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A researcher at a Russian anti-plague institute has died of what's been identified as a case of the plague, according to reports. Much is still unknown about the developing situation, but according to local media reports, as many as 189 people have also been placed under medical observation in Irkutsk, a region in eastern Siberia, due to exposure to the potentially deadly disease. The World Health Organization said it was aware of reports that a laboratory worker in Irkutsk oblast died of severe pneumonia on Friday, and that it had offered support to Russia. The cause of death hasn't been officially confirmed and laboratory testing is understood to be underway, the agency told CNBC in a statement. "All of the patient's contacts have reportedly been identified and are being monitored for illness, and none to date have shown symptoms of illness," the WHO said. What is the plague and how does it spread? Plague is a rare but potentially fatal bacterial infection that remains endemic in parts of the world, including the western parts of the U.S., but can be treated with antibiotics if identified quickly. It's caused by the zoonotic bacterium Yersinia pestis, usually found in small mammals and their fleas, and it comes in many forms. Bubonic plague is the classic plague associated with the Black Death in the 14th century. Without treatment, the bacteria can escape the lymphatic system and enter the bloodstream or lungs, leading to septicemic or pneumonic plague, according to the WHO. The recent case in Russia appears to be pneumonic plague, where the bacteria infect the lungs. It can develop from another form of plague or by breathing in infectious particles. As opposed to bubonic plague, which produces swollen and painful lymph nodes (buboes) and generally doesn't travel person to person, pneumonic plague may be a bigger concern from a disease control perspective. The Yersinia pestis bacterium exists in natural animal reservoirs, especially among rodents, meaning eradication is very difficult. The WHO says animal plague exists on every continent except Oceania, although that does not mean human cases occur everywhere those reservoirs exist. "Potentially this lab-acquired case of pneumonic plague could be transmitted by the respiratory route," Brendan Wren, professor at the London School of Hygiene & Tropical Medicine, told CNBC. "Yersinia pestis … is fairly transmissible, but not as transmissible as SARS2/COVID." What's happening with the suspected case in Russia? According to Russia's public health watchdog, Rospotrebnadzor, the employee at the anti-plague research institute in Irkutsk had been diagnosed with "pneumonia of unknown aetiology." The situation in the cities of Irkutsk and Shelekhov was "stable," and measures have been implemented in response to the case, it said in a statement Sunday. Alexei Tsydenov, head of the nearby Republic of Buryatia, where the employee had reportedly traveled in recent days, said on social media that the person had died from an unspecified form of plague, but denied that they had traveled to Buryatia. CNBC has not been able to independently verify the reports. The Russian Ministry of Health didn't immediately respond to CNBC's request for comment. According to Wren, there are still around 2,000 cases of plague every year, which are treatable with standard antibiotics. "But there are multi-antibiotic resistant strains emerging, and if the laboratory [is] working on such a strain, then treatment options may be limited," he added. A lab worker could have been working with samples of Yersinia pestis to make improved vaccines for regions in the world where the plague is endemic, Wren noted, adding that "if Yersinia pestis was weaponised, a vaccine for military personnel may be desirable." Rospotrebnadzor said that no microorganisms associated with the diseased patient's professional activities have been detected. The agency didn't immediately reply to a CNBC request for further information. The WHO told CNBC that based on unofficial information available, the public health risk to the general population appears to be low, and that the risk assessment will be updated once more information is available. — CNBC's Jenny Lee contributed to this report.
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