The death of a pathogen researcher in Siberia has raised concerns about the pneumonic plague, as Russian authorities provide little information publicly, so how worried should you be?
According to an infectious disease specialist and epidemiologist for the University of Chicago, Dr. Emily Landon, the response to what’s happening in Russia does not match the information being released publicly.
Here’s what to know:
What happened in Russia?
A woman who worked at an anti-plague research institute in the city of Irkutsk in Siberia, where the plague occurs naturally in wild animals, died at a hospital in nearby Shelekhov.
The news outlet Lyudi Baikala — or “People of Baikal” — identified the dead lab worker as Darya Shipilova, 28, and said she first was hospitalized with cold symptoms Sept. 29 and died three days later.
It quoted colleagues as saying she was a highly qualified and diligent researcher. They also emphasized that security rules at the facility are extremely strict.
The report quoted Shipilova’s neighbors as saying a team of disinfection experts did several cleanups of her apartment, leaving a strong antiseptic smell.
Shipilova’s mother, who worked as a doctor in the past, described her daughter as hard-working and dedicated, according to independent Russian news outlet Glubina, adding that she had not gotten official documents describing the cause of death.
Russian authorities said the lab worker died of what initially presented as a “typical” acute respiratory viral infection and that no recent cases of plague have been detected, according to the WHO. A local mayor said the hospital where the woman died was placed under quarantine.
Top Russian health officials have traveled to the region.
The World Health Organization said it has yet to determine the cause of death for the 28-year-old woman, and has asked Russia to provide more information. The U.N. health agency has cited initial, unconfirmed reports suggesting pneumonic plague.
Through an international health alert system, Russian health officials on Tuesday said a full range of preventive measures had been carried out — including tracing of the deceased woman’s contacts, medical monitoring and lab tests.
“Test results showed no presence of dangerous infectious disease pathogens in any of the contacts,” said the note from Russian authorities, which was relayed to The Associated Press by the WHO.
“Medical monitoring for 100% of the contacts has now been concluded,” it said. “The epidemiological situation is stable and remains under monitoring.”
What is pneumonic plague?
The severe disease is less common than the better-known bubonic plague linked to the Black Death in the Middle Ages. Pneumonic plague spreads from person to person, causing a severe form of pneumonia, but recovery rates are high if it is detected and treated in time.
Pneumonic plague and bubonic plague are caused by the same bacteria. The former is spread by respiratory particles while the latter is spread through bites from fleas that have jumped from infected rodents.
The bacteria, called Yersinia pestis, caused the Black Death in the 14th century. The single deadliest event in recorded human history spread throughout Europe, the Middle East and northern Africa, wiping out up to 30% to 50% of the population.
It was never eliminated, but it is treatable with antibiotics.
Symptoms of pneumonic plague include shortness of breath and coughing up blood, and they can occur in as little as 24 hours after exposure, according to the WHO. If untreated, the illness can be fatal.
The unusual response
Russian authorities have kept a tight lid on information about the case, which has been surrounded by secrecy.
While the case has raised global concerns, Russian state TV and other national state-controlled media have largely steered clear of the subject. Some state-backed news outlets withdrew earlier reports about the case.
In its tersely worded statements, Russia’s public health watchdog, Rospotrebnadzor, does not link the case to pneumonic plague, saying only that the lab worker had contracted pneumonia of “unknown” origin and that “extensive” testing found no evidence her illness was caused by any of the pathogens she worked with at the Irkutsk Anti-Plague Research Institute of Siberia and the Far East.
“We don’t understand how she was infected,” Van Kerkhove said. “We need information in a timely way. We need regular information. We need answers to the follow up of the questions that we have asked.”
“We have posed these questions to our colleagues in the Russian Federation. In fairness, they have responded. We’ve gone back with more questions,” she said.
WHO officials said it needs information in a regular and timely way — and noted an “iterative” process of questions and answers in such cases.
“We have posed these questions to our colleagues in the Russian Federation. In fairness, they have responded. We’ve gone back with more questions,” Van Kerkhove said.
Russia has told the WHO that 200 contacts have been placed in quarantine, Tedros Adhanom Ghebreyesus, the director-general of the Geneva-based health agency, told reporters on Wednesday.
He said his agency has requested more information on lab tests conducted on the deceased woman, the health status of the contacts and about what prompted the public health measures. He said the agency was also looking into reports of a second employee at the research institute contracting pneumonia.
“We don’t yet have the full picture of this event, and we are not able to conduct a full risk assessment,” Ghebreyesus said.
‘Something significant’: Chicago expert explains the situation
Landon shared in the calls for transparency, saying the measures being taken do not match the messaging.
“The usual response to a case of pneumonic plague is not what we’re seeing happening on the ground in Siberia,” Landon told NBC Chicago. “And … that’s what makes me a little concerned about this situation.”
Landon, who became a familiar face to many in Chicago for her candid messaging during the COVID-19 pandemic, said pneumonic plague is a rare, but potentially treatable disease.
“This is not the response you would see for a wild-type pneumonic plague case,” Landon said, adding “it’s definitely possible that there is something significant happening in Russia.”
Landon noted that while it’s not uncommon for government officials to try to ensure calm with their messaging in such situations, the response instead appears similar to a “high-consequence pathogen concern.”
“Plague, while it’s dangerous and bad, is not necessarily a high-consequence pathogen because we have readily available countermeasures with known antibiotics,” Landon said.
A high-consequence pathogen would be something that spreads easily from person to person, has a high mortality rate and has no easily available treatments or vaccines, Landon said.
“Something like Ebola would fall into that category, but also a new infection that no one had ever seen before like the beginning of COVID also falls into that category because we just don’t know what we’re dealing with yet. And the response on the ground in Siberia looks a lot more like a response to a high-consequence pathogen than it does to a response to an isolated case of plague,” Landon said. “And that brings up the question: could this be something we’ve never heard of before? Could it be something different than plague that is pretty bad? Or maybe it’s not a wild-type plague like what we see in what people pick up from animals in the wild. Perhaps it’s some sort of genetically engineered plague or an old bioweapon sort of plague. And that’s what most people are concerned could be the case here based on the response in the ground. But that doesn’t mean that it’s going to become a major pandemic.”
President Donald Trump said he would discuss the issue during a call with Russian President Vladimir Putin because Wednesday is the Kremlin leader’s 74th birthday.
“They’re sharing it a little bit with our people. We expect them to share it a lot with our people,” Trump said, adding that the Russians claimed to have the situation under control.
Asked Wednesday if the incident was a sign that plague might be developed as a bioweapon, Trump said, “We don’t think so. We’re going to find out soon enough, but we don’t think so.”
So how worried should you be?
Landon noted that despite the reason for the response on the ground, the measures being taken are reassuring.
“These measures that they’re taking, the quarantine, isolation, those are all the appropriate things and exactly what we would want to happen if there was a high-consequence pathogen issue,” she said.
Based on information so far, she believes there’s no need to panic.
“I definitely wouldn’t panic. I’m not panicking,” she said.
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