Pneumonic plague: symptoms, transmission, and treatment explained

A 28-year-old laboratory technician died of pneumonic plague in Russia's Irkutsk region, marking the most severe and contagious form of the disease caused by Yersinia pestis. The case has renewed attention on the illness, though antibiotics remain effective if administered promptly. Pneumonic plague can develop through direct inhalation of the bacterium or as a complication of untreated bubonic plague. Symptoms include sudden high fever, chills, headache, and rapid-onset pneumonia with shortness of breath, chest pain, and potentially bloody sputum. Without treatment, death can occur within 18-24 hours, with near-100% fatality. The disease spreads through infected flea bites, contact with contaminated animal tissues, or respiratory droplets from symptomatic patients, requiring close prolonged contact. Treatment with streptomycin, gentamicin, doxycycline, or fluoroquinolones reduces mortality to about 10% if started within 24 hours. Plague remains endemic in parts of Madagascar, Congo, Peru, Mongolia, Central Asia, Siberia, and the southwestern U.S., though European risk is negligible.