The reported death of a Russian woman following an incident at an anti-plague lab has drawn attention to a critical public health issue—how countries manage dangerous infectious pathogens and prevent potential accidents from becoming a serious public health threat.

Plague, a bacterial infection, can be treated effectively by a 10 to 14 day course of antibiotics, according to the CDC . The most important clinical concern surrounding a potential laboratory exposure at an anti-plague lab would be pneumonic plague, since it infects the lungs and can spread between people through respiratory droplets.

The Russian lab incident has created more questions than answers, as much more information is needed in order for the general public to understand and assess the public and global health implications from such an event. Currently, we still do not know what pathogen caused the death, how the exposure occurred or if the incident posed any risk to other workers or the surrounding public.

These questions inform how safeguards are understood more broadly when considering public and global health risks.

What We Know And Do Not Know

On October 2, a 28-year-old female laboratory worker Darya Shipilova died after developing pneumonia of undetermined cause. Reports suggest she may have accidentally broken a test tube containing plague bacteria, but Russian authorities have not confirmed that account.

Authorities initially placed 200 individuals under observation or quarantine, and 5,000 tests detected no dangerous pathogens from the laboratory incident. Russia also rejects reports of a second case, although the World Health Organization has requested further information, since they also do not know the cause of the woman’s death.

Three questions are still outstanding.

First, what caused the death? Understanding the specific pathogen involved, whether that pathogen was altered in any way, or if the cause was due to an unrelated illness is critical in assessing risk for the public and determining if the lab played any role.

Second, was there a breach in laboratory containment? An independent review would help investigate biosafety procedures, and this would help understand whether safeguards failed or whether death was unrelated to lab work.

Finally, were other people exposed? Negative tests and lack of additional cases are reassuring, but their reliability depends on the tests performed, their timing and the duration of follow-up. Some pathogens can have long incubation periods and there could be cases in the future if such pathogens were involved.

Could This Result In An Outbreak Or Pandemic?

The current information provided to the public does not establish a plague outbreak occurred, let alone that a wider epidemic is underway.

The plague is a bacterial infection caused by Yersinia pestis . As I have explained previously in Forbes , the bacteria can spread person-to-person once in the lungs but does not remain suspended in the air, limiting its potential to cause serious outbreaks or pandemics. In addition, effective antibiotic treatments mitigate its ability to spread widely. The WHO has assessed the regional and international risk as low to the general public.

The most important implications for this lab incident may revolve around global biosafety and disease surveillance. Without complete transparency of what ensued in the lab incident, the world will not understand what exactly happened, if a lab accident occurred, or to what extent it posed harm to those around the lab. This information is critical to learn from potential mistakes and mitigate risks from pathogens in the future. Global health and biosafety is the concern of everyone, not just some in a specific region.

If there is anything we have learned from prior outbreaks and serious pandemics like COVID-19, it is that clear communication is necessary in order to establish trust and confidence in our public health infrastructure. When public health issues occur, transparent communication on what we know, what we don’t know and what needs to be investigated is paramount so the public remains informed. This establishes and builds trust in public health systems. Without trust and confidence, public health and global health infrastructure fall apart.