Mystery illness in the Congo. 50 dead.

Over the past 3 months we've seen several reports of a `mystery' outbreak in the DRC (see WHO DON: Undiagnosed disease - Democratic Republic of the Congo), and while that first outbreak was eventually attributed to a combination of severe Malaria and malnutrition, there have been more recent, similar outbreaks reported in the DRC. 

The latest report comes from Equateur province, and while both Ebola and Marburg have been ruled out - and roughly half of the cases tested were positive for malaria -  the cause of this outbreak remains unknown. 

While most `mystery' outbreaks turn out to be due to something already known (malnutrition, measles, malaria, meningitis, contaminated food or water, etc.), every once in a while something more exotic is at work. 

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Increased disease surveillance has identified in total of 1096 sick people and 60 deaths in Basankusu and Bolomba fitting a broad case definition that includes fever, headache, chills, sweating, stiff neck, muscle aches, multiple joint pain and body aches, a runny or bleeding from nose, cough, vomiting and diarrhoea.

Last week WHO AFRO published a report on a DRC Investigation on Cluster of Illness and Community Deaths in Equateur Province, and while the cause remained undetermined, tests for Ebola and Marburg had come back negative. 

As we've seen often over the years, most `mystery' outbreaks turn out to be due to something already known (malnutrition, measles, malaria, meningitis, contaminated food or water, etc.), but every once in a while something more exotic is at work.  

Late yesterday the WHO published the following update, which describes the outbreak as both `localized'  and `declining' - and while the cause has yet to be determined - has set the local public health risk at `moderate', and the national and global risk as `low'.

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On 9 February 2025, officials in the Democratic Republic of the Congo reported to regional health authorities a cluster of 24 unexplained community deaths in a single village in Ekoto health area, Basankusu health zone, Equateur province. As of 25 February, a total of 53 deaths have been reported, with the last death occurring on 22 February. Deaths have occurred in all age groups, but adolescents and young adults, particularly males, appeared to be disproportionately affected in the initial cluster reported. Disease progression appeared to be fast, with a median time from onset of symptoms to death of one day.

Given the rapid decline in the incidence of reported deaths, their geographic clustering, the age profile of deaths and the rapid disease progression in the initial cluster, working hypotheses include chemical poisoning or a rapid onset bacterial meningitis cluster, on a background of malaria and other infectious illnesses endemic in the region. The definitive cause of illness remains undetermined, with initial samples testing negative for Ebola and Marburg viruses. 

Field investigations and additional laboratory testing are ongoing including but not limited to the cerebrospinal fluid testing and the toxicological analysis of environmental samples, including water and other samples to explore chemical causes. Local authorities began surveillance with a broad case definition including any individual with fever and at least one other symptom, to better understand disease patterns. 

The province faces a severe urban water crisis with only 5% of its urban population having access to drinking water. The water network suffers frequent leaks and has never been rehabilitated. Many households rely on unregulated private water sources such as wells, springs and streams which pose contamination risks.

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https://flutrackers.com/forum/forum/africa/emerging-diseases-other-health-threats-ah/1008994-kenya-who-in-kisii-to-identify-cause-of-mysterious-disease-likely-source-of-infection-is-a-contaminated-spring?view=stream">https://flutrackers.com/forum/forum/africa/emerging-diseases-other-health-threats-ah/1008994-kenya-who-in-kisii-to-identify-cause-of-mysterious-disease-likely-source-of-infection-is-a-contaminated-spring?view=stream or https://flutrackers.com/forum/forum/africa/emerging-diseases-other-health-threats-ah/1008994-kenya-who-in-kisii-to-identify-cause-of-mysterious-disease-likely-source-of-infection-is-a-contaminated-spring?view=stream