A 28-year-old woman who worked at an anti-plague research laboratory in Siberia died on Oct. 2, raising concerns and many questions. Russian officials have said that the woman died from a pneumonia of unknown origin and that no “emergency situations” had occurred at the laboratory where she worked. They stated they’d almost finished the investigation of her contacts to monitor for illness, with no concerning findings.
The Russian pronouncements contrasted with furious speculation elsewhere about what happened. Initial, unverified reports from local media suggested that the lab worker had accidentally broken a test tube containing Yersinia pestis, the bacterium that causes the plague. Local hospitals, including a maternity hospital, limited visitors and instituted enhanced health checks. A local factory required masks for its workers.
The World Health Organization has said, based on the unofficial information available, that “the public health risk to the general population appears to be low.” Indeed, the available evidence does not point to a global plague emergency. But this tragic death should prompt Americans to question whether we have the capacity to recognize and contain the next disease threat.
While the plague is of course deadly, it is treatable with antibiotics if identified quickly. The form of the plague the Siberian lab worker is rumored to have contracted is called pneumonic plague. It infects the lungs and can spread between people — unlike bubonic plague, the likely cause of the 14th-century Black Death, which is primarily transmitted by flea bites.
But even pneumonic plague has relatively limited transmissibility. Historically, one person infected with pneumonic plague has transmitted the disease to an average of 1.3 other people; by way of comparison, measles may transmit to 12 to 18 people in an unvaccinated population. Transmission of the pneumonic plague before symptoms appear has not been documented, so caregivers and close contacts have been the most at risk of infection. Masks, contact tracing and isolation and other established infection control procedures should work well to limit the spread of pneumonic plague.
Still, we should get better answers about what happened in Siberia than those that Russia has so far provided. Was there a laboratory accident? If so, when was it recognized, and what treatment did the exposed lab worker receive? What prompted the extensive monitoring of her contacts? Outsiders’ concerns were in part fueled by speculation about biological weapons. The U.S. intelligence community assesses Russia to have a clandestine biological weapons program. The former Soviet Union included Yersinia pestis, the causative agent of plague, in its armamentarium.
Disease surprises could come from many places. That’s why it’s dispiriting that the United States has so isolated itself. After withdrawing from the W.H.O. in January, and calling back the U.S. experts on loan to the organization, America now has less direct information about potential disease emergencies. The dismantling of the United States Agency for International Development cut off scientific collaborations and relationships through which emerging threats could be identified. Cuts and restrictions on infectious disease research have weakened American scientists’ ability to help establish safe laboratory practices internationally. We are diminishing our access to important public health information as well as our influence over what happens next.
The Trump administration fired thousands of people at the Department of Health and Human Services, including pandemic experts at the Centers for Disease Control and Prevention and the Administration for Strategic Preparedness and Response. Losing this expertise has weakened capabilities that took years to build. No quick fix — and no artificial intelligence model — can replace the professional judgment, experience and trusted relationships needed to investigate and assess what is truly going on in a disease outbreak anywhere in the world. Infectious diseases do not recognize borders.
During the Covid-19 pandemic, American biotechnology and biological expertise helped deliver vaccines, diagnostics and treatments. The response had profound shortcomings, especially the failure to ramp up diagnostic testing and the lack of personal protective equipment available to medical staff in the earliest days of the pandemic. We should be building on our capacity and correcting those failures. Instead, we are weakening our public health infrastructure while thousands of Americans, including many children, suffer from preventable infections like measles. We are also undermining preparation for future potential threats, such as H5N1 influenza — the bird flu. That virus was recently detected at a U.S. mink farm, and remains a potential pandemic pathogen. The Trump administration canceled a contract to develop an mRNA H5N1 vaccine for humans.
The lesson from an unexplained death in Siberia should be that disease emergencies demand evidence, expertise and cooperation. They demand continued investment in the tools that can be used to investigate and limit disease outbreaks. Most important, they demand investment in the people who can use those tools.
Gigi Kwik Gronvall is an immunologist and a professor in the Department of Environmental Health and Engineering at the Johns Hopkins Bloomberg School of Public Health. She is the author of the forthcoming book “Our Biological Future: A Crossroads for Life, Health, and the Planet.”
Source photo Chris Ware / Stringer via Getty Images.
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