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An outbreak of plague in Hlegu, Burma in 1977

Insights

A 1977 plague outbreak in Hlegu Town, Burma, affected mostly young males. Investigations revealed a rat fall, high flea indices, and limited vaccine effectiveness during the event.

Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Zoonotic Diseases

Background:

  • An outbreak of bubonic plague occurred in Hlegu Town, Burma, in February-March 1977.
  • The outbreak primarily affected children under 15, with males disproportionately impacted.
  • A preceding rat fall event was identified as a potential trigger.

Purpose of the Study:

  • To investigate the epidemiology of the plague outbreak in Hlegu Town.
  • To identify risk factors and contributing elements to the outbreak.
  • To evaluate the effectiveness of plague vaccination during the event.

Main Methods:

  • Retrospective investigation including rodent and flea surveys.
  • Serological testing of trapped rodents.
  • Active case finding and clinical assessment of suspected cases.
  • Field trial to assess plague vaccination efficacy.

Main Results:

  • 14 cases of bubonic plague with 2 deaths were reported.
  • Low infection rate (9.5%) of Yersinia pestis in deceased rodents, potentially due to non-plague deaths.
  • High flea indices, possibly linked to partial DDT resistance and ineffective insecticide spraying.
  • Plague vaccination during the outbreak did not induce a detectable antibody response.

Conclusions:

  • The outbreak was associated with a rat fall and high flea indices, complicated by insecticide resistance.
  • Limited effectiveness of plague vaccination was observed during the active outbreak phase.
  • Further research on vector control and vaccination strategies in outbreak settings is warranted.

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