‘Disease X’ Outbreak in DR Congo: What You Need to Know

By Adebowale Bello. B.Tech Microbiology. Freelance Health Writer.

Africa map showing the location of DR Congo. Click on image to enlarge.

December 9, 2024. The Panzi health zone in Kwango Province, about 260 km (160 miles) southeast of Kinshasa, the capital of the Democratic Republic of Congo (DRC), has become the epicenter of a public health crisis.

Between October and December 2024, over 400 cases of an undiagnosed disease have been reported. This disease, which primarily affects children, has been linked to symptoms such as fever, headache, cough, runny nose and body aches.

According to Roger Kamba, the Minister of health, 71 lives have tragically been lost, most of them children under the age of five and this health crisis has brought to light the vulnerabilities of rural, under-resourced communities in Africa, where health systems struggle to cope with complex emergencies.

The Scale of the Outbreak

The Panzi health zone has reported cases from nine out of its 30 health areas, with the majority concentrated in Tsakala Panzi, Makitapanzi and Kanzangi, in Kwango province (See map).

DR Congo map showing Kwango province, the epicentre of 'Disease X'.

The crisis disproportionately affects children, with 64% of cases reported in those under 14 years. Among those who have died, 71% are children, highlighting the devastating toll on the youngest members of the community.  

The high fatality rate (7.6%) is closely tied to severe malnutrition, a recurring challenge in this region due to worsening food insecurity. The Integrated Food Security Phase Classification (IPC) for Kwango Province rose from IPC 1 (acceptable) to IPC 3 (crisis level) between April and September 2024. This situation has left the community vulnerable to diseases that are often preventable or manageable under normal circumstances.

What Is Causing This Mystery Disease?

Currently, the disease cause is unknown, which is why it is referred to as 'Disease X'.

However the symptoms—fever, cough, fatigue and runny nose—point to respiratory illnesses. Hence, diseases like measles, pneumonia, influenza, malaria and even COVID-19 are under investigation. In addition, the main symptoms associated with death include difficulty in breathing, anaemia and signs of acute malnutrition which weakens the immune system and increases the severity of symptoms.  

Family members in close contact with each other have been found to contract this disease, thereby suggesting possible person-to-person transmission which further complicates the picture. It is also possible that more than one disease is at play, a situation that has been observed in similar outbreaks where malnutrition exacerbates the effects of multiple infections.

What are the Challenges to Effective Response?

The challenges in addressing this outbreak are daunting and these factors create an environment where even routine health challenges become life-threatening emergencies. Some of the barriers include:

• Remoteness of the Area: Panzi health zone is a two-day journey by road from Kinshasa, the capital of the Democratic Republic of the Congo (DRC). This timeline is worsened by heavy rains occurring during the raining season that have made roads nearly impassable.

•  Weak Health Infrastructure: There is a critical shortage of healthcare workers, medications and laboratory facilities in the region which means that samples are being sent to Kinshasa for analysis—a process that delays timely diagnosis and treatment.

• Limited Vaccination Coverage: A lack of immunization leaves children vulnerable to preventable diseases like measles.

• Logistical and Security Issues: Armed groups operating in the area pose risks to response teams, while poor mobile and internet connectivity hinders coordination.  

The Response So Far

Authorities and partners, including the World Health Organization (WHO) and the African Centres for Disease Control (Africa CDC) have mobilized rapid response teams to investigate and manage the outbreak. Some of the key actions taken so far include:  

• Case Identification: Teams are actively searching for cases in health facilities and communities, collecting data to understand transmission dynamics.

• Treatment and Care: Medications are being distributed to manage symptoms, and healthcare workers are receiving training to improve care quality.

• Laboratory Testing: Samples are being analyzed to identify the exact cause(s) of the outbreak, with rapid diagnostic tests for malaria and COVID-19 already in use.

• Risk Communication: Sensitization campaigns are educating the public about symptoms and prevention, while addressing misinformation to build trust.  

What Can Be Improved?

This outbreak is a stark reminder of the importance of investing in resilient health systems across Africa. Going forward, here are some critical steps to mitigate this crisis and prevent future outbreaks:  

• Strengthening Local Health Systems: Expanding laboratory capacity, training healthcare workers and ensuring the availability of essential medicines can help communities better respond to health emergencies.

• Improving Nutrition: Addressing food insecurity through targeted interventions can reduce the prevalence of malnutrition and its devastating impact on health outcomes.

• Boosting Vaccination Coverage: Ensuring all children receive routine immunizations is a cost-effective way to prevent outbreaks of diseases like measles.

• Enhancing Surveillance: Establishing robust disease surveillance systems will enable early detection and rapid response to potential outbreaks.

• Overcoming Logistical Barriers: Investments in infrastructure, such as better roads and communication networks, are crucial for timely healthcare delivery.

Wrap Up

While the exact cause of the Panzi outbreak remains unknown, the tragedy unfolding in this remote health zone serves as a wake-up call. Children should not die from treatable or preventable conditions in the 21st century. With coordinated efforts and sustained investments, we can build a future where every African child has the opportunity to thrive—regardless of where they are born.

Source: World Health Organization Newsroom

The Associated Press News Report

Published: December 9, 2024

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