A plague researcher’s death in Russia’s Siberian city of Irkutsk, attributed to the plague, has revived fears about one of history’s most feared infections and made headlines around the world. Is the post-Covid world on the brink of yet another pandemic?
Darya Shipilova, a 28-year-old employee of the Irkutsk Anti-Plague Research Institute, has died in hospital in the nearby town of Shelekhov on 2 October, according to independent media outlet Lyudi Baikala. The publication reported an unconfirmed account that she had broken a test tube containing plague bacteria before falling ill.
Regional authorities placed hundreds of her contacts under medical observation, but the Russian health watchdog denied that Shipilova showed plague symptoms. In a statement reported by Interfax, Russia’s disease control watchdog, Rospotrebnadzor, said that Shipilova had pneumonia of unknown cause and that investigators had identified no laboratory accident involving pathogens.
Still unconfirmed as a plague case, the incident nevertheless raises an urgent question: how dangerous is pneumonic plague today, and what can modern medicine do against it?
Meanwhile in the US: White House puts suspected Russian plague outbreak on watchlist
What is plague, and how deadly is it?
Small mammals and their fleas spread bacteria known as Yersinia pestis, which causes plague. Bubonic plague causes swollen, painful lymph nodes, septicaemic plague infects the bloodstream, and pneumonic plague attacks the lungs.
Inhaling infectious respiratory particles or spreading an infection internally can lead to lung infection, and close contact with a sick person who is coughing can spread pneumonic plague.
Medical causes explain its lethality, but treatment makes a big difference. According to WHO, untreated bubonic plague kills 30–60%, while pneumonic plague kills almost always within 18–24 hours. The UK Health Security Agency estimates 30% mortality from pneumonic plague despite prompt recognition and treatment.
Side story: Uzbekistan and Russia team up to study natural plague reservoirs
Russia is important for plague research. A 2018 study found 3,800-year-old plague genomes from Samara with flea-transmission adaptations. Other parts of Eurasia have older Y. pestis evidence. Separately, a 2022 Nature study linked the mediaeval Black Death strain to Kyrgyzstan graves from 1338–1339.
What are the early symptoms?
The first signs can resemble a more familiar infection:
- sudden fever;
- chills;
- headache;
- and marked weakness.
Pneumonic plague then produces a rapidly developing pneumonia, with cough, chest pain and difficulty breathing; mucus may become bloody. Nausea and vomiting can also occur. Symptoms commonly begin within one to three days of inhaling the bacteria and can worsen quickly.
Exposure history helps doctors distinguish a rare infection from much more common illnesses. NHS clinical guidance highlights compatible symptoms alongside recent travel to an active outbreak area or close, unprotected contact with a suspected or confirmed patient. Mayo Clinic advises emergency assessment for compatible symptoms in a plague-affected area.
Severe breathing difficulty requires emergency care. WHO does not recommend self-medicating with antibiotics: professional assessment and the correct treatment should not be delayed.
Can pneumonic plague be treated at all?
We’ve got some great news for you. Yes, pneumonic plague is treatable with antibiotics, and early treatment can save lives.
Doctors may use medicines such as gentamicin or ciprofloxacin, with the choice and route depending on the patient’s condition. Treatment is usually hospital-based and commonly lasts 10–14 days, sometimes longer. Blood and sputum samples help establish the diagnosis, but the US Centers for Disease Control and Prevention (CDC) says doctors should begin appropriate treatment when plague is suspected rather than wait for laboratory confirmation.
Read more: Drug-resistant tuberculosis strain detected across Europe
CDC guidelines allow respiratory droplet precautions to end after 48 hours of effective antibiotics and clinical improvement, including significantly reduced sputum production. Seven-day preventive antibiotics are available to close contacts with qualifying exposure. Not everyone in the area should take medication, but this is targeted protection for bacteria-exposed people.
