Public Health Questions Raised After Russia Plague Scare

Joining us now is doctor Peter Hotez. He's the dean of the school of tropical medicine at Baylor University. Doctor Hotez, great to speak with you. So so many of us relied on you during the pandemic, the COVID nineteen pandemic, to explain the science and what was happening epidemiologically and in terms of public health response. I think a lot of folks here are perhaps rightly nervous about what's happened here, and I wonder sort of what counsel you would give them in light of these news reports, in light of how little we know. We don't know the full story of what happened here. How concerned should we be about a potential outbreak here? Yeah. Let me let me give you some context. So this institute is a fairly old institute. It's been around almost a hundred years, and it was set up in a very strategic location North Of Mongolia in the Central Asian Steppes for a very good reason. It's one of the few places on our planet where there's naturally occurring plague circulating among animals, among small rodents, marmots, gerbils. And in fact, some there's good evidence to suggest that the Black Death, the bubonic plague of the thirteenth... Middle of the fourteenth century actually began in the Central Steppes of Asia, probably a few 100 miles west towards Kyrgyzstan. Stand. So that's the reason why the institute exists there to study plague. Then that's point one. Point two, then you have this individual, this tragic story of a 28 year old who who died of pneumonia and it's well known that bubonic plague has another form called pneumonic plague. And the thinking is, well, perhaps she died of of of plague pneumonia. And therefore, there was a big effort to identify any of her contacts and ultimately 200 individuals were either placed in quarantine or placed in medical observation. We don't know if they were put on antibiotics or what other measures there were and who... The the Russians do have an old school vaccine and who was vaccinated and who wasn't, all all making sense. The part that's unfortunate was the Russians did not abide by international health regulations to report this to the World Health Organization. And the WHO found out about it only through media reports. So it raised suspicion that perhaps the Russians are doing some kind of cover up or not being transparent. And you know, we still don't have the full story and so people start assuming perhaps the Russians were modifying the plague bacillus to make an antibiotic resistant, make it into a bioweapon, or some other untoward activity, although there's no evidence for that. So that's a very long way of saying there's more we don't know than we do know about this particular story. It's interesting because a lot of the reports were actually from local media in Eric Cook's. And when you looked at the national newscast, this was this was hardly mentioned even though you had the Russian foreign minister commenting it on the record. Can you explain to us the difference between pneumonic and bubonic plague and why you have to catch pneumonic plague so quickly or it can turn fatal in a matter of days, I think I was reading. Yeah. That's right. Well, bubonic plague, again, that was the the cause of the Black Death and the plague of Justinian in the in in the in the sixth century. That's transmitted by a flea, by an infected flea that transmits it from rodents to people. In the monarchic case, you can either progress to mnemonic plague after you have bubonic or it can be from individual to individual. And the problem there is it's a very short window period from when you're exposed via the aerosol route to you get pneumonic plague and just a couple of days. And not only that, it has an even higher mortality than bubonic plague. So as bad as bubonic plague is, pneumonic plague is essentially a hundred percent fatal unless unless you're vaccinated or treated with antibiotics. So that's where the panic is, is that this could be spreading via the aerosolized route. The good news is that if this really was pneumonic plague and it was spreading through the population, it's not subtle. Right? It's usually within a couple of days where everyone is getting sick and dying and clearly that's not happening unless there... Again, where there's some issue around transparency. How about at the middle left here? You mentioned the WHO finding out about this, a bit late, and you'd think that if there's any less to be learned from what we've experienced over the few years, it's that solarity is important. Move quickly here to to get this information out. In the minute we have left, do you do you feel confident now that the kind of broader global public health apparatus is getting some of the information that you say has been absent here over the last couple of days? You know, I think the best thing that could happen is that the Russians invite the World Health Organization to come in and do either a parallel investigation or an independent investigation, to put all this at rest. And and then the other problems on The US side, we do not have pandemic preparedness for plague. We have no vaccine stockpiled. No vaccine even made. The old school vaccine from the nineteen fifties and sixties, that's gone. That's all expired, and there's been no effort to make next generation plague vaccines even though it would not be that difficult. So it's another reminder that we've really let our guard down in terms of bio preparedness in this country.