What Do We Know About the Death of a Plague Research Lab Employee in Russia?

Russia is facing growing international pressure to clarify the circumstances surrounding the death of a woman who worked at a plague research institute in Siberia, amid concerns that her death may be linked to an unknown infectious disease, according to The Wall Street Journal.

U.S. Secretary of State Marco Rubio said on Tuesday during a visit to Iceland: "Russia must, of course, share more information with the world," adding: "That is what they should do."

Russian authorities informed the World Health Organization on Tuesday, four days after the woman's death, that they were unaware of any symptoms among people who had been in contact with her.

Russian authorities have not disclosed many other details regarding the incident.

How great is the risk to the world?
If the woman did indeed die from pneumonic plague, as some initial reports suggested, it is possible that those who came into contact with her were exposed to infection. However, scientists say it is unlikely that the disease has spread widely within Russia or to other countries.

This is primarily because the bacteria causing plague require close contact for transmission, and the symptoms of the disease appear quickly and can be treated with antibiotics.

As time passes since the woman's death without recording related deaths or infections, the likelihood increases that the woman was not infected with plague, or that she did not transmit the infection to others, according to The Wall Street Journal.

Scientists note that the institute where she worked conducts research on other diseases, and it is also possible that she contracted the infection outside of her workplace.

Based on available information, scientists say that the lack of recorded cases so far is encouraging, although this does not necessarily mean that no infections have occurred.

Samuel Scarpa, professor of public health and health sciences at Northeastern University, said: "Plague appears very quickly. If she had plague, we would have seen more cases by now if there was transmission of infection."

What did Russia say about the cause of death?
The Russian government stated that the woman died from "pneumonia of unknown origin," meaning that authorities do not know the pathogen that caused her lungs to become infected, let alone whether Yersinia pestis bacteria, which causes plague, was the reason.

People who came into contact with the woman are under strict medical observation. Russian authorities said on Tuesday that they identified two cases of COVID-19 and two cases of rhinovirus, which causes common colds, among these contacts.

Initial reports published by regional entities and media outlets raised concerns after stating that the woman died from pneumonic plague, which can be transmitted from person to person.

The absence of information issued by the Russian government increased anxiety regarding the nature of the disease that led to her death.

When did the symptoms begin?
The woman was 28 years old and worked at the Irkutsk Scientific Research Anti-Plague Institute. Local and independent media reported that her name was Daria Shchipilova and that she died on October 2, shortly after falling ill.

What is plague and how is it transmitted?
Plague is a disease caused by the bacterium "Yersinia pestis." The disease, known as the "Black Death" in the Middle Ages, caused the death of millions of people in Europe.

Plague infection is currently rare, but the disease still exists in parts of Africa and Asia, including Siberia.

Humans usually contract plague through fleas that have fed on infected wild rodents, or sometimes through handling tissues or bodily fluids of an infected animal, according to the U.S. Centers for Disease Control and Prevention (CDC).

When large numbers of rodents become infected and die, fleas seek other sources of food, including humans.

About seven cases of plague are recorded annually in the United States, most of them in northern New Mexico and Arizona.

Globally, several hundred cases of plague are recorded each year, according to experts.

How deadly is plague and can it be treated?
Plague can currently be treated with antibiotics, provided treatment begins quickly.

The disease is fatal in most cases if treatment does not begin within 24 hours of the first symptoms appearing, especially if it reaches the lungs and becomes pneumonic plague.

Pneumonic plague is considered the most dangerous form of the disease and the most transmissible, as it infects the lungs and is the only form of plague that can be transmitted directly from person to person.

The bacteria causing the disease are transmitted via respiratory droplets released during coughing or sneezing.

No cases of person-to-person transmission of pneumonic plague have been recorded in the United States since 1924, according to the CDC, but rare cases have been recorded among people exposed to cats that became infected after eating infected rodents.

The other two forms of the disease are bubonic plague, which affects lymph nodes, and septicemic plague, which spreads through the bloodstream and is also highly dangerous.

These two forms can develop into pneumonic plague if the bacteria spread to the lungs.

Does pneumonic plague spread as fast as COVID-19?
Transmission of pneumonic plague requires close face-to-face contact, typically within a distance not exceeding 6 feet.

Respiratory droplets carrying "Yersinia pestis" bacteria are heavy and fall quickly onto surfaces, so the bacteria do not spread easily at speeds approaching those of influenza or the coronavirus.

However, the disease can spread rapidly due to its short incubation period, as symptoms can appear within one day or up to a week, and the cough of an infected person can carry large numbers of bacteria.

What are the symptoms of pneumonic plague?
Patients quickly develop fever, headache, and weakness, before their condition rapidly deteriorates into shortness of breath, chest pain, and cough, sometimes accompanied by bloody or watery sputum, according to the CDC.

People who have been in close face-to-face contact with a patient suffering from pneumonic plague are given prophylactic oral antibiotics to prevent the development of infection before symptoms appear.

What are neighboring countries doing?
Kazakhstan, which shares the longest land border with Russia, has imposed temperature checks on people crossing the border, according to the country's state news agency.

Kyrgyzstan and Uzbekistan, which do not share a land border with Russia, experience heavy air traffic with Russia and have enhanced traveler monitoring, according to the health ministries of both countries.

What are U.S. authorities doing?
U.S. President Donald Trump said the United States is following the situation in Russia "intensively" and is ready to provide assistance, but clarified that he had not communicated with Russian President Vladimir Putin regarding the incident.

What is Russia's record in handling health crises?
Trust in Russian authorities has declined following previous health crises, including the COVID-19 pandemic, during which the government was accused of downplaying death tolls.

In 1979, Soviet authorities denied an anthrax leak, attributing deaths to contaminated meat.

In 1992, former Russian President Boris Yeltsin acknowledged that the disaster resulted from an accident at a military biological warfare research facility in Sverdlovsk, now known as Yekaterinburg.