Historical reconstruction of the community response, and related epidemiology, of a suspected biological weapon attack in Ningbo, China (1940)

Abstract

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.