WHO Report on Russian Lab Worker's Death Stresses 'Key Uncertainties'

Without a cause of death, it remains unclear whether Russia's precautionary measures were appropriate.

WHO report on Russian lab worker's death highlights 'key uncertainty'

Without a cause of death, it's unclear whether Russia's precautions were correct.

Tedros Adhanom Ghebreyesus, head of the World Health Organization (WHO), speaks at a press conference on the 75th anniversary of the founding of the World Health Organization in Geneva, April 6, 2023.

Over the weekend, the World Health Organization released an outbreak report on the events surrounding the death of a Russian infectious disease researcher earlier this month, stressing that Russia has yet to report a confirmed cause of death. With this "key uncertainty", the UN health agency said it was impossible to assess the risk of the event or whether Russia's public health measures would have been sufficient to prevent the spread of the unknown disease.

The World Health Organization reported that it has so far seen no evidence of ongoing transmission of the mysterious disease. "However, confidence in the assessment is limited due to the lack of a confirmed causal diagnosis, and remaining uncertainty about the source and mode of exposure," the agency wrote in its report.

The agency described the sequence of events as information obtained from Russian officials, noting that it only learned of the death through media reports on Oct. 2. WHO subsequently contacted Russian authorities and requested information on 3, 6, 7 and 8 October.

Initial media reports indicated that a laboratory worker fell ill in September 29, possibly following an incident at the laboratory, the Irkutsk Anti-Plague Research Institute (APRI) of Siberia and the Far East. Some early reports suggested that the researcher - identified by the media as 28-year-old Daria Shipilova - died of the plague after a test tube broke.

On October 2, the Irkutsk branch of the Russian health agency Rospotrebnadzor (RPN) said in a statement that a "special sanitary-epidemiological expert commission" had already met on a suspected case of a high-threat pathogen. Health and epidemic control measures including identification, monitoring and testing of all contacts were carried out. At the time, the RPN said all contacts had tested negative for high-risk pathogens.

On October 6, Russia's National Focal Point for International Health Regulations (NFP) first responded to WHO information requests, saying that no cases of plague had been recorded in Irkutsk Oblast. The NFP has confirmed that an APRI laboratory worker has died of a severe case of pneumonia after developing symptoms consistent with an acute respiratory viral infection. The worker was tested for a number of dangerous pathogens, but all tests were negative. Doctors classified the cause of death as pneumonia of undetermined cause.

The NFP also reiterated information from the RPN that public health measures had been taken and that people in contact with the laboratory worker had tested negative for high-risk pathogens. The NFP added that the widest range of possible contacts were identified and tested in accordance with Russian public health laws.

In subsequent responses, the NFP provided more details about the test and some results that were not alarming. According to officials, 5,500 laboratory tests have been conducted on the contacts. They tested for a wide range of pathogens including influenza, SARS-CoV-2, other respiratory infections and bacterial infections including plague and strep. Among the contacts, they identified two cases of Covid-19, three cases of rhinovirus and one case of Haemophilus influenzae, a group of common bacteria that includes those that can cause respiratory infections and pneumonia. They also found some opportunistic infections.

As of October 9, Russian officials told the WHO that they had not detected any dangerous pathogens in the laboratory's research collection in any of the contacts and were no longer under surveillance. The monitoring period was set for seven days for all contacts.

Officials also added that the deceased worker was not infected with the Yersinia pestis plague bacteria and that the worker had been vaccinated against the infection due to occupational hazards. They added that there had been no biosafety or laboratory biosecurity incidents at APRI and that the deceased worker had not traveled outside the area in the two weeks before becoming ill.

Reviewing all the information coming out of Russia, the WHO was largely at a loss as to what happened and the risks the event posed, concluding: “A key uncertainty for this event is the lack of a confirmed diagnosis in the deceased laboratory worker. Without a cause of death, the agency cannot "independently assess whether the length of the surveillance period reported for the calls was sufficient to rule out all possible causes of fatal disease." They also do not rule out the possibility of laboratory exposure.

Beth is Ars Technica's senior health reporter. Beth holds a Ph.D. in microbiology from the University of North Carolina at Chapel Hill and attended the Communication Sciences Program at the University of California, Santa Cruz. He specializes in coverage of infectious diseases, public health and microbes.