Adam’s Journal
The plague surfaced earlier this month with the death of a woman who worked at a research lab in Siberia.
We haven’t gotten a lot of clarity from the Russian government about what happened. However, officials have said that no “emergency situations” had occurred and that there’s no risk of an epidemic.
How worried should we be?
Dr. Scofield Prescribes
Reports indicate that a 28-year-old lab worker died of a pneumonia of unknown origin. The Soviet Union’s long history of advanced bioweapons research – along with acknowledgement that this particular lab studies pathogens that include plague – has prompted concerns around the world.
Initial, unverified reports from local media suggested the worker broke a test tube containing bacteria that cause the plague. If this was the case, she likely became ill by inhaling bacteria that became airborne.
The resulting illness, plague pneumonia, which strikes the lungs, can be treated with antibiotics. But if treatment doesn’t happen rapidly, disease onset is extremely fast – and deadly. Symptoms can develop within a day or two of exposure, and untreated patients typically die within 24-72 hours of developing symptoms.
Unlike Covid or the measles, transmission of the pneumonic plague before symptoms has not been documented. So, you don’t have seemingly healthy people who can spread the illness.
And when people do become symptomatic, they grow catastrophically ill quickly. That means they’re not typically interacting with many people or traveling once they’ve developed symptoms.
As a result, pneumonic plague has limited person-to-person transmissibility. So, it doesn’t pose a great risk for spreading.
Through history, there have, indeed, been pandemics of plague. Unlike the pneumonic plague, that plague – called bubonic plague – does not spread person to person. Rather, it transmits through bites from infected fleas, causing enlarged and painful lymph nodes, along with fever and chills.
Like pneumonic plague, it is treatable with antibiotics. But left untreated, mortality is estimated to run as high as 60%.
Bubonic plague is now known to have caused the Plague of Justinian in the 6th through 8th centuries. It also caused the Black Death, which killed up to one-third of Europe in the 14th century. And in the 1890s, an outbreak of bubonic plague reached San Francisco from Hong Kong, thanks to infected fleas that made the intercontinental journey.
Eventually, those fleas transmitted plague to ground rodents like prairie dogs and squirrels in the Southwestern US. Today, there are a handful of cases of plague each year in this part of the country, usually from contact with these animals – and their fleas.
Local health departments monitor prairie dog colonies in this region for unusual death rates, which can signal plague infections among the animals. They may be cute, but if you head on a road trip to the Grand Canyon and stop for a picnic lunch along I-40, steer clear of the prairie dogs.
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Dr. Hal Scofield is a physician-scientist at the Oklahoma Medical Research Foundation, and he also serves as Associate Chief of Staff for Research at the Oklahoma City VA Medical Center. Adam Cohen is OMRF’s senior vice president and general counsel. Send your health questions to contact@omrf.org.
