Mysterious Illness Claims Dozens in Democratic Republic of congo
A surge of deadly respiratory illnesses has gripped the Panzi health zone in Kwango Province, Democratic Republic of Congo. As of December 16, 2024, the outbreak has claimed the lives of 48 individuals, with a total of 891 suspected cases reported. While the exact cause of the outbreak has yet to be determined, preliminary laboratory results indicate a combination of common respiratory viruses, malaria, and acute malnutrition may be driving the surge in severe cases, notably among vulnerable children under five years old.
The initial alert was raised on November 29,2024,following an alarming increase in deaths among young children experiencing fever,cough,and breathing difficulties. Enhanced surveillance efforts,implemented in response,revealed a broader pattern of febrile illnesses across the region.
Although the number of reported cases is not unusual given the prevalence of pneumonia, malaria, and respiratory infections during the rainy season, the sharp rise in deaths triggered immediate concern.
Children under five have borne the brunt of the outbreak, accounting for 47% of all cases and a staggering 54% of all deaths. This concerning pattern highlights the vulnerability of young children to severe illness and the tragic consequences of malnutrition in the context of infectious disease outbreaks.
Laboratory testing of 430 samples, including blood, swabs, urine, and breast milk, has identified positive results for malaria and a range of common respiratory viruses such as Influenza A (H1N1, pdm09), rhinoviruses, SARS-COV-2, Human coronaviruses, parainfluenza viruses, and Human Adenovirus.
Multidisciplinary response teams have been deployed to investigate the outbreak, strengthen medical care, and provide crucial risk communication and community engagement. They are working tirelessly to address the health needs in the Panzi health zone, particularly for vulnerable populations facing food insecurity.
“The event highlights the severe burden from common infectious diseases (acute respiratory infections and malaria) in a context of vulnerable populations facing food insecurity,” a statement from the World Health Organization read. “It emphasizes the need to strengthen access to health care and address underlying causes of vulnerability, particularly malnutrition, given the worsening food insecurity.”
Outbreak of Acute Respiratory Infections and Malaria in kwango Province, DRC
In late 2024, Kwango province in the Democratic Republic of Congo (DRC) experienced a concerning surge in cases of severe illness and deaths. Initial investigations pointed to a combination of factors, including prevalent common viral respiratory infections like influenza and SARS-CoV-2, and a sharp rise in falciparum malaria cases.
Laboratory tests conducted on patient samples revealed a high prevalence of both respiratory viruses and malaria parasites. Of the 89 samples tested, 64 were positive for common respiratory viruses such as influenza A (H1N1, pdm09), rhinoviruses, and SARS-CoV-2. Additionally, 55 out of 89 samples tested positive for Plasmodium falciparum.
The situation was further complicated by a deterioration in food security in Kwango province, leading to increased levels of acute malnutrition. The province was already classified as facing a serious acute malnutrition situation, and projections indicated a further worsening of the nutritional status in the coming months.
This confluence of factors - widespread viral and parasitic infections coupled with severe malnutrition - created a perfect storm for increased disease severity and mortality. The situation highlighted the vulnerability of populations facing food insecurity and underscored the urgent need for robust healthcare access and improved nutritional support.
Public Health Response
The DRC ministry of
Health, in collaboration with the
World Health organization (WHO) and the Africa Centres for Disease Control and Prevention (africa CDC), swiftly launched a coordinated response to the outbreak.
Coordination and Leadership
Daily coordination meetings were established at the national level, bringing together key stakeholders to ensure a unified and effective response. A national rapid response team, consisting of experts from the Ministry of
Health, the National Institute for Biomedical Research (INRB), and WHO, was deployed to Panzi on December 10th, 2024, following their departure, a joint МоН-Africa CDC rapid response team, supported by WHO, continued the efforts on the ground.
Surveillance
To better understand the extent and spread of the outbreak, a comprehensive surveillance system was put in place. A clear case definition was established based on observed clinical symptoms,guiding surveillance and reporting efforts. Active case searches were conducted in both healthcare facilities and the wider community. Data collection focused on creating a detailed line list of cases and conducting in-depth epidemiological analysis to identify trends and risk factors.
