Concern as mystery disease kills over 50 people in DRC

Grungy photo of feet with toe tag on a morgue table.[Courtesy]

For the past eight weeks, the Democratic Republic of Congo (DRC) has been more than just a war zone. Amid ongoing violence, where civilians are being killed and women and children subjected to horrific abuse, the country now faces a growing health crisis.

A deadly outbreak of an unidentified illness has already claimed over 50 lives in the northwestern Équateur province, raising fears of another potential epidemic in a nation with fragile healthcare infrastructure.

The mysterious illness was first detected in January when three children in the remote village of Boloko reportedly consumed a bat. Shortly after, they exhibited severe symptoms, including high fever, fatigue, vomiting, and internal bleeding, before succumbing within 48 hours. Since then, the outbreak has escalated rapidly.

As of February 16, health officials have recorded 431 suspected cases and 53 deaths across two outbreaks in Équateur province, according to the World Health Organisation (WHO). The first cluster was reported in Boloko, within the Bolomba health zone, while the second and larger outbreak was identified in Bomate village in the Basankusu health zone.

Dr Serge Ngalebato, medical director at Bikoro Hospital, a regional health monitoring centre, described the situation as alarming. “The interval between symptom onset and death is just 48 hours in most cases. That’s what’s really worrying,” he said.

In Bomate village, the larger of the two affected areas, health officials have recorded 419 cases, including 45 deaths. The outbreak in Boloko, first identified on January 21, has seen 12 reported cases, resulting in eight deaths—meaning two-thirds of those infected have died.

Symptoms reported among the patients resemble those of hemorrhagic fevers, such as Ebola, Marburg, or yellow fever, all of which are known to cause high fever, internal bleeding, and severe organ damage.

However, laboratory tests conducted at the National Institute for Biomedical Research in Kinshasa have ruled out Ebola and Marburg. Some samples have tested positive for malaria, but officials remain uncertain whether that fully explains the severity and rapid progression of the disease.

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Public health threat

The WHO has classified the outbreak as a “significant public health threat” and is actively working with local health authorities to determine the cause. “We are investigating whether this could be another viral infection, food poisoning, or exposure to a toxic agent,” WHO spokesperson Tarik Jašarević said.

The possibility of zoonotic transmission—where diseases jump from animals to humans—is a key focus of the investigation. Scientists have long warned that regions where wild animals, such as bats, are consumed as food pose a heightened risk for the emergence of new infectious diseases. WHO data shows that outbreaks linked to animal-to-human transmission in Africa have surged by more than 60 per cent over the past decade.

The outbreak in the DRC bears similarities to previous instances of disease spillover from wildlife, including the 2013–2016 West African Ebola epidemic, which was traced back to human contact with infected fruit bats. In the case of the current outbreak, health officials are examining whether the consumption of the bat by the three children in Boloko was the initial trigger.

The remote location of the outbreak, combined with the DRC’s fragile healthcare system, presents serious challenges in containing the disease. Many affected villages have little to no access to medical facilities, and health surveillance in these areas is extremely limited.

Even in larger health centres, resources are scarce. Hospitals in Équateur province are already struggling with shortages of essential medical supplies, making it difficult to provide adequate care.

“There is an urgent need for stronger surveillance, testing, and medical intervention to prevent the situation from worsening,” said Dr Ngalebato.

The DRC has faced multiple disease outbreaks in recent years, including Ebola, cholera, and monkeypox. Malaria remains the most prevalent health threat, infecting around 30 million people annually and causing nearly 25,000 deaths in 2022 alone, according to the Severe Malaria Observatory.

Last year, another mystery illness killed over 140 people in a different region of the DRC before being identified as a severe respiratory form of malaria. Given the country’s history with such outbreaks, health officials are being cautious about drawing conclusions too early.

While the outbreak remains confined to rural parts of northwestern DRC, global health experts are closely monitoring the situation. The emergence of new diseases with pandemic potential is a growing concern, particularly in areas where healthcare infrastructure is weak and disease surveillance is limited.

Public health teams are also working to educate communities about potential transmission risks and encourage safe food-handling practices. Given the suspicion that the outbreak originated from wildlife consumption, experts stress the importance of limiting human contact with wild animals to reduce future health risks.