A 28-year-old researcher at a plague institute in Siberia has died, and while Russia attributes her death to "pneumonia of unknown etiology", the possibility of pneumonic plague has put global health agencies on alert. The cause of death has not been confirmed.
What Happened?
The woman worked at the Irkutsk Anti-Plague Research Institute in Shelekhov. Russia's watchdog, Rospotrebnadzor, said testing found no microorganisms linked to her work and denied any laboratory accident, though Russian media reported she broke a test tube containing plague bacteria in late September.
Buryatia's regional head said she died "possibly from the plague". Nearly 200 contacts are under medical observation. WHO is in touch with Russian authorities, and the US Centers for Disease Control and Prevention is monitoring the case.
What Is Pneumonic Plague?
Plague is caused by the bacterium Yersinia pestis, carried by small mammals and their fleas. Bubonic plague infects the lymph nodes, septicaemic plague enters the blood, and pneumonic plague infects the lungs.
It develops either from inhaling infectious droplets or when untreated bubonic or septicaemic plague spreads to the lungs. The World Health Organization calls it the most virulent form.
How It Spreads
Pneumonic plague passes between people through respiratory droplets, typically through coughing and close contact. Bubonic plague does not spread this way, which is why the pneumonic form worries health officials most.
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Symptoms And Progression
Incubation is usually one to four days and can be as short as 24 hours, according to WHO.
Early signs are fever, chills, headache and weakness, followed by rapidly worsening pneumonia with chest pain, breathlessness and a cough that can bring up bloody sputum.
Untreated, it can lead to respiratory failure and shock, and WHO says it can be fatal within 18 to 24 hours of onset.
Treatment And Containment
Laboratory tests on blood, sputum or lymph node fluid confirm the disease, but authorities advise starting antibiotics when plague is strongly suspected.
US guidance says treatment should begin within 24 hours of symptoms, using drugs such as ciprofloxacin, levofloxacin, streptomycin or gentamicin.
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Patients are isolated, and WHO recommends seven days of preventive antibiotics for close contacts and health workers. There is no widely available licensed vaccine in the US.
How Deadly Is It?
Untreated pneumonic plague is almost always fatal. A CDC-published meta-analysis found a death rate of about 17% among treated patients, well below the 50% often quoted.
Should People Worry?
The same bacterium caused the Black Death, which killed more than 50 million people in Europe, according to CNN. Today it is rare and treatable, and no wider outbreak has been confirmed. Experts have urged calm while testing continues.
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