Moreover, investigations into community deaths were undertaken to shed light on the context of thes fatalities and identify any contributing vulnerabilities.
Authorities in the Democratic Republic of Congo are responding to a deadly surge in respiratory illnesses and malaria cases in the Panzi region. Initial reports indicated an unusual spike in deaths, prompting a swift action plan by
health officials.
A Complex Health Crisis
Symptoms began appearing in late October, including fever, cough, headaches, and body aches. While the rainy season typically brings an increase in respiratory illnesses and malaria, the alarming rise in fatalities triggered the response. Early laboratory findings suggest the surge is driven by a combination of acute respiratory viruses and a resurgence of malaria,further compounded by a worsening nutritional crisis in the region,disproportionately affecting young children.
“The epidemiological information together with the early laboratory result indicate an event triggered by an increase in acute respiratory virus cases associated with malaria, with a background of a worsening of the nutritional situation in panzi, disproportionally affecting young children,”
health officials stated.
A Vulnerable Region
The situation is particularly dire given the Democratic Republic of Congo’s already high burden of malaria. The WHO African Region bears the brunt of the global malaria epidemic, accounting for approximately 94% of cases and 95% of deaths worldwide. Children under five are most vulnerable,making up 76% of malaria deaths in the region.
Adding to the complexity, the region faces a severe nutritional crisis. The Integrated food Security Phase Classification (IPC) for Kwango province, where Panzi is located, escalated from a level of ”acceptable” food security in April 2024 to a “Crisis Level” in September 2024. The IPC currently classifies the Panzi
health zone as experiencing a “serious” level of acute malnutrition,projected to worsen to a “critical” phase from January 2025.
Multifaceted Response Efforts
The
World Health Organization (WHO) is leading a multi-pronged response,deploying a senior epidemiologist and data manager to bolster surveillance activities and improve data collection.Provincial and national Rapid Response Teams, including WHO, UNICEF, and Médecins Sans Frontières, have been mobilized to support case management in affected areas. These teams are providing essential medical supplies, including medication, to
health facilities.
Six oxygen concentrators are being installed at the Panzi General referral Hospital and three hotspot
health centers to provide crucial respiratory support for patients. Laboratory capacity is also being strengthened with the delivery of equipment and reagents to facilitate testing for malaria and COVID-19.
Health officials are also working to enhance public awareness through community engagement campaigns, promoting preventative measures and encouraging early healthcare seeking. Infection prevention and control measures are being reinforced among healthcare workers to minimize the risk of transmission.
Rising Mortality in Panzi Health Zone: Urgent call for Public Health Action
A convergence of factors has led to alarming mortality rates in the Panzi
health zone, situated in the Democratic Republic of Congo. This article delves into the complex challenges contributing to this crisis and outlines crucial steps needed to mitigate its impact.
While common infectious diseases are expected to pose a greater threat due to transmission spikes, the current situation highlights the devastating effects these illnesses can inflict on vulnerable populations already grappling with malnutrition. Strengthening malaria control, improving access to care, and addressing malnutrition are paramount.
Notable gaps in case management further exacerbate the situation. Frequent stock-outs of essential medications and the lack of free healthcare services create an insurmountable barrier for impoverished communities, leading to delayed treatment and ultimately, increased severity and mortality from treatable infections.
Access to the affected area is severely hampered by logistical limitations. The remote location requires a two-day or longer journey from Kinshasa, further complicated by the rainy season’s impact on roads. Limited telecommunication coverage impedes the rapid deployment of emergency response teams and resources.
The lack of a functional laboratory in the
health zone or province compounds the problem, necessitating the transportation of samples to Kinshasa for analysis—a process that delays diagnosis and hinders timely interventions.
Adding another layer of complexity, insecurity in the region poses a constant threat. Attacks by armed groups endanger both response teams and local communities, further disrupting vital relief efforts.
Based on these factors, the public
health risk level for the affected communities is assessed as **high**, demanding an integrated, multi-faceted public
health approach to minimize mortality from infections, improve nutritional status, and fortify malaria control.
