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ABSTRACT
During World War II, members of the Imperial Japanese Army biological warfare Unit 731 conducted a live test deployment of plague-infected fleas in Ningbo, Zhejiang Province, China. The deployment triggered an outbreak involving 165 cases in downtown Ningbo, 112 of which were fatal (68% case fatality rate). Despite lack of access to effective medical countermeasures, the Ningbo community exhibited a high degree of social cohesion and resilience in the context of effective public health response. These findings support the value of community preparedness and strong public health infrastructure to mitigate the impact of biological weapons.
Acknowledgements
The authors thank the anonymous Americans who were interred in Shanghai and surviving family members of the Smith and Lengyel families that provided testimony and insight for this study. The authors thank Lucie W. Sidley and Jim Liu for Chinese translation assistance. The authors also thank Jane Blake and Heather Baker for comments on the earliest drafts of this manuscript.
Disclosure statement
No potential conflict of interest was reported by the authors.
Notes
1. Summers, Manchurian Plague, 9–14.
2. Summers, Manchurian Plague, 19–25.
3. Mori and Kasukawa, Chugokugawashiryo, 28–29.
4. Mori and Kasukawa, Chugokugawashiryo, 15–16; Mori and Kasukawa, Chugokugawashiryo, 37–54; Mori and Kasukawa, Chugokugawashiryo, 142–143; Mori and Kasukawa, Chugokugawashiryo, 152; Saikinsen.net, 731 butai saikinsen kokka baisyoseikyu sosyo; and Mori and Kasukawa, Chugokugawashiryo, 172–184.
5. Withers MR, ed. USAMRIID, 40.
6. Harris, Factories of Death, 105–106.
7. Trial of Former Servicemen, 269–270.
8. Air Target Maps, 152A–44; and Shabad, Population of China’s Cities, 32 – 42.
9. Air Target Maps, 152A–44.
10. Ying, Disease Spread by Rodents, 65 – 73.
11. Smith, Diaries of ECS, Folder 1.
12. Smith, Diaries of MSC, Folder 6 – 8.
13. Crouch, Japanese Biological Warfare.
14. Trial of Former Servicemen, 270.
15. “Infectious Disease Detected,” Shishi Gongbao.
16. Ying, Disease Spread by Rodents, 65 – 73.
17. Smith, Diaries of MSC, Folder 6—8; and Crouch, Japanese Biological Warfare, Folder 1.
18. “Plague Outbreak,” Shishi Gongbao.
19. “Infectious Disease Detected”, Shishi Gongbao; Ying, Disease Spread by Rodents, 65—73; and “Plague Outbreak”, Shishi Gongbao; and “Quarantine Special”, Shishi Gongbao.
20. Ying, Disease Spread by Rodents, 65—73.
21. “Quarantine Special,” Shishi Gongbao.
22. “Bureau Burns Down”, Shishi Gongbao.
23. “Aiming at Plague,” Shishi Gongbao.
24. Butler, “Plague History,” 202–209.
25. “Infectious Disease Detected”, Shishi Gongbao; “Arrival of County Magistrate”, Shishi Gongbao; “Plague in Yin County”, Shishi Gongbao; “Plague is Epidemic”, Shishi Gongbao; and “Epidemic Prevention Bureau Quarantines”, Shishi Gongbao.
26. “Arrival of County Magistrate,” Shishi Gongbao.
27. “Plague in Yin County,” Shishi Gongbao.
28. “Epidemic Prevention Bureau Quarantines,” Shishi Gongbao.
29. McGrath, “Biological Impact,” 407–419.
Additional information
Notes on contributors
James M. Wilson
Dr. James M. Wilson is the Director of the Nevada Medical Intelligence Center at the University of Nevada-Reno. Dr. Wilson is a board-certified, practicing pediatrician who specializes in operational health security intelligence, with a focus on the anticipation, detection, and warning of infectious disease crises. He has led the creation of several of the most powerful systems in the world used for anticipation and detection of infectious disease crises and disasters. Dr. Wilson was the first operations chief of the Department of Homeland Security’s National Biosurveillance Integration Center and worked with the Intelligence Community during the birth of formal health security intelligence in the mid-2000s. Dr. Wilson led the private intelligence teams that provided tracking of H5N1 avian influenza as it spread from Asia to Europe and Africa, detection of vaccine drifted H3N2 influenza in 2007, warning of the 2009 H1N1 influenza pandemic, discovery of the United Nations as the source of the 2010 cholera disaster in Haiti, and several investigations of alleged and confirmed laboratory accidents and biological weapon deployments. Dr. Wilson is a strong advocate for effective and accountable global health security intelligence and the need for credible and balanced threat assessments.
Mari Daniel
Mari Daniel is a D.C.-based research consultant specializing in East Asian issues. Beginning her career at the James Martin Center for Nonproliferation Studies, she has worked for the past 20 years as an open-source analyst on issues ranging from weapons of mass destruction proliferation, public health, and political and socio-cultural issues in East Asia. Notably, while with the Georgetown University Medical Center, her analysis of media sources aided in the early detection of fatal pediatric H1N1 cases in East Asia.