Thousands more are fleeing in cars, rickshaws and even bullock carts to escape the air-borne pneumonic plague which many people believe - mistakenly - can kill within 15 minutes after it strikes. More than 200,000 people have escaped Surat, and medical authorities are afraid plague carriers will spread the disease to Bombay, a city of 12 million.
Already, the plague refugees have begun swarming into Bombay. Chabildas Bagadia, a businessman who left Surat by train with his family, said: 'Conditions are pathetic. People are vomiting blood and dying after suffering for six hours before treatment is given. We just gathered what little we could and fled.' Bombay hospitals are readying quarantine wards, and rat-catchers are sending their catch to the city's laboratories to verify if the plague has hit.
In Surat, health workers are spraying 250 tons of pesticides, since the plague is transmitted from rodents' fleas. Pnemonic plague is a more contagious form of bubonic plague since it attacks the lungs and can be spread by a cough or sneeze.
India now faces an outbreak of plague in two neighbouring states, Maharashtra and Gujarat.
In Surat, where unofficially, the death toll may exceed 100, the plague is of a more deadly variety. Unless it is treated with antibiotics, it is 80 per cent fatal. Its victims are stricken with fevers, chills, and pneumonia before dying within four days. In Maharashtra, the plague is bubonic. So far, 89 cases have been identified but none fatal.
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