Between 24 October and as of 5 December 2024, 406 cases of an unknown disease were reported in the Panzi Health Zone of Kwango Province in the Democratic Republic of Congo, with 31 known fatalities, a case fatality ratio of 7.6%. Symptoms of the disease include fever, headache, cough, runny nose, and body ache, according to a press release issued by the World Health Organization on 8 December 2024. The number of both cases and deaths is likely to be higher than the official figure, with the Ministry of Health of the Democratic Republic reporting that they are aware of deaths within the local community of people who have not visited health facilities.
Cases of the unknown disease have been reported in nine of the thirty health areas which make up Panzi Health Zone, Kahumbulu, Kambandambi, Kanzangi, Kasanji, Kiama, Mbanza Kipungu, Makitapanzi, Mwini ngulu, and Tsakala Panzi, with the majority of the cases in Tsakala Panzi (169 cases), Makitapanzi (142 cases) and Kanzangi (78 cases).
Children under five years old account for 53% of cases and 54.8% of the deaths, with 64.3% of the cases and 71% of deaths occurring in children under 15. One hundred and forty five cases, including nine fatalities, have been reported in adults. Women and girls make up 59.9% of the cases, and the majority of deaths have occured in villages.
Panzi Health Zone has a low vaccine uptake rate, poor food security, transport networks are poor (it takes about two days to reach Kinshasa by road in the rainy season). There are few trained health workers in the region, with very little care management and almost no access to diagnostic services.
Malaria is endemic to the region, with few control measures in place, as are a number of other potentially fatal diseases, including measles, influenza, respiratory tract infections, E. coli, and Covid-19. The high rate of food insecurity in the region means that malnutrition may be a contributing factor towards fatalities.
The lack of systematic medical recording in Panzi Health Zone means that although an increase in cases of fever, coughs, headaches, and body aches have been noted since October, it is unclear what the baseline rates for these symptoms are. Nor are there accurate records of vaccination schemes in the area, making it unclear to what extent the outbreak relates to vaccine deprivation. Many cases of the illness have been reported in family clusters, potentially suggesting transmission within households.
The area where the outbreak is occurring is very remote, with poor roads, limited mobile phone and internet coverage, and frequent shortages of even basic medication. There is no functional diagnostic laboratory in Kwango Province, requiring samples to be shipped to Kinshasa for analysis, a journey of two days by road in the rainy season. This process is further hampered by a lack of a formal sampling procedure in the region, and a poor security situation, with a number of armed groups operating in the area.
The remote locality of the outbreak may make it harder for the disease to spread to other areas, but with no effective monitoring or diagnostic program in place there is little way to be sure. In addition, the area of the outbreak is close to the border with Angola, creating a potential for the disease to spread across the border.
See also...
