A lab worker's plague death in Irkutsk puts handling procedures under scrutiny

Plague kills, but it rarely travels far ^[4]. Yersinia pestis infects more than 1000 people a year around the world, usually through flea bites that cause the bubonic form, and it circulates constantly in wild animals ^[7][8]. Antibiotics usually clear it ^[12]. "Plague is not a historical disease," Zania Stamataki at the University of Birmingham said. "Human cases occur every year, including outbreaks of the pneumonic form" ^[5].

The lung infection is the dangerous one. It can spread through the air when a patient coughs, though masks and keeping a distance stop that ^[10]. So the response in Irkutsk, close to 200 contacts under observation and several hospitals quarantined, is the ordinary approach to a treatable disease ^[2][3]. No one is expecting a large outbreak ^[4].

That leaves the lab. The accident is reported to have involved a broken test tube, and if staff were following the procedures for handling dangerous microbes it should not have caused an infection; workers should have been wearing protective equipment ^[13]. "This can be controlled and stopped with appropriate surveillance and control measures," Simon Clarke at the University of Reading said ^[11].

There has been speculation that a plague engineered for biowarfare was involved, with no evidence behind it ^[14]. Pneumonic plague is nearly always fatal if it is not treated quickly, so a death is no sign of an unusually dangerous strain ^[15]. And because Y. pestis infects people and animals so often, there are real reasons to study it in a lab ^[16].

The former Soviet Union ran a large bioweapons programme that modified Y. pestis to resist antibiotics, although resistant strains have arisen naturally too and were first found in Madagascar in the 1990s ^[17][18]. Lab accidents have caused infections, deaths and outbreaks before. At least 68 people died of anthrax in Sverdlovsk in 1979 after what the US called an accidental release from a military facility, and a 2007 foot-and-mouth outbreak in the UK was traced to labs ^[19][20]. There is no evidence the covid-19 pandemic started with one ^[21]. Russia has repeatedly claimed, without evidence, that Ukraine is developing bioweapons with US help ^[24].

Officials have not confirmed the pathogen was Y. pestis, and the circumstances of the accident are still unclear ^[6]. Stamataki said lab-acquired infections with Y. pestis are rare but not impossible ^[22]. "This incident warrants a full account of what happened," she said. "That account matters beyond Russia" ^[23].