Alerts

The World Health Organisation (WHO) on 27 December 2024  provided an update on the mysterious disease outbreak in the Panzi health zone, Kwango Province, Democratic Republic of the Congo. Initially reported as an undiagnosed illness on November 29, the outbreak is now identified as a combination of acute respiratory infections and falciparum malaria, compounded by severe malnutrition.

Since the alert, 891 cases and 48 deaths, predominantly among children under five, have been reported across 25 of Panzi’s 30 health areas. Enhanced surveillance has revealed a mix of symptoms including fever, cough, and body weakness, with many cases linked to common respiratory viruses (e.g., Influenza A, SARS-CoV-2) and malaria.

Preliminary findings

Laboratory tests on 430 samples indicate:

• 62% tested positive for malaria.
• 64 samples showed infections with respiratory viruses like Influenza A, rhinoviruses, and SARS-CoV-2.

Severe malnutrition, affecting nearly half the children under five in the area, has exacerbated the impact of these diseases.

Response efforts

Authorities, with support from WHO, Africa CDC, and UNICEF, have intensified their response:

• Surveillance: Active case searching and enhanced data collection continue in affected areas.
• Case management: Health workers are receiving training, and essential supplies, including oxygen concentrators, are being delivered to facilities.
• Laboratory testing: Further virological and bacterial analysis is underway to refine understanding of the outbreak.
• Risk Communication: Public awareness campaigns are being conducted to encourage early care-seeking and preventive behaviors.

Challenges and broader implications

Kwango Province faces a crisis of food insecurity and malnutrition, classified as IPC Phase 3 (Serious) and projected to worsen. Malnutrition weakens immunity, increasing vulnerability to infections and worsening disease outcomes. Limited healthcare access, shortages of medical supplies, and poor infrastructure compound the crisis.

The outbreak highlights the urgent need to:

1. Strengthen healthcare systems and access to treatment.
2. Address food insecurity and malnutrition.
3. Improve surveillance and response capacities in remote, vulnerable regions.

While risks remain localized to Panzi, the event underscores the critical intersection of health, nutrition, and poverty in driving preventable deaths. Continued international support is vital to mitigate the crisis and prevent similar outbreaks elsewhere in the country.

Read full WHO report here: https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON547

New undiagnosed disease in DR Congo: urgent action needed - Lancet

The outbreak of an undiagnosed disease in DR Congo, reported by WHO on Dec 8, 2024,1 is a pressing global health concern that demands swift and coordinated action. As of Dec 5, 406 cases and 31 deaths have been reported in the Panzi health zone in Kwango province, with influenza-like symptoms and anaemia. Most affected individuals are children aged younger than 5 years, many of whom are severely malnourished.

The remoteness of the region and poor infrastructure complicate the identification of the pathogen, with suspicions that multiple diseases could be contributing to these cases. Furthermore, the outbreak has the potential to transcend regional boundaries, particularly as DR Congo shares porous borders with Angola, where provinces such as Uige are vulnerable to cross-border transmission. Mobility between these regions could facilitate the spread of the disease to neighbouring African countries, raising the potential for a Public Health Emergency of International Concern.

With disease samples dispatched to Kinshasa for laboratory testing to determine the pathogen's origin, we are in a crucial window to prevent its further spread. Today, the approach must be different. The disease's unknown nature warrants containment measures at both the local and international levels. These measures should include the immediate restriction of cross-border movement in affected regions, enhanced disease surveillance, and the rapid mobilisation of health-care resources to DR Congo and neighbouring countries. Additionally, the international community must recognise that this is not solely an African challenge; it is a global health threat. Comprehensive funding and logistical support should be prioritised, enabling rapid diagnostic efforts, contact tracing, and the provision of personal protective equipment to front-line workers.

The risk of spillover into neighbouring countries underscores the urgency for Angola and other countries in the region to heighten preparedness measures. These measures should include deploying rapid response teams, establishing quarantine protocols, and intensifying public health communication to mitigate panic and misinformation. In this interconnected world, a delayed or fragmented response could allow this disease to evolve into a global health crisis. By learning from our recent past, we can change the trajectory of this outbreak and safeguard lives across continents. The experience with COVID-19 has shown that delays in responding to outbreaks can have catastrophic consequences. Therefore, it is imperative that the global community acts decisively to contain this undiagnosed disease in DR Congo, protecting not only African populations, but also global public health.

Reference

Undiagnosed disease—Democratic Republic of the Congo

https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON546

At least 79 people have died from an unknown disease that is causing flu-like symptoms in south-western Democratic Republic of Congo, the health ministry says.

Media reports quoting the health ministry says the majority of people who have died are between the ages of 15 and 18.

