New Delhi, February 19
The Union Health Minister, Dr C.P. Thakur, confirmed that the mysterious disease which had claimed four lives so far was nothing but the much-dreaded plague.

Addressing mediapersons here after wide ranging consultations with experts and meeting with the Prime Minister, the Health Minister said: “This unfortunately is one thing that really turned out to be plague.” While rubbing his hands and smiling in embarrassment, Dr Thakur added, “The good aspect is that it is totally contained. The state government and the Central Government are working day and night to contain the outbreak.”

The minister expressed confidence that the disease had been contained as no new case had been reported after February 8. He said nearly two incubation periods for plague bacteria were over. The incubation period of plague bacteria is maximum seven days. He said public health experts had assessed that the infection had been confined to the area of its origin but the Public Health administration of the Himachal Government had been advised to keep a vigil in neighbouring areas as well as the state.

Relying on laboratory investigations done at the National Institute of Communicable Diseases here, the Health Minister said: “The sequence of tests collectively confirmed that the cases related to infection with yersinia pestis commonly known as pneumonic plague.”

He said the aforesaid conclusion was supported by other clinical and epidemiological evidence. He added that the procedure for identifying and confirming the pathogen was in full conformity with the World Health Organisation guidelines.

He said that the culture isolates from two suspected cases, sputum specimens from two cases, lung autopsy from one case and one lung lavage material, were examined in the NICD laboratories. The investigations led to the following inferences: Smear examination showed bipolar, short thin bacilli morphologically resembling yersinia pestis, the fluorescent antibody test was found positive for yersinia pestis, molecular tests confirmed the presence of yersinia pestis specific pla and f1 genes. He said that the DNA fingerprint had identity with a known sequence of plague bacilli and the bacteriophagelysis test for plague was positive.

He said that of the 16 persons affected with plague, 12 were under medication. The condition of one person was reported to be serious. While five patients were under medication at Vivil Hospital, Rohru, six were at the PGI and one at Indira Gandhi Medical Institute, Shimla.

Dr Thakur told TNS that he planned to visit the patients at the PGI tomorrow and visit Himachal Pradesh the day after. He said he had submitted a report to the Prime Minister earlier in the evening and was asked to go ahead and make the information on the exact nature of the disease public. He said that the NICD team which visited Himachal Pradesh issued detailed guidelines to the local health authorities for containing the spread of the infection. The significant components included quaratine of the affected villages, distribution of antibiotics to close contacts of the infected persons, formalin fumigation of the affected villages and vehicles, awareness campaign and door-to-door interaction in the affected villages.

Replying to a question, Dr Thakur said the Himachal Government had not ignored warning signals on the possible recurrence of plague. He said the disease had recurred after 22 years in the state.

Health Secretary Javed Chowdhury said the ministry would notify the outbreak of the disease soon. He said the significant fact was that the origin of the infection had been traced to the same hamlet in Hatkoti village from where the first case was reported. He said: “Twelve days have passed since the last case of plague was reported. There is no secondary infection. The notion that plague is an eradicated disease ought to be dispelled. We are not underestimating the seriousness of the matter. We should be very alert but there should be no sensationalism.”

Mr Chowdhury drew attention to WHO statistics released last September. It reported that of the 2000 to 3000 cases of plague reported every year between 1985 and 1999, nearly 200 deaths had been reported.

Asked whether he would also visit Himachal Pradesh, Mr Chowdhury said, “If necessary, we will go but our epidemiological supervision will continue.”

WHO Representative to India Robert Kim-Farley said the government had done “rapid and competent work” and made a very “commendable effort” in containing the spread of the disease. He said plague had an incubation period of 2 to 6 days and since no case had been reported since February 8, that “speaks for itself” about the fact that it has been contained. “It can no longer be considered as an infected outbreak.”

Mr Farley said plague was endemic in many parts of India and many parts of the world, including the USA. “It is not a big deal in a situation where the area is endemic. It should not be treated as big news though plague carries a big emotional label. The government is following WHO guidelines.”

Chandigarh, February 19
Keeping their fingers crossed, doctors in charge of the situation at the PGI are counting critical days ever since the hospitalisation of the last plague patient on February 13. Five days have now passed without any fresh admissions at either Shimla or Chandigarh and doctors are already making sounds of the situation being well under control.

Although the incubation period of the disease is one to seven days but the PGI experts have decided to wait for another 10 days before declaring that all is safe and there is no chance of the present outburst of the deadly disease breaking out into an epidemic.

The PGI today handed over the report of its findings to the Union Ministry of Health and Family Welfare, New Delhi. ‘‘Both the NICD and the PGI are supposed to give separate reports to the Ministry which will then compile and release the necessary information.’’ said Dr S.K. Sharma, Director, PGI.

Following PGI’s statement that the highly contagious disease which has claimed lives of four members of a family of Himachal Pradesh as being plague, the hospital authorities all over the region are now in a state of high alert.

Rife with the knowledge of plague’s deadly epidemic potential, no one is taking any chances. But all agree that efforts need to be made to control any public panic which may lead to worsening of the situation.

And it seems the Surat lessons have been well learnt. According to an international report on the Surat plague, ‘‘The alarm that plague is still able to evoke was highlighted by the public panic and over-exaggerated international response to reports of outbreaks of bubonic and pneumonic plague in India in 1994. Except for large outbreaks of pneumonic plague in Manchuria in the early part of the 20th century, person-to-person respiratory transmission of plague has occurred only sporadically and has been limited to clusters of close contacts of pneumonic plague patients, such as household members and caregivers.’’

However, doctors also state that this time over there is a strong element of luck also. With each passing day it is avidly clear that the disease is going to limit itself to this family where chances of the first person who died of the disease being the only one who contacted bubonic plague and spread it as pneumonic plague to his family members. In comparison to this, according to reports of plague in Surat, 10 per cent of the population of the Mamla village in Maharashtra was already suffering from bubonic plague by the end of August, 1994, before pneumonic plague spread to Surat in September, 1994.

Meanwhile, the Minister for Horticulture, Himachal Pradesh, Mr Narinder Bragta visited the PGI and met the attendants of the six patients and assured them of all help from the government. He also said that in May, 2002, and September, 2002, the Government of Himachal Pradesh would be conducting a survey in collaboration with the NICD of the areas where the disease started.

The condition of two of the six patients, admitted to the PGI with plague is said to be serious. While Rakesh and Naveen are in respiratory distress, Purshottam and Pradeep still have fever while Jyoti and Satya are fine.‘‘ We will be discharging the two who are now fine in a day or two,’ ’said Dr S. Verma, Head of the Department of Internal Medicine, PGI.