A 28-year-old worker at a research laboratory in Siberia recently died of pneumonia. The facility studies plague, among other pathogens, raising fears that she had been exposed at the laboratory.
But Russian health officials so far have not linked the death of the worker, Darya Shipilova, to infection with Yersinia pestis, the bacterium that causes plague. And despite early reports that dozens had been quarantined near the research facility, health officials said that there no risk of an epidemic.
Still, the death has prompted concerns around the world, in part because of the Soviet Union’s long history of advanced bioweapons research, which led to outbreaks of anthrax and smallpox.
After unconfirmed reports of a second unusual case of pneumonia in the region, the World Health Organization sought additional information from Russian officials. President Trump said he planned to speak to President Vladimir V. Putin of Russia “very soon” about the death.
A Lack of Clarity
Early reports cited local officials saying that Ms. Shipilova was exposed to Y. pestis during her work at the Irkutsk Anti-Plague Research Institute of Siberia and the Far East.
Y. pestis was responsible for two of history’s deadliest pandemics: the Black Death and the Plague of Justinian. As a lung infection, plague is contagious, although not as infectious as some other respiratory infections. (The bacterium also infects the bloodstream and lymph nodes.)
In its early stages, plague can be successfully treated with antibiotics. There are hundreds of cases each year, mostly in Africa, according to the W.H.O.
Russian health officials said that Ms. Shipilova had died of pneumonia of unknown cause. While plague can lead to pneumonia, the filling of the lung’s air sacs with fluid, it can have many other causes, including seasonal flu.
“Unfortunately, young people can die from pneumonia, so that development alone wouldn’t be enough to raise concern,” said Dr. Tom Inglesby, an epidemiologist at Johns Hopkins Center for Health Security. “What I do think is concerning is the Russian reaction so far.”
More than 200 people who had been in contact with the deceased were quarantined in local hospitals, and Russian officials have not explained why, Dr. Inglesby said. Nor have they announced the cause of death, if not plague.
Testing had not turned up any infection in Ms. Shipilova or her contacts with any pathogen related to her work, Russian health officials said.
The Information Experts Want
Lab accidents can and do happen, even when researchers are following safety protocols. But the lack of transparency surrounding the death and the number of people potentially exposed is unusual, other experts said.
“Something is not adding up about this situation,” said Jennifer Nuzzo, an epidemiologist at Brown University.
“You don’t quarantine 200 people for one plague case,” she added. “You don’t close multiple hospital units in response to one infection.”
After an unusual infection like this, health officials often provide the genome sequence of the virus or bacterium involved. This helps researchers pinpoint exactly which pathogen is to blame and how to fight it.
Public health experts suspect that Russian officials have already sequenced the pathogen involved in Ms. Shipilova’s death, and they wonder why that information has not been made public.
“Without that, the risk is uncertain, and I think we should be putting pressure on Russia to share the genome sequence,” said Dr. Raj Panjabi, a physician and former White House biosecurity official.
If officials identify the cause of infection, they will be better able to answer other crucial questions, including how the exposure happened.
“If Y. pestis is confirmed and the presentation was pneumonia, the likely route is inhalation of an infectious aerosol during laboratory work,” said Dr. Tom Frieden, a physician and former director of the Centers for Disease Control and Prevention.
But until more information is released, he added, “anyone claiming to know more is guessing.”
It is not known what pathogens Ms. Shipilova might have been working with, he and others noted, nor what safety protocols were in place in her lab.
Are Lab Exposures Common?
Thanks to safety protocols and modern personal protective equipment, exposures to pathogens in labs are not common.
Most facilities are equipped with robust air filtration systems, carefully guarded containers for infectious materials and protective gear that acts as a barrier between lab workers’ bodies and the substances they are working with.
Y. pestis is a particular concern, Dr. Frieden noted. It requires that laboratories maintain a certain airflow, HEPA filtration, respiratory protection, precautions against aerosols, trained staff members and health monitoring.
“Done right, it’s safe,” Dr. Frieden said. “The problem is that ‘done right’ is not verifiable, and it’s not easy.”
The last time a fatal exposure to Y. pestis occurred in a laboratory environment was in 2009, when Malcolm Casadaban, a biologist at the University of Chicago, died after contact with a weakened form of the bacterium.
When accidents do happen, Dr. Panjabi said, it’s important to have a system in place to characterize the outbreak, including how fast the threat is moving, who is at risk and what options are available to mitigate that threat.
“The larger issue of maintaining biosafety in high consequence in labs that study dangerous pathogens is a national security issue in every country,” Dr. Panjabi said. “And it needs more attention.”
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