More than 300 people have been infected with patients exhibiting symptoms like fever, headaches, runny noses and coughs, breathing difficulties and anaemia.

Response teams have been sent to Kwango Province, specifically the Panzi health zone, where the disease is most common, to manage cases and investigate the nature of the disease. Symphorien Manzanza, a civil society leader, told Reuters news agency the situation was worrying as the number of infected people continues to rise.

"Panzi is a rural health zone, so there is a problem with the supply of medicines," he said.

A World Health Organisation (WHO) Africa region official told the BBC they have "dispatched a team to the remote area to collect samples for lab investigations".

Authorities have urged the population to remain calm and vigilant. They urged people to wash their hands with soap, avoid mass gatherings, and avoid touching the bodies of the deceased without qualified health personnel.

A local MP told Top Congo Radio that about 67 people had fallen sick and died between 10 and 26 November. "It should be noted that Panzi hospital is short of medicines to cope with this epidemic. We really need assistance," said the MP.

The Serengeti-Mara ecosystem, spanning 30,000 square kilometers across Kenya’s Maasai Mara and Tanzania’s Serengeti, is a vital habitat with diverse landscapes, including savannahs, grasslands, riverine forests, and acacia woodlands. This ecosystem hosts the Great Migration, where millions of wildebeest, zebras, and other herbivores journey annually in search of food and water. This migration sustains numerous predators like lions and cheetahs, maintaining an ecological balance that exemplifies the region’s biodiversity. The ecosystem also supports species like elephants, giraffes, hippos, and a rich variety of bird species, creating a unique setting for intricate ecological interactions.

However, climate change threatens the stability of this ecosystem. A study featured in The Guardian, conducted by a research team from universities in Europe, IUCN, and Kenya Meteorological Department has examined the Mara-Serengeti’s weather patterns since 1913, noting increased temperatures, variable rainfall, and recurring severe droughts over recent decades. Average minimum temperatures have risen significantly, with Narok Town showing a 5.3°C increase from 1960 to 2024. Rainfall has also increased, alongside more frequent and intense droughts and floods, all of which are straining resources vital for wildlife and communities alike.

Global climate systems, especially the Southern Oscillation Index (which influences El Niño and La Niña events) and the Indian Ocean Dipole (IOD), have exacerbated these extreme weather conditions. Since 1970, El Niño and La Niña events have become more intense and frequent, leading to unpredictable rainfall and drought cycles in East Africa. Additionally, a warming Indian Ocean has strengthened the IOD, contributing to more frequent severe floods and droughts. These intensified climate patterns, driven by global warming, disrupt traditional migration and breeding cycles, reduce water and vegetation availability, and heighten competition between wildlife and human communities.

The impact on the ecosystem is profound. Wildlife populations are declining as animals face shrinking habitats and limited resources. Field observations, historical data from Kenya’s Game Department, and district records show that extreme weather events have repeatedly coincided with notable shifts in wildlife distribution and population. The researchers systematically ruled out other factors like poaching, pollution, or disease, confirming that climate change is the main driver.

The Serengeti-Mara ecosystem stands at a critical juncture. Conservation efforts must adapt to mitigate the effects of climate change and ensure the long-term resilience of this biodiverse landscape. Balancing the needs of both wildlife and local communities is essential to preserving the ecosystem's health and supporting those who depend on it.

Read full article in The Guardian on this link .

The Democratic Republic of the Congo (DRC) continues to face a significant Mpox outbreak, with 23 of its 26 provinces reporting confirmed cases. According to a recent UNICEF Mpox situational report, as of October 2024, over 31,350 suspected cases and 992 deaths have been recorded, with a case fatality rate of 3.1%. In response, the report indicates, UNICEF has launched a vaccination campaign in eight health zones across three provinces, reaching 14,180 people, mostly frontline workers. However, testing challenges and limited resources hinder the ability to fully control the outbreak, particularly in hard-to-reach areas.

Eastern provinces, such as South Kivu and North Kivu, are witnessing a rise in case fatality rates, exacerbated by overcrowding, inadequate WASH infrastructure, and frequent cross-border movement. Vulnerable children, particularly those facing malnutrition or undiagnosed HIV, are at heightened risk of severe Mpox outcomes. Meanwhile, new hotspots continue to emerge in provinces like Haut Uele and Ituri.

In Tshopo province, where 79 deaths have been reported, UNICEF, in collaboration with local partners, has established nine treatment centers to curb the outbreak. Despite these efforts, the province still struggles with a high case fatality rate of 4.9%. UNICEF’s efforts to disseminate preventive messages have reached over 43 million people nationwide, raising awareness through various media channels.

