By Chinedu Asadu and Jean-Yves Kamale
Kinshasa: Health officials are still working to determine the cause of two illness outbreaks in north-western Democratic Republic of the Congo that have killed more than 50 people over the past five weeks, nearly half of them within hours of the first symptoms.
The outbreaks in two villages 190 kilometres apart began on January 21 and include 419 cases and 53 deaths. Health officials still do not know if the cases are related. It’s also unclear how the diseases are spreading, including whether they are spreading between people.
Illnesses have been clustered in different health zones of Equateur province, about 640 kilometres from Kinshasa.
Health workers dressed in protective gear at an Ebola treatment centre in Beni in DR Congo. Ebola has been ruled out this time.Credit: AP
The first victims, in Boloko, were children who ate a bat and died within 48 hours, the Africa office of the World Health Organisation said this week. More infections were found in the other village, Bomate, where at least some of the patients have malaria.
More than two weeks later, a second and larger outbreak was recorded in Bomate, where more than 400 people have fallen ill. According to WHO’s Africa office, no links have been established between the cases at the two locations.
Dr Serge Ngalebato, medical director of Bikoro Hospital, a regional monitoring centre, and one of the government experts deployed to respond to the outbreak, says the situations in the two villages are somewhat different.
“The first one with a lot of deaths, that we continue to investigate because it’s an unusual situation, [and] in the second episode that we’re dealing with, we see a lot of the cases of malaria,” Ngalebato said.
The WHO Africa office said the quick progression from sickness to death in Boloko was a key concern, along with the high number of deaths in Bomate.
What are the symptoms?
Congo’s Health Ministry said about 80 per cent of patients shared similar symptoms, including fever, chills, body aches and diarrhoea.
While many common infections can cause these symptoms, health officials initially feared the symptoms and the quick deaths could also be a sign of a haemorrhagic fever such as Ebola, which was also linked to an infected animal.
However, Ebola and similar diseases, including Marburg, have been ruled out after more than a dozen samples were collected and tested in the capital, Kinshasa.
The WHO said it was investigating a number of possible causes, including malaria, viral haemorrhagic fever, food or water poisoning, typhoid fever and meningitis.
What is being done in response?
Congo’s government said experts have been sent to the villages since February 14, mainly to help investigate the cases and slow the spread.
Ngalebato said patients have been responding to treatments that target the different symptoms.
The remote location of the villages has hindered access to patients, and the weak healthcare infrastructure has made it difficult to carry out surveillance and manage patients. Such challenges are common in disease outbreaks in Congo. In December, an unknown illness killed dozens.
In the latest outbreaks, several victims died even before experts could even reach them, Ngalebato said.
Urgent action is needed to “accelerate laboratory investigations, improve case management and isolation capacities, and strengthen surveillance and risk communication”, the WHO Africa said.
Gorillas in Congo’s forests are naturally infected with different parasites which cause malaria.Credit: Ian Nichols and the National Geographic Society
Is there a link to Congo’s forests?
There have long been concerns about diseases jumping from animals to humans in places where people regularly eat wild animals. The number of such outbreaks in Africa has surged by more than 60 per cent in the last decade, the WHO said in 2022.
Experts say this might be what is happening in Congo, which is home to about 60 per cent of the forests in the Congo Basin, the largest expanse of tropical forest on earth.
“All these viruses are viruses that have reservoirs in the forest. And so, as long as we have these forests, we will always have a few epidemics with viruses which will mutate,” said Gabriel Nsakala, a professor of public health at Congo’s National Pedagogical University, who previously worked at the Congolese Health Ministry on its Ebola and coronavirus response programs.
AP