Wu Lien-teh: The Pioneer Who Introduced Mask Prevention During the 1910 Manchurian Plague

In October 1910, China's first plague patient was discovered in the Russian concession of Harbin. The infection had spread from the first plague case that emerged in Russian Dauria a month earlier. Unlike the flea-borne bubonic plague that had spread to pandemic levels in the 14th century, this was pneumonic plague, transmissible through airborne droplets. The rate of spread was also remarkably fast.

The person who recognized this distinction and first introduced mask-based prevention measures—requiring medical staff to wear masks made of cotton and gauze to prevent airborne transmission of pneumonic plague—was Wu Lien-teh, a Chinese of overseas origin. Born in Penang, this Malaysian-Chinese physician was China's preeminent bacteriologist and the first Chinese person to earn a medical doctorate from Cambridge University in England. From 1907, at the invitation of the Qing Dynasty, he had come to China and was serving as vice president of the Tianjin Army Medical College. When plague patients emerged and the disease spread in Harbin in 1910, he was dispatched to the Manchurian region to address the crisis.

Through his research on the plague that erupted in Manchuria in northeastern China, Wu Lien-teh identified the disease's origin and transmission routes. By March 1911, he had successfully contained the spread of plague in the northeastern region, primarily through mask-based prevention measures. On April 3, 1911, an International Plague Conference was convened in Fengtian, where Wu Lien-teh participated as the representative of China's Qing Dynasty, organizing the conference and serving as its chairman. The conference, attended by approximately 30 medical experts from 11 countries including China, Japan, and Russia—nations with political and commercial interests in the Manchurian railways—is recognized as the first international plague conference and a starting point for international public health cooperation.

The spread of plague throughout Manchuria was linked to the railway networks established by Russia and the South Manchuria Railway Company. Ironically, the development of transportation infrastructure accelerated the plague's spread. Despite the successful conclusion of Wu Lien-teh's plague prevention efforts and the convening of the International Plague Conference, the Qing Dynasty could not prevent the outbreak of the Xinhai Revolution six months later.