The old word “plague” is making headlines again.
Charles Maynes, NPR Russia correspondent reported this week on what we know about a Russian researcher working in a lab studying plague who died last week of pneumonia of unknown origin.
Maynes reports that the employee was a 28-year-old woman who worked in a laboratory in Siberia, about 4,500 kilometers from Moscow. An investigation by Russia’s consumer health watchdog concluded that no pathogens in his body were linked to his work with an infectious disease.
But local media outlets have raised concerns about the spread of pneumonic plague, which NPR has not independently confirmed.
It is one of the diseases studied in the laboratory in Siberia. It is aerial and can be deadly.
While noting that 200 “contacts” were in quarantine, Russia denied the existence of plague cases in the region. But questions loom. At a press conference on Wednesday, World Health Organization chief Tedros Adhanom Ghebreyesus said these Russian assurances were – at the very least – incomplete: “We do not yet have a complete picture of this event and we are not able to make a full risk assessment.“
In the meantime, here’s what we know about the bacterial disease plague – and its variant known as pneumonic plague.
Variations of the plague
The plague comes in several versions, depending on the part of the body invaded by the bacteria. When a flea bites a person, they usually develop what is called bubonic plague. In this case, the telltale sign is one or more swollen, painful lymph nodes, called buboes. (The word “bubonic” comes from the Greek boubonwhich means groin, because some people have swollen lymph nodes in the groin.) Doctors can diagnose the condition by taking a sample of the person’s blood or lymph nodes and then submitting the sample to a laboratory for analysis.
But when the bacteria spreads to the lungs, it can cause what is called pneumonic plague. In this case, there are often no telltale signs of the plague, according to at the Centers for Disease Control and Prevention.
This version is much more dangerous, says medical entomologist Adelaide Miarinjara at Emory University. “It spreads fairly easily between people because it spreads through droplets, almost like COVID spreads.”
And people can die more quickly from pneumonic plague than other forms, she adds, because the disease progresses more quickly. “The key here is early diagnosis. If people don’t expect it or seek treatment, they can die.”
Treatment involves antibiotics, often given by IV infusion.
In 2017, Madagascar experienced a major outbreak of pneumonic plague when a person from a rural area of the country brought the disease to the coastal town of Toamasina. This city had not seen a case of plague for almost a century, explains Miarinjara, who was in Madagascar at the time. “A person transmitted the disease on public transport,” she specifies.
The country recorded more than 2,400 suspected cases, including nearly 1,900 cases of pneumonic plague. One study estimated that about 25% of people with confirmed cases died during this outbreak.
The quarantine story
As for reports of Russian “contact” with a quarantined lab worker, this reflects a long-standing response to diseases like the plague.
The idea of isolating or quarantining sick people goes back at least 3,000 years old. The book of Leviticus in the Bible mentions how to isolate lepers.
The word “quarantine” itself arose during the Black Death, when the city-state of Dubrovnik, now part of Croatia, enacted what is likely the first state-imposed isolation.
At the time, Dubrovnik was a wealthy trading city located on the Adriatic Sea. The city leaders wanted to keep the bubonic plague out. So they started forcing visitors to wait 40 days on a remote island outside the city before disembarking.
They called the wait quarantinefrom the Italian word meaning “40”.
“The first quarantine was largely improvised,” says Ivana Marinavić, head of educational programs at the university. Lazarets of Dubrovniksaid NPR in 2021. The Lazarets were the first buildings ever built for the sole purpose of quarantining.
If you broke quarantine during the plague, the consequences were serious. “Torture, or cut off your nose or ears,” Marinavić told NPR.
For stories about life in our changing world, Subscribe to NPR’s Global Health newsletter.
Gn headline