The Mpox outbreak in the Democratic Republic of the Congo (DRC) prompted swift action, with the arrival of 99,100 doses of the JYNNEOS vaccine in early September 2024. This critical shipment, facilitated by Africa CDC and UNICEF, marked the beginning of a large-scale vaccination campaign aimed at curbing the spread of the virus. The DRC’s Minister of Health, Samuel Roger Kamba, alongside key officials from Africa CDC and UNICEF, emphasized the importance of this milestone in protecting vulnerable populations, especially frontline health workers. The vaccines are seen as a crucial tool in the fight against the escalating epidemic, which has already resulted in thousands of cases and hundreds of deaths this year.

The JYNNEOS vaccine rollout follows Africa CDC's declaration of Mpox as a Public Health Emergency of Continental Security (PHECS) in August 2024. The vaccination campaign is part of a broader effort by the DRC Ministry of Health and international partners to mitigate the crisis, with a focus on protecting children and high-risk groups. By mid-September, the DRC is expected to have received a total of 200,000 vaccine doses. These actions underscore the commitment of African and international health organizations to control the outbreak and safeguard the health of communities across the country.

Read more from UNICEF Democratic Republic of the Congo Humanitarian Situation Report No. 2 (Mpox) of September - October 2024 on this link .
 

In the past 24 hours, Uganda has confirmed 11 new Mpox cases, bringing the total to 164 cases since the outbreak began, with a case fatality ratio (CFR) of 0.6%. Among the confirmed cases, 13 patients are being moved to treatment units across districts including Nakaseke, Nakasongola, Kasese, and Wakiso. Tragically, one death has been recorded. Several districts, such as Adjumani, Kabale, and Mbarara, continue to host active admissions as health authorities ramp up efforts to control the outbreak. For further details, refer to the WHO Mpox Outbreak Situation Update from October 21, 2024.

Read more from WHO Mpox Outbreak in Uganda situation update of 21 October 2024 on this link . 

Read EAC calls for heightened public awareness to combat spread of Mpox on this link .

Rwanda has reported no new Marburg virus infections or deaths for nearly a week, according to the country’s health minister.

Speaking to reporters in Kigali, Health Minister Sabin Nsanzimana confirmed that there has been no "community transmission" of the virus. He emphasized that all positive cases so far have come from known contacts of infected individuals.

Nsanzimana highlighted that the last six days have seen no new cases or fatalities, attributing the control of the outbreak to the effective identification and isolation of those exposed. This, he noted, is crucial in halting the spread of haemorrhagic fevers like Marburg. See latest updates from Rwanda Ministry of Health on this link . 

On January 11, 2023, Uganda officially declared the end of the Ebola outbreak caused by the Sudan ebolavirus, following 42 consecutive days without any new cases since the last patient was discharged from care.

In total, there were 142 confirmed cases of Sudan virus disease (SVD), resulting in 55 deaths (a case fatality rate of 39%), while 87 individuals recovered. Additionally, 22 deaths were reported among probable cases, individuals who passed away before samples could be collected, bringing the overall case fatality rate to 47%. Among the affected were 19 healthcare workers, seven of whom tragically died.

The World Health Organization (WHO) reported that over 4,000 contacts were monitored for 21 days during the outbreak.

The virus spread across nine districts in Uganda, including Bunyangabu, Jinja, Kagadi, Kampala, Kassanda, Kyegegwa, Masaka, Mubende, and Wakiso.

Background

On 20 September 2022, the Ministry of Health in Uganda, together with WHO AFRO, confirmed an outbreak of SVD in Mubende District, Uganda, after one fatal case was confirmed. 

The index case was a 24-year-old man, a resident of Ngabano village of the Madudu sub-county in Mubende District. The patient experienced high fever, diarrhoea, abdominal pain, and began vomiting blood on 11 September 2022. Samples were collected on 17 September 2022 and SVD was laboratory-confirmed on 19 September. The patient died on the same day, five days after hospitalisation. 

This was the fifth SVD outbreak that occurred in Uganda.

What is Ebola?

Ebola virus disease (EVD) is a rare, severe, and often fatal illness in humans. The disease was first identified in 1976 during two simultaneous outbreaks in South Sudan and the Democratic Republic of the Congo, near the Ebola River, from which it takes its name. Ebola is caused by a virus from the Filoviridae family, which includes three genera: Cuevavirus, Marburgvirus, and Ebolavirus. There are six species of Ebolavirus: Zaire, Bundibugyo, Sudan, Taï Forest, Reston, and Bombali.

Transmission

Ebola is thought to be spread to humans from infected animals, particularly fruit bats, which are considered the natural hosts. The virus can also be transmitted through contact with blood, organs, or other bodily fluids from animals like chimpanzees, gorillas, monkeys, or forest antelopes. Human-to-human transmission occurs through direct contact with body fluids of infected individuals or contaminated objects, like clothing or bedding.

