DRC mystery outbreak could be more than malaria, officials say

A man in the Democratic Republic of the Congo (DRC) has died with symptoms of haemorrhagic fever, leading officials to suspect that a still-unidentified virus may be involved alongside malaria in a mysterious outbreak that has killed dozens of people in the Central African country, health authorities said.

National authorities said earlier this week that malaria was the most likely culprit in the flu-like disease outbreak, which has killed at least 37 people and sickened nearly 600.

More than 80 per cent of patients have tested positive for malaria, but the death of the man with haemorrhagic fever – not normally associated with parasite-caused malaria – could indicate a virus is at work as well.

The man died Thursday in the remote Panzi area of Kwango province where the outbreak has been recorded, Africa Center for Disease Control and Prevention (Africa CDC) official Ngashi Ngongo told reporters.

That has led to a working hypothesis that the outbreak is either “severe malaria on a background of malnutrition” or “a viral infection that is happening on the background of malaria,” Ngongo said.

Malaria is endemic in the Panzi area, where there also are high levels of malnutrition, complicating the diagnosis of the latest outbreak.

So far, there have been 592 reported cases and 37 deaths confirmed in health facilities, Ngongo said. That is an increase of 65 cases and five deaths compared to last week.

There have been an additional 44 deaths documented in communities, which are currently being investigated.

Majority of cases tested positive for malaria

Out of samples taken from 51 cases, 86 per cent have tested positive for malaria. Tests for additional diseases are being conducted at national laboratories and are expected next week, Ngongo said.

World Health Organization (WHO) chief Tedros Adhanom Ghebreyesus said last week that most of the blood samples collected in the Panzi area were positive for malaria, but that it was possible that more than one disease was involved and that further samples were being collected and tested.

Most of the cases and deaths reported in Panzi have been children under 14, according to the WHO.

Symptoms have included fever, headache, cough, and anemia.

Experts from WHO and the DRC’s rapid response team were in the area last week to investigate and take samples.

The Panzi health zone, around 700 km from the capital, Kinshasa, is hard to access. The experts took two days to arrive, according to the DRC’s health minister.

Because of the lack of local testing capacity, samples had to be taken to Kikwit, more than 500 km away, according to Dieudonne Mwamba, the head of the National Institute for Public Health.

Panzi was hit by an epidemic of typhoid fever two years ago, and there is currently a resurgence of seasonal flu across the country, Mwamba added.

The area also has low vaccination coverage, leaving children vulnerable to a range of diseases including malaria, the WHO chief said Tuesday.