The UK is on alert as the death toll from a mystery illness in the Democratic Republic of Congo (DRC) has continued to rise.
The World Health Organisation (WHO) said it was conducting further investigations alongside local health authorities after confirming the number of cases has jumped from 419 to 1096 and the number of deaths has risen from 53 to 60.
Dr Katherine Russell, Consultant Epidemiologist at UK Health Security Agency said: “UKHSA is aware of an outbreak of illness in DRC, and we are monitoring the situation closely with international partners.”
Since the beginning of the year, cases of the as-yet unidentified illness have been growing recorded in northwestern Congo in the Basankusu and Bolamba areas which are about 180 kilometres apart, the WHO said.
Symptoms have included fever, headache, chills, sweating, stiff neck, muscle aches, joint pain and body aches, nose bleeds or a runny nose, cough, vomiting and diarrhoea. Deaths occurring within two days of symptom onset.
Initial tests for deadly viruses Ebola and Marbug have come back negative and the WHO said roughly half of the tests so far have been positive for malaria, which is common in the region.
“Further tests are to be carried out for meningitis. Food, water and environmental samples will also be analysed, to determine if there might be contamination,” the WHO said.
The WHO has also sent a rapid response team to the region to investigate the situation and provide additional treatment for diseases including malaria, typhoid and meningitis.
Dr Zania Stamataki, Associate Professor in Viral Immunology, University of Birmingham, said the UK should “remain vigilant” as viral infections can remain dormant for days before people start showing symptoms, meaning people could travel and mix with others while they weren’t feeling to sick, spurring transmission.
“Infections know no borders and do not respect country lines. People travel and infections travel with them, either hitching a ride in a person or in animal carriers, so one cannot exclude spread outside of a country’s borders,” she said.
“In the UK and in other countries we need to remain vigilant and watch for symptoms. Symptoms of a haemorrhagic fever-type disease should be reported to the UK Health Security Agency via a registered medical practitioner.
“This outbreak, as well as previous outbreaks in the DRC are of significance to the rest of the world and we need to keep a close eye and assist with diagnosis and treatment. The large number of deaths of children and young people may be worsened by malnutrition and pre-existing conditions like malaria, that could weaken the immune system.”
The WHO previously said the outbreak began in the town of Boloko after three children ate a bat and died within 48 hours following hemorrhagic fever symptoms.
While it remained unclear whether the outbreak was caused by a bat-related virus, Dr Stamataki said bats carried many viruses that could be severe in humans.
“If the infection originated from a virus that came from a bat, this tells us that it is unlikely that we have pre-existing immunity to this new infection for humans, so we are unprotected, we suffer severe disease and even death,” Dr Stamataki said.
Dr Amanda Rojek, Senior Clinical Fellow, Pandemic Sciences Institute, University of Oxford, said this could be a situation where several common diseases are contributing to cases, and it was reassuring the tests for the deadly Ebola and Marbug viruses had been negative so far.
“Investigations will now be underway to examine the cause of the outbreak - which could include infectious diseases, or diseases caused by exposures to toxic or contaminated substances. Local health care teams will also be trying to identify how cases might be linked to each other,” she said.
“The outbreak investigation team will be verifying reports of a bat being consumed by children who later died of their illness because this raises the possibility of a zoonotic disease - that is, a disease spread from animals to humans. However, rumours are often rife early during an outbreak, and so verification of this information is important.”
Dr Rojek said support for local healthcare and scientific research were vital to managing and understanding outbreaks like this.
