Pathogen Behind Flu-Like Outbreak in Congo Still Not Identified, WHO Says Malnutrition Playing a Critical Role

Medical-News: A mysterious flu-like illness is spreading through the Democratic Republic of the Congo (DRC), leaving health officials racing to identify its cause. Since October 24, 2024, the Panzi health zone in Kwango Province has reported 406 cases of an undiagnosed disease. Tragically, 31 lives have been lost, with children under five bearing the brunt of the outbreak. Severe malnutrition, prevalent in the affected communities, has emerged as a key complicating factor in this health crisis.


Pathogen Behind Flu-Like Outbreak in Congo Still Not Identified, WHO Says Malnutrition Playing a Critical Role

The Panzi health zone is a remote, rain-soaked region where access to healthcare is severely limited. Reaching the area from the capital, Kinshasa, requires a grueling 48-hour journey over deteriorated roads. The ongoing rainy season has further hindered response efforts. Despite the deployment of rapid response teams by the Ministry of Health and the World Health Organization (WHO), the pathogen remains unidentified, raising concerns about a worsening health emergency.
 
WHO highlights malnutrition as a critical factor
In a statement issued on December 8, 2024, the WHO acknowledged that while laboratory investigations are still underway, malnutrition is likely playing a significant role in both the severity and the spread of the disease.
https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON546
 
WHO officials noted that malnourished individuals, particularly children, are more susceptible to infections and have weaker immune responses. The organization stressed the urgent need to address underlying nutritional deficiencies alongside efforts to identify the pathogen.
 
Dr. Imane Sidibe, a senior WHO epidemiologist, told various Medical News journalists, “This outbreak underscores the devastating interplay between malnutrition and disease. While we work to identify the pathogen, we cannot ignore the critical role of nutrition in mitigating the impact of this health crisis.”
 
Symptoms and spread of the disease
The disease presents with symptoms typical of respiratory infections, including fever, cough, runny nose, headache, and body aches. Some patients also develop breathing difficulties, anemia, and acute malnutrition - symptoms that have proven fatal in severe cases. Alarmingly, over 64% of reported cases are children aged 0–14, with the majority being under five years old. Among those who died, 71% were children, underscoring the vulnerability of younger age groups.
 
The outbreak has spread across nine health areas within the Panzi health zone, with Tsakala Panzi, Makitapanzi, and Kanzangi being the hardest hit. Community deaths, which are often underreported and insufficiently investigated, suggest that the actual number of cases and fatalities may be higher than currently recorded.
 
< strong>Potential causes under investigation
The exact cause of the outbreak remains elusive, with health officials exploring several possibilities. Suspected pathogens include influenza, COVID-19, acute pneumonia, malaria, and measles. Coinfections, in which patients suffer from multiple illnesses simultaneously, are also being considered.
 
Malaria, a common illness in Kwango Province, may be contributing to the symptoms, though this hypothesis has yet to be confirmed. Other potential contributors include vaccine-preventable diseases like measles, as vaccination rates in the region are alarmingly low. Laboratory analyses of collected samples are ongoing at the National Institute for Biomedical Research (INRB) in Kinshasa.
 
Adding to the challenge is the possibility of multiple pathogens being involved. Dr. Sidibe emphasized that the illness might not be caused by a single disease but rather by a combination of infections exacerbated by malnutrition and poor healthcare access.
 
Malnutrition and food insecurity complicate the crisis
Kwango Province has experienced a sharp deterioration in food security in recent months, with the Integrated Food Security Phase Classification (IPC) escalating to Level 3 (Crisis) as of September 2024. Chronic food shortages have left many families struggling to feed their children, leading to widespread malnutrition. In the Panzi health zone, all severe cases of the undiagnosed illness have been reported in malnourished individuals.
 
Malnutrition weakens the immune system, making it harder for the body to fight off infections. In children, the impact is even more pronounced, as their developing bodies require adequate nutrition to sustain growth and immune function. Addressing malnutrition in affected communities is critical to reducing the disease’s severity and preventing further deaths.
 
WHO’s response and current efforts
The WHO and DRC health authorities have launched an urgent response to contain the outbreak. Efforts include:
 
Surveillance and case tracking
Health workers are conducting active case searches in communities and health facilities, investigating family clusters of cases, and gathering data on community deaths. The aim is to understand how the illness is spreading and identify the most affected populations.
 
Case management and supplies
Medical supplies, including rapid diagnostic tests (RDTs) for malaria and COVID-19, have been distributed to assist healthcare providers. Training sessions are being held to equip local health workers with the skills needed to manage cases effectively.
 
Laboratory investigations
Samples from affected patients are being analyzed at the INRB in Kinshasa. While awaiting results, health teams are using clinical data to rule out or confirm suspected illnesses.
 
Risk communication and community engagement
Public health messages are being broadcast to educate communities about the symptoms of the illness and the importance of seeking care. Community leaders are being engaged to build trust and encourage cooperation with health authorities.
 
Logistics and security
The rainy season and the region’s isolation have made it challenging to transport medical supplies and personnel. In addition, the risk of armed conflict in the area poses a threat to response teams. WHO has called for enhanced logistical support and security measures to ensure continuity of the response.
 
Ongoing challenges and global implications
The Panzi health zone’s remote location and limited healthcare infrastructure remain significant obstacles. Stockouts of essential medications, a lack of free healthcare, and poor diagnostic capacity have left many patients without adequate care. The absence of local laboratories has delayed crucial testing, prolonging uncertainty about the illness’s cause.
 
Although the outbreak is currently confined to Panzi health zone, its proximity to the Angolan border raises concerns about potential cross-border transmission. Enhanced surveillance and coordination between the DRC and Angola will be essential to prevent the disease from spreading further.
 
Conclusions
The outbreak in Congo is a grim reminder of how malnutrition, poor healthcare access, and infectious diseases can intersect to create a public health crisis. While health officials work tirelessly to identify the pathogen, addressing underlying malnutrition and improving healthcare infrastructure must remain priorities. Children, who are disproportionately affected by the outbreak, deserve immediate and sustained interventions to reduce preventable deaths.
 
Global support is crucial to strengthen Congo’s response capacity and to build resilience against future outbreaks. This crisis should serve as a wake-up call for the international community to invest in addressing the root causes of health vulnerabilities in underserved regions.
 
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