Mystery disease in Congo is mix of illnesses that’s turned deadly

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(Bloomberg) — A flu-like illness that’s sickened hundreds of people in the Democratic Republic of Congo is a mix of diseases common in the region that have morphed into severe forms in a population weakened by hunger.

Health authorities have two working hypotheses: severe malaria or a viral infection, both against a background of malnutrition, Ngashi Ngongo, head of incident management for the mpox outbreak at the Africa Centres for Disease Control and Prevention, said in a briefing Thursday. They also reported the death of an adult male patient with hemorrhagic fever syndrome.

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The bulk of the more than 500 cases since October are in children younger than five years, who have been weakened by a lack of food.

The outbreak in the remote southwestern province of Kwango renewed concerns that this may be a new pathogen with the potential for global spread just a few years after Covid-19 shut down borders and brought economic and social activities to a halt. Early reports of the illness — initially dubbed ‘Disease X’ — pointed to it being airborne.

First reported in the Panzi health zone, national authorities were alerted more than five weeks later on Dec. 1. A high case fatality rate of 6.2% triggered concern that what was unfolding was more than typical diseases for that region.

Challenges in getting good-quality samples to a national laboratory in the capital, Kinshasa — some 700 kilometers (435 miles) from the outbreak zone — delayed identification of patient specimens. Poor road conditions and recent heavy downpours mean it takes two to three days to make that trip.

Malaria is arguably one of the world’s most neglected diseases, with most deaths occurring among the poor. The lack of a lucrative commercial market has slowed the development of a vaccine.

With the rainy season, malaria becomes a more frequent threat. The tendency of the parasite to mutate has also made it harder to produce an effective inoculation. Still, children in Cameroon and Ivory Coast this year became the first nations to deploy malaria shots.

Congo, which is as big as the US states of Alaska and Texas combined, is home to 10% of the world’s tropical forests and is among the world’s poorest nations. Increased interaction between humans and animals has seen diseases such as mpox and Marburg increasingly spread to people from infected rodents and bats in the region.

Earlier this year, the spread of a new strain of mpox prompted the WHO to declare the disease a public health emergency of international concern, though the virus’ spread out of Africa has remained sporadic.

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