Suspected Russian Plague Death: How Much Should We Worry?

A suspected case of pneumonic plague killing a laboratory technician in Russia has sparked global alarm about the possibility of wider transmission. But how easily does pneumonic plague spread, how dangerous is it today, and why are laboratories working with the bacteria that causes it?

RFE/RL spoke to Brendan Wren, a professor of microbial pathogenesis at the London School of Hygiene & Tropical Medicine, whose research includes studying Yersinia pestis, the bacterium that causes plague, about the situation and Russia’s moves to deal with it.

RFE/RL: If this was pneumonic plague, how does it spread between people, and how easily can it spread?

Brendan Wren: Pneumonic plague is transmitted by the respiratory route but is not particularly transmissible and certainly not as transmissible as the respiratory SARS virus.

The unfortunate incident in Russia is clearly an isolated occupational infection and to date has not been transmitted to another person, so is not an outbreak. Other persons may have been in contact with the infected person, so isolation and observation of those potentially affected is a sensible measure.

RFE/RL: How rare and how dangerous is pneumonic plague? Can it be treated effectively?

Wren: It is such a rapid and fatal infection that can kill within 24 hours, so although antibiotics may be available, it may be too late if administered when the infection has taken hold. There are also increasing reports of antibiotic-resistant Yersinia pestis strains, the causative bacterial agent of plague. So some antibiotics may not work.

There are approximately 1,000 cases of plague worldwide each year. It is endemic in parts of Russia, China, and the United States.

RFE/RL: Why would a laboratory be working with plague bacteria in the first place? What are such laboratories studying or trying to achieve?

Wren: Generally, to make improved vaccines that could be used in regions of the world where plague is endemic. If Yersinia pestis was weaponized, a vaccine for military personnel may be desirable.

RFE/RL: Based on what is publicly known so far, how concerning is this case? Does it pose any meaningful risk to the wider public?

Wren: In my view this is an isolated case. We no longer live in medieval times, and plague is not particularly transmissible in modern times. It would seem that the authorities are taking sensible procedures to contain this single laboratory-acquired case.