Plague has spread from central parts of Africa to the Mediterranean and it, has caused a death around 40 million. It has also spread in Central Asia, Sicily. Later, it was also found in Yunnan, and in the latter half of nineteenth century, it was spread in Hong Kong and in Bombay, India also. And, then it has spread among all major port cities.

By the year 1910, plague had reached practically all the countries around the globe. The spread of the disease was ultimately controlled due to several international regulations that were put into place. Of instance, there used to inspection of ships to ensure that they did not have rats. Also, the harbors were checked to ensure that any rats were exterminated. Other than the outbreak of pneumonic plague in Manchuria in the first half of the 20th century, there have not been significant outbreaks of plague every since. Also, if there were, the outbreak was restricted to people who were in close contact with the infected person, invariably the family members or the caregivers. However, it must be pointed out that India faced an outbreak of pneumonic plague in the year 1994. This happened in Surat, a city in the state of Gujarat in the western part of India. While the media reported that the outbreak was severe, as a matter of factm just 50 deaths occurred.

The second pandemic of plague broke out in central Asia. It reached Sicily due to sea routes when the ship came from Constantinople. This occurred in the year 1347. From here, the disease spread like wild fire and was constantly striking people for the next 4 centuries. It also managed to find it way into Britain during this time. The disease was so deadly that it managed to kill practically quarter of the population on the continent. So, it should not come as a surprise to learn that this pandemic was called Black Death.

From the year 1979 till 1993, around 16,312 cases of plague have been reported and about 1,668 fatalities have been reported from twenty countries to the WHO. During this period, the US saw about 227 cases of plague.

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