The death of a 28-year-old woman who worked in a laboratory where plague research is carried out in Russia is raising concerns about the cause of her illness.
The woman died on Friday, according to the World Health Organization (WHO), without confirming the cause of her death. A Russian official stated that the woman died of pneumonia of “undetermined” origin and did not link her death to her work at the Irkutsk Anti-Plague Institute, in Siberia and the Far East.
However, the United States Department of State reported that it is monitoring reports of a fatal case of suspected pneumonic plague in the Irkutsk region, in southeastern Siberia, in coordination with the Centers for Disease Control and Prevention (CDC).
Key details are still unknown, such as whether the woman was actually infected with plague and, if so, whether it was naturally occurring plague or bacteria studied in the laboratory. Scientists also do not know how quickly his disease progressed or what treatment he received. Nearly 200 people who were in contact with her are under preventive medical observation.according to Russian media.
“Maybe it will turn out that he died of something unrelated and that it was just a coincidence” that he worked in a plague laboratory, said Lisa Morici, a microbiologist and immunologist at Tulane University School of Medicine.
“If there were weapons programs, biological weapons programs in these laboratories, that would worry me much more,” Ashish Jha, former White House COVID response coordinator, said in an interview with our sister network NBC News. “We need to understand that right now,” he added.
The situation continues to evolve rapidly. But here’s what we know about pneumonic plague, how it spreads and how dangerous it is.
What is the plague?
Plague is an infection caused by bacteria Yersinia pestis. Known as the Black Death during the 14th century, the disease caused several global pandemics that decimated the population over the centuries, before the discovery of antibiotics.
It occurs in three main forms: bubonic, pneumonic and septicemic, according to the WHO. All three are caused by bacteria Yersinia pestisbut they affect different parts of the body.
(First death in the United States in almost two decades from the bubonic plague)
Bubonic is the most common form, Morici noted. It is primarily transmitted through infected flea bites or direct contact with infected rodents, which can cause painful, swollen lumps in the lymph nodes. It is usually not contagious.
However, if left untreated, it can spread to the lungs and become pneumonic plague, which can be transmitted from person to person through respiratory droplets, Morici explained.
Septicemic plague occurs when the bacteria grows and spreads through the bloodstream.
How is pneumonic plague spread?
Pneumonic plague can spread through the air when an infected person or animal coughs or sneezes.
Respiratory droplets don’t travel very far, perhaps a distance of three to six feet, said Dave Wagner, director of the Pathogens and Microbiome Institute at Northern Arizona University. “They fall to the ground pretty quickly.”
It is the least common form of the disease, according to the WHO.
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William Schaffer, an infectious disease expert at Vanderbilt University Medical Center, said people in close contact are most at risk. Pneumonic plague does not spread “remotely across a room, but through face-to-face contact,” he noted.
“Most people are very unlikely to get the pneumonic form of the disease,” Morici said.
COVID, for example, spreads rapidly through the air, traveling distances greater than six feet.
“It’s nothing like the COVID-19 pandemic,” he said.
How deadly is it?
Although pneumonic plague is the least common form of the disease, it is also the most deadly.
“It is the one that causes the most fear, because it can kill very quickly,” Morici commented.
Their progression is extraordinarily rapid, Wagner noted. Symptoms usually appear one to two days after exposure, and patients require treatment within 48 hours of symptom onset to avoid life-threatening complications. Symptoms include difficulty breathing, cough, and blood in the phlegm.
(Arizona reports one death from bubonic plague, the disease that killed millions in the Middle Ages)
Because of how quickly it attacks the respiratory system, public health experts consider this strain to be the most likely candidate for a biological attack, according to Morici.
People with pneumonic plague are often quarantined, he noted. Healthcare personnel often use personal protective equipment, such as N95 masks or even full-body protective suits, due to the risk of accidental exposure.
“We are applying the strictest levels of biocontainment,” he said.
How is it treated?
Antibiotics are very effective against plague, including pneumonic plague.
“That’s why we don’t have major plague outbreaks anymore,” Wagner said.
Schaffner said there is no evidence to suggest that plague bacteria are evolving to become resistant to antibiotics. “We are not going to turn the year 2026 into the Middle Ages, when the Black Death caused a huge number of deaths throughout Europe. That will not happen.”
(Rabies cases are skyrocketing in the United States, according to CDC data)
Wagner said he has no reason to believe that this suspected case of plague will “trigger a massive spread.”
“The plague we have today is the same one that plagued humanity for so long in great pandemics,” he said.
Does the plague exist in the United States?
About seven cases of plague are reported in the United States each year, according to the CDC. Most are produced in rural areas of the southwest of the country, including Arizona, California, Colorado and New Mexico. These are areas where the bacteria Yersinia pestis It circulates naturally among wild rodents, such as prairie dogs, and their fleas.
Most people are quickly treated with antibiotics and recover. Deaths from plague in the United States are rare, although they do occur.
Last July, an Arizona man died of pneumonic plague after being exposed to sick cats. Within a week, he went to the emergency room with shallow breathing, a rapid heart rate, chest pain, and a dry cough.
Despite receiving antibiotics and oxygen, he died eight hours after being admitted to the hospital. Subsequent tests confirmed that he was suffering from pneumonic plague.
