1994 plague in India
The 1994 plague in India was an outbreak of bubonic and pneumonic plague in south-central and southwestern India from August 26 to October 18, 1994. 693 suspected cases and 56 deaths were reported from the five affected Indian states as well as the Union Territory of New Delhi. These cases were from Maharashtra (488 cases), Gujarat (77 cases), Karnataka (46 cases), Uttar Pradesh (10 cases), Madhya Pradesh (4 cases) and New Delhi (68 cases). There are no reports of cases being imported to other countries.
In the first week of August 1994 health officials reported unusually large numbers of deaths of domestic rats in Surat city of Gujarat state. On 21 September 1994 the Deputy Municipal Commissioner of Health (DMCH) for Surat city received a report that a patient had died seemingly due to pneumonic plague. The DMCH of Surat alerted medical officers in the area where the patient had died. Later that day, a worried caller informed DMCH about 10 deaths in Ved Road residential area and around 50 seriously ill patients admitted to the hospital. This triggered the biggest post-independence migration of people in India with around 300,000 people leaving Surat city in 2 days.
Outbreak of disease and panic
News of the plague spread through Surat city through the night of 21 September 1994. Ill-prepared, medical shops quickly exhausted stocks of tetracycline. This led to panic with people fleeing hospitals fearing infection from other sick patients.
Due to the migration of infected people from Surat city, suspected plague spread to five states. A total of around 52 deaths were reported from India due to this suspected plague outbreak.
Over the course of this event, many flights from India to the nearby Gulf region were suspended. Some countries also put a hold on the imports from India.
The epicenter of the plague was Surat, Gujarat. 52 people lost their lives and close to a quarter of the city's citizens fled the area for fear of being quarantined. Although the plague only lasted a little over two weeks, it caused widespread panic. Tourism was negatively affected, flights to India were cancelled, and some planes from India were fumigated at airports.
Large scale flooding occurred due to the heavy rain and clogged sewers. This caused dead animals to remain out in the open, which added to the already unhygienic conditions. Many people were afraid that the refugees would disperse the plague and potentially spread it around the world, but this never happened probably because of the efficient response by the Indian health authorities.
Much like the Black Death that spread through medieval Europe, some questions still remain unanswered about the 1994 epidemic in Surat. Initial questions about whether it was an epidemic of plague arose because the Indian health authorities were unable to culture Yersinia pestis, but this could have been due to lack of sophisticated laboratory equipment. Yet there are several lines of evidence strongly suggesting that it was a plague epidemic: blood tests for Yersinia were positive, a number of individuals showed antibodies against Yersinia and the clinical symptoms displayed by the affected were all consistent with the disease being plague.
A committee under chairmanship of Professor Vulimiri Ramalingaswami was formed by the Government of India to investigate the plague episode. In 1995 the committee submitted the report 'The Plague Epidemic of 1994' to the Government of India. The report concluded that the disease was plague.  The former programme director in the New Delhi WHO office, Satnam Singh, has disagreed with that conclusion.[not in citation given] Also the origin of disease could not be traced. Within a few weeks the spread of disease and panic ended. Nevertheless, this 1994 plague episode in India is remembered for the panic it caused, both in India and in the international community.
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