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Here's a scenario I devised for a U.S. annexation of Japan in the aftermath of WWII. The actual "story" would take place a generation later and involves the National Guards of the post-annexation states plotting a Teutoberger Wald of U.S. regular troops in Japan in an attempt to restore Japanese independence. This is the back-story:

POD: There's some kind of problem with the Manhattan Project, delaying the use of the atomic bomb. Conventional bombing and blockade continue, with all the attendant mass starvation.

Things get really nasty when a ship from Manchuria containing Unit 731 goodies, including lots of plague-infested rats, is sunk near the Japanese coastline. It's close enough that the rats can swim to safety and disperse throughout the nearby countryside, spreading the Black Death.

Basically there's a massive outbreak of the plague on top of the starvation caused by the blockade and the deaths from the conventional bombing. Due to the weakened condition of most of the Japanese population, it's ridiculously effective.

Essentially Japanese society totally collapses and the U.S. invades and occupies the country. The destruction is so great that the U.S. has to take over the day-to-day administration of Japan. Statehood comes on by inertia.
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