Plague and Cholera — The Epidemic versus the Endemic

Abstract

Between 1892 and 1940, over ten million people died of plague in India and over 15 million died of cholera. Plague and cholera instilled fear in their victims and in anyone who might come into contact with them or their effects. Indian port cities, teeming with undernourished populations housed in overcrowded and insanitary dwellings and without access to pure water, could not have been more welcoming of disease. Bombay, in particular, was ripe for plague infestation. It hosted an abundant and susceptible population of black rats, whose traveling companions, Xenopsyllia Cheopis, happened to be one of the best flea vectors for plague transmission. Modern transport, the grain trade, and the close proximity of rodents, fleas and humans in Indian homes disseminated plague and its vectors through Indian towns and villages. The impoverished were especially susceptible, since they could not afford to build the sanitary dwellings that would shelter them from rats and their plague-carrying rat fleas. Cholera, too, found its home in particular groups: the poor, who were especially vulnerable during famine or scarcity; migrants searching for work or food; and pilgrims.¹ Plague and cholera fed on the economic deprivation, dense and unhygienic living conditions, and chronic malnutrition that afflicted the poor.² Those living in rural poverty, unlike some urban dwellers, lacked access to the few piped water systems being constructed in urban areas.