Leading Article: There need not be another Plague Year

THE FEAR and despair that plague has evoked this week in parts of India can be well understood from A Journal of the Plague Year, Daniel Defoe's account of 1665, when an epidemic hit London. 'The shrieks of women and children at the windows and doors of their houses, where their dearest relations were perhaps dying, or just dead, were so frequent to be heard as we passed in the streets,' wrote Defoe, 'that it was enough to pierce the stoutest heart in the world to hear them.'

The better-off left and the King escaped to Oxford as the sick lost faith in doctors: 'The physicians were seized with it, with their preservatives in their mouths . . . and they dropped down dead, destroyed by that very enemy they directed others to oppose.' Likewise, this week, the hospitals of Surat emptied and doctors fled, taking Defoe's misbegotten advice that 'the best physic against the plague is to run away from it'.

Echoes of the terror that is now prevalent in India persist even in modern Britain. The plague killed thousands of people in London in 1665 - the open expanse of Blackheath is said to contain the remains of many of those who succumbed. The plague at its height destroyed social and political institutions; unsurprisingly, the word remains in common usage as a way to describe any great calamity, affliction or evil. In La Peste, Albert Camus used the image of a modern city stricken by plague as an allegory for the German occupation of France. Little wonder, then, that curiosity is tinged with horror at the thought that even a few isolated cases of this condition may be returning to Europe undetected through busy airport terminals.

Other deadly illnesses have enjoyed a less bleak literary resonance. The symptoms of tuberculosis both cursed and inspired the Romantic poets. 'Youth grows pale, and spectre thin, and dies,' wrote Keats, who like Shelley was consumptive. Latterly Aids has inherited the imagery of lost youth once associated with TB. Meanwhile the cultural significance of cancer has been explored by Susan Sontag in her aptly titled book Illness as Metaphor.

Such images and mystification make it difficult to consider diseases in a strictly rational manner. This is particularly regrettable at a time when some infectious diseases are again becoming more widespread and more difficult to cure. The development of drug-resistant strains, the vulnerability of people with HIV, and social upheaval in areas such as Africa and the former Eastern bloc have combined to re-create once-banished problems of public health.

It would be easy to forget, as even Surat's fleeing doctors seemed to have done this week, that both bubonic and pneumonic plague are curable using antibiotics such as tetracycline and streptomycin that have been available for decades. The current outbreak can be easily dealt with, so long as appropriate and early action is taken.

This plague is highly infectious and can prove fatal within 24 hours of the onset of illness if not promptly treated, but it is, in principle, a less life-threatening condition than, say, Aids. Even TB, which is again rampant in Africa, is sometimes drug-resistant and requires in any case a drug programme that can last for up to two years.

Britain must, of course, first ensure that any domestic cases of the plague are spotted quickly; to that extent this week's headlines will be helpful in raising awareness. A public information campaign may be necessary. The World Health Organisation also needs to ensure that India has the resources of trained personnel and antibiotics to ensure that the disease is quickly contained. If these straightforward measures are adopted, what is in danger of being mythologised as the Great Plague of India will make newspaper headlines only for a few weeks, rather than the whole year in which the baleful cries of Londoners disturbed the ears of Daniel Defoe.