Unidentified illnesses have killed more than 50 people in north-western Congo’s Equateur province over the past five weeks, with nearly half of the victims dying within hours of falling ill. Notably, ‘crying’ is also one of the symptoms reported by patients.
Health officials report 419 cases and 53 deaths since the outbreaks began on January 21 in two remote villages separated by over 120 miles.
Authorities are still investigating the cause of the diseases and whether the cases in the two villages—Boloko and Bomate—are linked. It is still unclear how the diseases are spreading, including whether human transmission is involved.
Outbreak details
The first outbreak was recorded in Boloko, where three children died within 48 hours after eating a bat. In Bomate, more than 400 people have fallen ill, with malaria identified in some patients.
However, no connection has been established between the outbreaks in the two villages, according to the World Health Organization (WHO).
Dr Serge Ngalebato, medical director of Bikoro Hospital and a member of the government response team, noted differences between the two outbreaks. “The first one with a lot of deaths is an unusual situation that we continue to investigate. In the second episode, we see many cases of malaria,” he said.
Symptoms and investigation
Congo’s ministry of Health reported that about 80% of patients exhibit symptoms such as fever, chills, body aches, and diarrhoea.
Patients experienced symptoms including neck and joint pain, sweating, and shortness of breath. Those under 59 years old reported intense thirst, while children exhibited persistent crying.
Initially, concerns were raised about the possibility of a hemorrhagic fever like Ebola, due to the rapid progression from sickness to death. However, Ebola and similar diseases like Marburg have been ruled out after testing more than a dozen samples.
The WHO is now investigating other potential causes, including malaria, viral hemorrhagic fever, food or water poisoning, typhoid fever, and meningitis.
Response and challenges
Congo’s government dispatched health experts to the affected villages on February 14 to help investigate the outbreaks and contain the spread. However, the remote locations and weak healthcare infrastructure have hindered access to patients and complicated surveillance and case management.
The WHO has called for urgent action to “accelerate laboratory investigations, improve case management and isolation capacities, and strengthen surveillance and risk communication.”
Zoonotic concerns and environmental link
The first victims in Boloko were children who consumed a bat, raising concerns about zoonotic transmission—where diseases jump from animals to humans. The WHO specified that Africa has seen a 60% surge in such outbreaks over the past decade, partly due to human interactions with wildlife in forested areas.
Congo, which hosts about 60% of the Congo Basin’s tropical forests, is particularly vulnerable. “All these viruses have reservoirs in the forest. As long as we have these forests, we will always face epidemics with viruses that can mutate,” explained Gabriel Nsakala, a public health professor at Congo’s National Pedagogical University.
International involvement
The United States, the largest bilateral donor to Congo’s health sector, has supported the training of field epidemiologists to help detect and control disease outbreaks. However, the Trump administration recently froze foreign aid during a 90-day review, which could impact the ongoing response efforts.
