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つまり、1898年にアメリカに併合されたハワイでは、1899年にホノルルのチャイナタウンで小さなペストの発生がありました。この時点で、細菌が特定され、貧困と生活条件の悪さとの関連が認識されました。また、ネズミとの具体的な関連が一般的に理解されるようになりましたが、公式には1905年まで証明されませんでした。

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