A long-term and active anti-plague drive is required at the national level, covering the entire country/population of both rats and man. Preventive steps are required even in normal times, but more vigorously when a plague epidemic is predicted. Specific measures must be undertaken when such a situation arises.

1. Prediction of the plague epidemic

Surveillance units can playa great role. Incidence of plague in wild/urban rats, and/or a fall in the wild/urban rat population should be regularly monitored.

An epidemic of plague in rats is an indication that an epidemic of plague in the human population is going to occur in about 2-3 weeks. Hence, we have 2-3 weeks to take necessary steps, so that the plague epidemic does not occur in man at all.

Since the plague epidemic in rats usually occurs after an earthquake, such an occurrence is itself a warning signal.

2. What should be done when an epidemic of plague in manhas been predicted?

The following measures should be immediately taken:

1. All plague-infected wild/urban rats should be trapped and killed. In case, the rats have already died as a result of plague, they should be carefully disposed off, and the surroundings properly disinfected by spraying insecticides, so that rat-fleas which leave the dead rats are also killed. Those attending/ doing this cleansing operation are instructed to wear boots with knee-high socks, gloves, aprons, caps, goggles, masks, so as to protect themselves from being bitter by the ratfleas.

2. All possible measures need to be taken so that rats from outside do not enter the houses. Grain stores/godowns, ideally the whole building/house, should be rat-proof. Rats harbouring in grain stores are a great nuisance. They may be even responsible for spreading the disease to other countries when infected rats are carried in grain bags by ships. All such rats must be trapped and examined for plague-infection. All grain stores must be free from rats. A close watch is also required to see that ships have no rats.

3. Proper sanitation in and around houses, as well as in the concerned cities is of utmost importance. There should be proper and regular disposal of garbage. This avoids an unnecessary increase in the number of rats/rat-fleas.

4. One should not walk barefoot and with bare legs, so as to avoid being bitten by rat-fleas. Sleeping on the floor may prove dangerous.

5. In case there is sudden death of several rats, authorities must be immediately informed so that all necessary steps can be taken in that area, besides disposing off the dead rats.

6. 'Pest repeller' devices should be used at various places like restaurants, hotels, bars, kitchens, stores, bedrooms, etc. to keep rats away from human beings. These are electronic devices that emit ultrasonic sounds which are highly disturbing to rats and even snakes, etc., so that rats do not come near the appliance or into the room/hall where the device has been installed. Of course, the sound of the device is not audible to human beings and is harmless.

7. Likewise, insect repellent oils/creams may be used, especially on the exposed parts of the body, to avoid being bitten by rat-fleas.

8. People of the area where plague has been suspected/ predicted, should to be immediately vaccinated with anti-plague vaccine, like Haffkine's vaccine, which is available in India. If sufficient quantities cannot be made available for mass immunization, the vaccine should be procured from some other countries, as it is only useful when given in time.

9. Whenever the occurrence of a plague epidemic is predicted, people should be properly cautioned regarding its consequences, and necessary steps of prevention (as detailed above), should be explained through various media, like newspapers, magazines, TV, radio, public announcements, etc. At the same time, detailed instructions must be supplied to all health personnel, including those at the rural level. A requisite number of beds should be kept reserved in the various hospitals of the region/city, and an adequate store of drugs is needed. At the same time, it is necessary to pass on the word to all drug-manufacturers for keep an eye on the production of drugs essentially required for the treatment of plague. There has to be sufficient production of drugs so as to meet the urgent demands of hospitals / chemists.

In conclusion, it may be said that if all the above steps of prevention are strictly followed, an epidemic of plague can be prevented, which will save mankind from mass mortality.