Could it be a terror attack? “There’s no vaccine” — the plague that claimed 200 million lives is spreading… Doctor issues warning

As concerns arise over the possibility of a plague outbreak in Siberia, Russia, fear is spreading worldwide. The plague claimed the lives of up to 200 million people in medieval Europe, and because no vaccine has yet been developed, early treatment remains the best course of action. Just how lethal is the plague, and what is the risk of its spread?

In a phone interview with reporters on the 7th, Um Joong-sik, professor of infectious disease at Gachon University Gil Hospital, stated, “If it is true that plague was exposed in a laboratory, early containment is possible with antibiotics (such as streptomycin, gentamicin, quinolones, and doxycycline), so I do not think a major ‘outbreak’ will occur.” However, he warned, “But if someone developed the plague for the purpose of biological terrorism, it could lead to large-scale infection and spread.”

The 2001 “anthrax terror” incident in the United States is a representative case of bioterrorism, where damage occurred as anthrax spores (powder) contained in letters sent to senators and journalists were dispersed. Of those who inhaled the white powder scattered from the opened letters at the time, five died and 17 were infected with anthrax and received treatment.

Professor Um added, “Recently, several research institutes have possessed plague bacteria, but this is mainly for experimental purposes to research and develop treatments and vaccines.” He continued, “However, plague bacteria are a strain that can be used for biological terrorism, similar to anthrax, and there are reports that some possess it for such purposes. Even if that is true, the relevant research institute would not officially announce it as such.”

The plague is an acute febrile zoonotic infection caused by infection with the plague bacterium (Yersinia pestis, Y. pestis). According to local Russian media, Daria Shipilova, a 28-year-old woman who worked at a plague research institute in the Irkutsk region of Siberia, Russia, broke a test tube containing pneumonic plague pathogens on the 25th of last month. Four days later, on the 29th, she was hospitalized with severe pneumonia symptoms and died in early this month. Local media raised the possibility that Shipilova had been infected with “pneumonic plague.”

The plague is divided into three types: △bubonic plague, △septicemic plague, and △pneumonic plague. Among these, pneumonic plague has the highest fatality rate and the strongest transmissibility between humans. Pneumonic plague occurs when the plague bacterium invades the lungs, allowing transmission between people through coughing, sneezing, etc., from infected individuals. It is the most toxic and lethal among known bacterial diseases.

Professor Um explained, “The plague can invade multiple organs, but the most lethal form is when it reaches the lungs.” He added, “The incubation period for the plague bacterium is usually within one week, so antibiotic treatment must be started as soon as possible. If symptoms appear and the start of treatment is delayed, the prognosis for pneumonic plague is poor even with antibiotics.”

If infected with pneumonic plague, chills, fever, headache, muscle pain, weakness, dizziness, and chest pain begin suddenly. Respiratory system signs such as coughing, difficulty breathing, and hemoptysis usually appear on the second day of onset. If left untreated, the mortality rate of the plague exceeds 50%.

The problem is that symptoms of pneumonic plague are similar to those of a cold or flu, which can lead to missed early diagnoses. Professor Um warned, “The key is to quickly know about exposure to the plague bacterium and start treatment.” He added, “If there was an intentional cover-up, or if the infected person did not know they were infected with the plague bacterium, the mortality rate increases.”

Rospotrebnadzor, Russia’s state public health and consumer protection institutional investor, announced in an official statement that the woman died of “pneumonia of unknown cause.” To date, Russian authorities have not officially confirmed a plague outbreak in the Irkutsk region.

Regarding this, Professor Um stated, “Even for pneumonia occurring in the community, the rate at which the exact causative pathogen is identified is only half.” He suggested, “It may be difficult to identify the causative pathogen of the pneumonia in the deceased researcher, leading them to announce it as unknown.” Nevertheless, he analyzed, “However, in this case, circumstances suggest that an ‘event’ in the laboratory (breaking a test tube containing pneumonic plague pathogens) was likely the cause of death.” He added, “If she was indeed infected with the plague in the laboratory, it would be pneumonic plague caused by inhalation.”

Local independent media in Russia reported that approximately 200 people who had contact with the deceased researcher at the hospital where she was transferred before her death have been designated as isolation observation targets, and that an obstetrics and gynecology hospital in the city has also been placed under isolation measures. Professor Um said, “Contacts are likely being isolated without symptoms and taking preventive antibiotics (such as doxycycline and ciprofloxacin).” He added, “In this case, the possibility of community spread of the plague is low.”