaper Kesari and was sentenced to eighteen months of rigorous imprisonment.

Public reaction to the health measures enacted by the British Indian government ultimately revealed the political constraints of medical intervention in the country. The experiences were formative in the development of India's modern public health services.

Global distribution

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

• Beihai, Qing China 1882.
• Guangzhou, Qing China 1894.
• British Hong Kong 1894.
• Japanese Taiwan, Empire of Japan 1896 (until 1923 Great Kantō earthquake).
• Jeddah, 1896.
• Mecca, 1898.
• Bombay Presidency, India, 1896–1898.
• Calcutta, India, 1898.
• French Madagascar, 1898.
• Kobe, 1898.
• Khedivate of Egypt, 1899.
• Manchuria, China 1899.
• Paraguay, 1899.
• Porto, Portugal, 1899.
• South Africa, 1899–1902.
• Republic of Hawaii, 1899.
• Glasgow, United Kingdom, 1900.
• San Francisco, United States, 1900.
• Manila, 1900.
• Australia, 1900–1905.
• Russian Empire/Soviet Union, 1900–1927.
• Fujian, China 1901.
• Thailand, 1904.
• British Burma, 1905.
• French Tunisia, 1907.
• Trinidad, Venezuela, Peru and Ecuador, 1908.
• Bolivia and Brazil, 1908.
• Cuba and Puerto Rico, 1912.

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.

1894 Hong Kong plague

The 1894 Hong Kong plague was a major outbreak of the third pandemic in the world from the late 19th century to the early 20th century. In May 1894, the first case occurred in Hong Kong. The patient was a national hospital clerk and was discovered by Dr. Yu Xun, the Dean of the National Hospital, who had just returned from Canton. When the Chinese-style buildings were built, the Taiping Mountain area in Sheung Wan, the most densely-populated area in Hong Kong, became the hardest hit area of the epidemic. Controlling the epidemic naturally became the top priority of the Governor of Hong Kong. From May to October 1894, the plague in Hong Kong killed more than 6,000 people, one third of the population fled Hong Kong. In the 30 years starting in 1926, the plague occurred in Hong Kong almost every year and killed more than 20,000 people. Through the maritime traffic in Hong Kong, the plague epidemic originating in Yunnan, China, spread to all parts of the country after 1894 and eventually spread to all inhabitated continents.

There were several reasons for the rapid outbreak and rapid spread of the plague. Firstly, in the early days of Kailuan, Sheung Wan was a Chinese settlement. The design of the houses there, in the mountains, included no drainage channels, toilets, or running water. The small buildings and the lack of floor tiles were other weaknesses in the design. Secondly, during the Ching Ming Festival in 1894, many Chinese living in Hong Kong returned to the countryside to sweep the 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.

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.

Penelitian penyakit

Y. Pedtis diisolasi oleh Ricardo Jorge selama wabah Porto tahun 1899.

Para peneliti yang bekerja di Asia selama "Wabah Pandemi Ketiga" mengidentifikasi penyebab wabah dan basil wabah. Pada tahun 1894, di Hong Kong, ahli bakteriologi Prancis kelahiran Swiss Alexandre Yersin mengisolasi bakteri penyebab (Yersinia pestis, dinamai Yersin) dan menentukan cara penularan yang umum. Penemuannya mengarah pada metode pengobatan modern, termasuk insektisida, penggunaan antibiotik, dan akhirnya vaksin. Pada tahun 1898, peneliti Prancis Paul-Louis Simond mendemonstrasikan peran kutu sebagai penyebab pandemi.

Penyakit ini disebabkan oleh bakteri yang biasanya ditularkan melalui gigitan kutu dari inangnya yang terinfeksi, seringkali tikus hitam. Bakteri tersebut dipindahkan dari darah tikus yang terinfeksi ke kutu tikus (Xenopsylla cheopis). Bacillus berkembang biak di perut kutu. Ketika kutu berikutnya menggigit mamalia, darah yang dikonsumsi dimuntahkan bersama dengan basil ke dalam aliran darah hewan yang digigit. Wabah yang serius ini sebelum muncul manusia didahului oleh wabah pada populasi hewan pengerat. Selama wabah, kutu terinfeksi yang telah kehilangan inang hewan pengerat biasanya mencari sumber darah lain.

Pemerintah kolonial Inggris di India menekan peneliti medis Waldemar Haffkine untuk mengembangkan vaksin wabah. Setelah tiga bulan bekerja terus-menerus dengan staf terbatas, formulir untuk uji coba pada manusia sudah siap. Pada 10 Januari 1897 Haffkine mengujinya pada dirinya sendiri. Setelah tes awal dilaporkan ke pihak berwenang, relawan di penjara Byculla digunakan untuk tes kontrol, semua tahanan yang diinokulasi selamat dari epidemi, sementara tujuh narapidana dari kelompok kontrol meninggal. Pada pergantian abad, jumlah inokule di India saja mencapai empat juta. Haffkine ditunjuk sebagai Direktur Laboratorium Wabah (sekarang disebut Institut Haffkine) di Bombay.

Lihat pula

• Garis waktu wabah
• Wabah besar London (1665)

Bacaan lanjutan

• Media tentang Plague, third pandemic di Wikimedia Commons
• Advisory Committee for Plague Investigations in India (1911), Report On Plague Investigations In India, 1906–1910 
• Hazrat Mirza Ghulam Ahmad, The Promised Messiah. Noah’s Ark: An Invitation to Faith.
• Gandhi, M. K. The Plague Panic in South Africa
• Gregg, Charles. Plague: An Ancients Disease in the Twentieth Century. Albuquerque, University of New Mexico Press, 1985.
• Kelly, John. The Great Mortality: An Intimate History of the Black Death, the Most Devastating Plague of All Time. New York: HarperCollins Publishers, 2005. ISBN 0-06-000692-7.
• McNeill, William H. Plagues and People. New York: Anchor Books, 1976. ISBN 0-385-12122-9.
• Orent, Wendy. Plague: The Mysterious Past and Terrifying Future of the World's Most Dangerous Disease. New York: Free Press, 2004. ISBN 0-7432-3685-8.

Pranala luar

• Visual Representations of the Third Plague Pandemic