Did plague kill a Russian lab worker? What to know about the Irkutsk case

A laboratory worker’s death at a Siberian anti-plague institute prompted Russian authorities to place nearly 200 people under medical observation and drew attention from Washington, but officials have not confirmed that plague was the cause.

The woman, identified by outlets as a 27- or 28-year-old employee of the Irkutsk Anti-Plague Research Institute, was hospitalized Sept. 29 with severe pneumonia in Shelekhov, a town near Irkutsk. She was placed on a ventilator and died within days, The Moscow Times reported. Alexei Tsydenov, head of the neighboring republic of Buryatia, first said she died of plague, then edited his post to say she “may have” died of it, according to Meduza.

Russia’s public health watchdog, Rospotrebnadzor, has described the illness as “pneumonia of unknown etiology,” Newsweek reported. The agency said testing found no microorganisms tied to her laboratory work, and a commission convened by the institute and the watchdog found no emergency or security breach, according to Interfax as cited by The Moscow Times. Russian authorities have also told the World Health Organization that no case of plague has been recorded in Irkutsk and that her illness first presented as a typical acute respiratory viral infection, WHO spokesman Christian Lindmeier said. Irkutsk Gov. Igor Kobzev earlier referred only to a suspected case of a “particularly dangerous infection.”

Several Russian outlets, including the independent Lyudi Baikala and the pro-Kremlin REN TV, reported that she died of pneumonic plague and told medical staff she had broken a test tube containing live bacteria. Meduza noted that REN TV and the Telegram channel Mash, which also carried the report, have close ties to law enforcement and security agencies. Another account, also unconfirmed, said she had returned from Thailand. Authorities have not substantiated either version.

At least 197 people who may have had contact with her were reportedly placed in isolation, including more than 100 in hospital wards. Rospotrebnadzor said testing of contacts found two COVID-19 cases and two rhinovirus cases but no other infections. On Tuesday, Russian authorities told WHO through an international health alert system that monitoring of all identified contacts had concluded after tests found no dangerous pathogens, according to The Associated Press. Authorities also canceled planned public events in Irkutsk, and law enforcement reportedly opened a criminal investigation into possible health safety violations.

Pneumonic plague is a lung infection caused by the bacterium Yersinia pestis. Unlike bubonic plague, which is usually spread by infected fleas, it can pass between people through respiratory droplets. It is treatable with antibiotics, especially when started early. Symptoms include fever, headache, weakness and rapidly worsening pneumonia. Russia’s last recorded plague case was in 2016, when a child in the Altai Republic fell ill, according to Meduza.

In Washington, Secretary of State Marco Rubio said Monday the U.S. was monitoring the situation and did not consider it a cause for alarm. President Donald Trump said the U.S. would help Russia, and the Department of Health and Human Services said the CDC is monitoring with the State Department. On Tuesday, Rubio urged Russia to be more transparent, saying, “Maybe there’s nothing there. Maybe it’s bigger than we thought.” WHO said it is in contact with Russian authorities and that the risk outside Russia is very low.

Some outside experts are skeptical. Dr. Amesh Adalja of the Johns Hopkins Center for Health Security said he does not think the illness was plague and that the Russian response does not match one. He noted that inexpensive antibiotics can prevent and treat the disease, and he called on Russia to share clinical samples and genetic sequencing so independent labs can confirm the cause.