What we know - and don't know - about rare pneumonic plague death of employee at Russian research institute

A possible case of pneumonic plague in Russia presents a "very low" risk outside the country, according to the World Health Organization (WHO), as investigators look into what caused the death from pneumonia of a lab employee there last week.

Russian authorities have quarantined a hospital and placed scores of people under medical observation after the 28-year-old employee at the Irkutsk Anti-Plague Research Institute of Siberia and the Far East research institute died from a mysterious case of pneumonia, fueling fears — still unconfirmed — that she may have contracted pneumonic plague.

On Tuesday, the U.N. health agency said it has been in contact with Russian authorities following reports of the death.

The case and the investigation, led by Russian officials, have revived memories of the COVID-19 pandemic and allegations that the coronavirus may have emerged at a Chinese lab. WHO has not provided a definitive answer as to how the pandemic began.

Darya Shipilova worked at the Irkutsk Anti-Plague Research Institute of Siberia and the Far East. Russian health authorities say extensive testing found no evidence that her illness was caused by pathogens linked to her work, but officials have yet to publicly identify what killed her.

The extraordinary precautions surrounding the case have fueled speculation inside and outside Russia. Reuters reported Oct. 5 that all known contacts had been traced and placed under medical supervision and that authorities said no new cases had been identified among employees of the institute.

US monitoring Russian pneumonic plague death situation closely

President Donald Trump said Monday that he was watching the situation with concern and that the United States would be willing to help, though he said he had not spoken to Russian President Vladimir Putin about the case.  

What they're saying:

Asked about Trump’s remarks, Kremlin spokesperson Peskov said Tuesday that "it is always very good when mutual assistance is offered." He wouldn’t elaborate further, deferring to Rospotrebnadzor.

Secretary of State Marco Rubio said Monday that the U.S. was "watching and monitoring it closely," adding, "I don’t think it’s cause for alarm, but it is cause for focus and a cause just to keep an eye on it."

Rubio said information released by Russia appeared to show "there was a worker at the lab that was infected" and concern that the illness could have spread internally. He noted that travel between Russia and the U.S. is limited but warned that "something like that gets out, it just quickly spreads."

"We encourage Russia to be more transparent and share more information with the world," Rubio said, adding this has so far been "quite limited, but hopefully that will change in the next few hours and days."

Pneumonic plague is a form of the disease that affects the lungs

The incubation period for pneumonic plague — which means lung-based and is the most virulent form of the disease — can be as short as 24 hours, according to WHO. It’s a less common but severe form that can spread between people through respiratory particles.

If untreated, the illness can be fatal, but recovery rates are high if detected and treated in time — within 24 hours of the onset of symptoms, WHO says.

Symptoms include shortness of breath and coughing, often involving the coughing up of blood.

The more common form of plague — bubonic plague — is caused by the bite of an infected flea, and can develop into open sores filled with pus.

Pneumonia is a form of acute respiratory infection that is mostly caused by viruses or bacteria, and is spread generally through contact with infected people or from airborne droplets. WHO says pneumonia is the single largest infectious cause of death in children worldwide.