[6] The World Health Organization collected reports of excessive rat deaths in Malma in the Beed district of Maharashtra on 5 August 1994, followed by complaints of fleas.
[8] The Ganesh Chaturthi festival created crowds in the city shortly thereafter, promoting the spread of pneumonic plague, which was declared on 21 September.
[9] In the first week of August 1994, health officials reported unusually large numbers of deaths of domestic rats in Surat city of Gujarat state.
On 21 September 1994, the Deputy Municipal Commissioner of Health (DMCH) for Surat city received a report that a patient had died seemingly due to pneumonic plague.
Later that day, a worried caller informed DMCH about 10 deaths in Ved Road residential area and around 50 seriously ill patients admitted to the hospital.
Initial questions about whether it was an epidemic of plague arose because the Indian health authorities were unable to culture Yersinia pestis, but this could have been due to lack of sophisticated laboratory equipment.
It also improved its plans for emergency travel advisories, and fired some corrupt officials and disciplined ineffective city workers, including street sweepers.