Still No Clarity About Mystery Disease In DRC, But All Severe Cases ...

There is still no clarity about the cause of the mystery disease affecting people in the Panzi district of Kwango province in south-west Democratic Republic of Congo (DRC), despite hopes that it would be diagnosed by the past weekend.

Getting laboratory test results is proving more challenging than previously hoped as the district’s “limited laboratory capacity means that samples have to be transported to the national reference laboratory in [the capital of] Kinshasa”, according to the Africa Centres for Disease Control and Prevention (Africa CDC).

But the 700 km journey to Kinshasa currently takes about 48 hours due to poor roads and the rainy season, according to the World Health Organization (WHO).

The communication network is also limited in Panzi, a rural community of around 200,000 people spread over more than 7,000 square kilometres.

By last Thursday, 406 cases and 31 deaths of the undiagnosed disease had been recorded (case fatality ratio of 7.6%). However, the reported cases peaked in epidemiological week 45 (week ending 9 November 2024), according to the WHO. It took almost six weeks for Panzi health officials to notify national health officials about the unusual rise in cases.

All severe cases were malnourished, according to the WHO’s Disease Outbreak News (DON) from Sunday.

“The clinical presentation of patients includes symptoms such as fever (96.5%), cough (87.9%), fatigue (60.9%) and a running nose (57.8%),” according to the WHO.

Almost two-thirds of cases (64.3%) are children under the age of 15 , and over half of the children’s cases involve kids under the age of five. Some 71% of deaths occurred in children under 15.

“The area experienced deterioration in food insecurity in recent months, has low vaccination coverage and very limited access to diagnostics and quality case management,” according to the WHO.

In addition, the area is experiencing a shortage of supplies and health workers, with limited malaria control measures and access to transport.

Given the context of Panzi and patients’ symptoms, the WHO has listed the main diseases that are suspected. These include measles, influenza, acute pneumonia (respiratory tract infection), hemolytic uremic syndrome from E. coli, COVID-19 and malaria. 

Both the WHO and Africa CDC have sent health experts to assist the DRC’s team to assess the situation, accelerate diagnostic testing, and implement control measures.

The multidisciplinary team includes epidemiologists, laboratory scientists, infection prevention and control experts.

Since the mpox outbreak, the Africa CDC has been working closely with the DRC’s Ministry of Health (MoH), the National Institute of Biomedical Research (INRB), the National Public Health Institute (NPHI) to strengthen disease monitoring through genomic surveillance. 

“This collaboration focusses on creating a sustainable national pathogen genomics strategy and decentralising laboratory capacity to improve outbreak response and preparedness,” according to Africa CDC.

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