Malaga viral infections specialist reassures the public about global healthcare's capacity to treat pneumonic plague

The authorities have put under surveillance 200 people who had been in contact with the deceased prior to her death, but they have reportedly not detected any new cases.

The WHO (World Health Organization), which consistently requests information to shed light on the incident, rates the risk in Europe as "very low". Following society's harrowing experience with Covid-19, many residents of Malaga are persistently asking themselves what the next pandemic might be: from mpox to hantavirus, via avian flu, Newcastle disease, dengue or the chikungunya virus. There is no shortage of candidates.

Sur interviews biologist Ana María Ortega Prieto, co-principal investigator of the immune response to viral infections group at the Malaga institute for biomedical research (Ibima Bionand). Her research focuses on human viral infections, particularly hepatitis B and C, HIV and coronavirus, as well as the study of the innate immune response.

Ortega rejects any parallels with the coronavirus pandemic and urges people not to cause alarm. She simply advises that we continue to follow the investigation closely.

 —Is there currently any real risk of pneumonic plague spreading to Malaga from Russia? 

—As far as we know at present, there is no cause for alarm in Malaga. The WHO has issued an initial assessment indicating a very low risk for Europe. We must continue to monitor the investigation, but we do not have any data to suggest that there is a threat to our city.

 —If it were ultimately confirmed that the Russian researcher died of pneumonic plague, what would be the risk to someone travelling from Russia to Malaga? 

—It depends on where they are and if they are exposed. Travelling from Russia does not necessarily mean they have been in contact with the bacterium. If that person were in close contact with someone who was ill or were exposed in a way linked to the case, the health authorities would have to decide what action to take.

 —Is pneumonic plague a highly contagious disease? Is it easily transmitted from one person to another? 

—It can be passed between people and cause outbreaks, so it is an illness that must be taken seriously. Transmission is mainly linked to close contact with an infected person, particularly when they are coughing. It is a serious condition, but effective antibiotics are available. The key is to recognise the symptoms and start treatment as soon as possible.

 —Is it transmitted in a similar way to coronavirus, for example via aerosols and during everyday contact, or does it require much closer contact with an infected person? 

—I wouldn't compare it directly to Covid-19. With pneumonic plague, transmission between people is mainly linked to close contact with someone who is ill and coughing or sneezing. With Covid-19, one of the difficulties is that a person can transmit the virus before they have symptoms or even without ever developing them. The fact that both can be transmitted via the respiratory tract does not mean that they spread in the same way.

 —Could someone with pneumonic plague infect a lot of people on a plane, a train or in an enclosed space or is the risk of transmission considerably lower? 

—They could infect people close to them, but travelling on the same aeroplane or train does not mean that all passengers are exposed to the same risk. We would need to know whether the patient had a cough, who was in close proximity to them and for how long. Without that information, it would be inaccurate to speculate on how many people they might infect or imagine a scenario like that of Covid-19.

 —What symptoms in Malaga would suggest that a person has pneumonic plague rather than conventional pneumonia or flu? 

—It can cause a fever, a cough, chest pain and shortness of breath and can progress rapidly. The problem is that these symptoms also occur in other infections. There is no single symptom that allows you to recognise it at home. To suspect it, it is very important to know the person's possible exposures. A diagnosis requires laboratory tests. If anyone is having difficulty breathing or their condition worsens significantly, they should seek medical attention and explain whether they have had any high-risk contact.

 —Is the healthcare system in Malaga prepared to quickly detect, isolate and treat a possible case of plague?  

—In Spain, we have a specific protocol for monitoring and responding to a possible case of plague.

 —Which hospital or department would initially take charge of that patient? 

—The decision as to which hospital in Malaga would treat them and how their care would be organised rests with the Andalusian health service, which is the body best placed to provide accurate information on this matter.

 —Is there currently any reason why people from Malaga who have travelled to Russia or who are planning to do so, should take any special precautions? 

—There is no reason to assume that someone has been exposed simply because they have travelled to Russia. Anyone planning to travel should check the latest official advice. If a person has had close contact with a suspected case or has been identified as having been exposed, they should report this to the health authorities, even if they are feeling well, so that they can assess whether they require follow-up or any preventive measures.

 —In a nutshell: should the people of Malaga be concerned about this or are we facing a very different scenario to that of Covid-19? 

—Based on what we know today, the investigation must continue, but there is no reason to cause alarm in Malaga or compare this incident with what we experienced with Covid-19.

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