In the fall of 1910, a deadly epidemic began near Manzhouli, a border town between China and Russia, and spread rapidly across Northeast China. Railway lines carried the disease through cities, including Harbin, Changchun, and Mukden, now known as Shenyang. Although the outbreak remained concentrated in the Northeast, cases were also reported farther south. By the time it was contained in 1911, it had killed an estimated 60,000 people.
The epidemic was not only a medical emergency. Russia and Japan had extensive political and economic interests in Manchuria and questioned whether the weakened Qing government could control the outbreak. Chinese officials feared that failure could give the two foreign powers another justification to expand their authority in the region.
At the time, plagues were generally associated with rats and the fleas that fed on them. Yet the disease moving through Manchuria did not behave like the familiar bubonic form. Victims developed high fevers, coughed up blood, and often died within days. The illness appeared to pass directly between people, but its precise nature remained uncertain.
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