While the national risk level is considered **low** due to the localized nature of this event and the fact that the rising mortality is driven by a range of illnesses amplified by the population’s vulnerability,it serves as a chilling warning.Many other areas in DRC are experiencing increasing malnutrition rates, and the scenario witnessed in Panzi could unfold elsewhere.
Therefore, proactive measures are imperative to prevent similar situations from arising in other vulnerable regions within the contry. At the regional and global levels, the risk remains low at present.
WHO Recommendations: A Multi-pronged Approach
To effectively address the escalating situation in Panzi, the
World Health Organization (WHO) recommends a comprehensive set of actions:
Strengthening coordination mechanisms is crucial at all levels – national, provincial, zonal, and local – to ensure a unified and streamlined response.
Establishing improved communication infrastructure, such as satellite phones, is essential to overcome the limitations imposed by inadequate network coverage in the affected areas.
Prioritizing surveillance efforts will provide a clearer understanding of disease trends and mortality patterns.
Active case searches should be conducted both within
health facilities and across communities, with a particular emphasis on areas reporting deaths and households experiencing clusters of illness.
Community-based surveillance must be bolstered to enable early case detection and facilitate rapid response efforts.
“Careful characterization of the clinical syndrome and outcomes and an improved case definition based on the information collected will be necessary to understand the situation,” emphasizes the WHO. “In particular, data which clarify possibility of coinfection and multiple pathologies, and uncertainties in outcomes among vulnerable groups should be collected.”
The WHO’s Global Clinical Platform, designed for rapid anonymized data analysis, is highly recommended for capturing in-depth details about patient syndromes and outcomes.
Effective case management hinges on ensuring a consistent supply of essential medications, access to oxygen therapy, and training healthcare workers in basic emergency and critical care to enhance treatment and reduce fatalities.
Rapid diagnostic tests (RDTs) for malaria should be widely distributed to facilitate prompt diagnosis and treatment. Long-term efforts to strengthen laboratory capacity and decentralization are crucial for establishing localized diagnostic capabilities within the affected
health zone, enabling early identification of causes of death.
reinforcing infection prevention and control measures across all
health facilities is paramount. Training healthcare workers on best practices—including the correct use of personal protective equipment like masks and gloves, and also strict hand hygiene protocols—is essential for minimizing transmission risks within
health facilities and ensuring the safety of healthcare delivery.
The
health sector plays a vital role during food crises. It is indeed crucial to prevent, reduce, and reverse the interconnected relationship between malnutrition, disease, and mortality—before, during, and after severe food shortages.
strengthening intersectoral coordination and collaboration, especially between the
health, nutrition, water, sanitation and hygiene (WASH), and food security clusters, is critical for a comprehensive humanitarian response. Data collection and analysis must be enhanced to inform effective decision-making.
Risk communication and community engagement are fundamental for raising public awareness. Targeted messages should be disseminated to educate and empower communities.
## Congo Faces Dual Health Crisis: Respiratory Infections and Malnutrition
The Democratic Republic of Congo is grappling with a serious public
health challenge. The
World Health Organization has issued a warning about a surge in acute respiratory infections complicated by malaria in the country [[1](https://www.who.int/emergencies/disease-outbreak-
news/item/2024-DON547)]. This alarming trend is further compounded by a concerning malnutrition crisis, painting a bleak picture for vulnerable populations [[2](https://www.ipcinfo.org/ipc-country-analysis/details-map/en/c/1157190/?iso3=COD)].
The ongoing outbreak requires a multi-pronged approach.
Health officials are working tirelessly to raise awareness among the public about the symptoms of respiratory illnesses,preventive measures,and the critical importance of seeking early medical attention.
Effectively addressing this crisis hinges on building strong community partnerships. Engaging with local leaders is crucial for establishing trust and encouraging adherence to public
health guidelines. combating misinformation and addressing community fears around the outbreak are equally important to foster collaboration and ensure a successful response.
Beyond public
health measures, logistical and security considerations are paramount. Ensuring a robust supply chain for the timely delivery of medical teams and essential resources to affected areas is essential. Developing contingency plans to navigate potential security challenges posed by armed groups will be vital to protecting response personnel and maintaining the continuity of life-saving operations.