Health-care workers and individuals involved in burial ceremonies are at increased risk of infection. Ebola can also be sexually transmitted after recovery, and pregnant women may still carry the virus in breast milk or pregnancy-related fluids after recovery.

Symptoms

Ebola symptoms typically appear 2 to 21 days after exposure and begin with fever, fatigue, headache, and muscle pain. This progresses to vomiting, diarrhea, rashes, and both internal and external bleeding. People can only transmit the virus once symptoms develop, and those who recover may experience long-term symptoms such as joint pain, memory loss, and vision problems.

Diagnosis

Distinguishing Ebola from other diseases like malaria or typhoid fever can be difficult. Diagnosis is confirmed through methods such as:

Antibody-capture ELISA

Antigen-capture detection tests

RT-PCR assay

Electron microscopy

Virus isolation by cell culture

Treatment

Immediate medical care is essential for improving survival rates. Treatment includes fluids, pain management, and medications for secondary infections. An effective vaccine exists for the Zaire species of Ebola, and antibodies administered intravenously increase the chance of survival. Research continues on vaccines and treatments for other species of Ebola.

Prevention and Control

Preventive measures include regular handwashing, avoiding contact with body fluids of infected individuals, safe burial practices, and vaccination for those at risk of the Zaire Ebola species. Outbreak containment relies on a combination of case management, contact tracing, safe burials, and community engagement. Health-care workers must follow strict infection control measures to prevent transmission.

WHO Recommendations

WHO emphasizes the importance of raising awareness and following guidelines to reduce the risk of transmission. Laboratory samples should only be handled by trained professionals in properly equipped facilities. Health-care workers should use personal protective equipment and follow standard precautions at all times.

More details on this link .

The IGAD Climate Prediction and Applications Centre (ICPAC) has released its October to December 2024 seasonal forecast, revealing contrasting weather patterns across East Africa. Drier-than-normal conditions are expected in the eastern parts of the region, particularly in southern Ethiopia, Somalia, eastern Kenya, and central and southern Tanzania. These areas face increased risks of drought, which could exacerbate food insecurity and affect livelihoods. On the other hand, western parts, including northern Uganda, western Kenya, northern Tanzania, southern Burundi, and parts of Rwanda, are predicted to receive above-normal rainfall, likely boosting agricultural productivity and water availability.

This forecast highlights the urgent need for coordinated action to mitigate the impacts of these climate extremes. Warmer-than-average temperatures are also expected across the region, with the highest probabilities in eastern Tanzania, Kenya, and Ethiopia. In contrast, cooler conditions are anticipated in northern Tanzania and parts of Uganda, Kenya, and South Sudan. Experts, including IGAD's Executive Secretary Dr. Workneh Gebeyehu, stress the importance of early warning systems and preparedness efforts to address the region's food security challenges and build resilience against the growing threat of climate change.

Read more on this link . 

Burundi’s Ministry of Health declared a cholera outbreak on Wednesday, 6th September 2023, with 15 cases reported in the western part of the country, an area prone to water shortages.

Polycarpe Ndayizeye, spokesperson for the Ministry of Public Health and AIDS Control, confirmed that cholera patients had been admitted to hospitals and treatment centers in the municipality of Bujumbura. He called on authorities, residents of affected areas such as Bujumbura, Gatumba, and Rugombo, and all stakeholders to collaborate in combating the outbreak. Residents, especially those in impacted districts, were urged to strictly adhere to hygiene practices to help contain the disease.

Earlier this year, cholera claimed two lives in Bujumbura’s health district, notably at Kajaga beach on Lake Tanganyika. Water shortages, particularly during the dry season from May to September, exacerbate the risk of cholera outbreaks in Burundi’s western region.

Causative agent

Cholera is caused by the bacterium Vibrio cholerae. It produces a toxin that targets the intestines, leading to severe watery diarrhea and dehydration. According to the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), not all strains of V. cholerae cause illness; only specific toxin-producing strains are responsible for cholera outbreaks.

How cholera spreads

Cholera spreads through the consumption of contaminated food or water, particularly in areas with inadequate sanitation or limited access to clean water. The bacterium thrives in environments where drinking water, food, or sanitation is compromised, often after natural disasters or in densely populated areas.

Symptoms

Symptoms of cholera typically manifest within 2-5 days after exposure and include:

Profuse watery diarrhea (often described as “rice-water stools”)

Vomiting

Rapid dehydration

Muscle cramps

Severe thirst

If untreated, cholera can lead to shock and even death within hours due to the rapid loss of fluids.

Preventive measures

Preventing cholera requires addressing the core issues of water and sanitation. The WHO, Africa CDC, and US CDC recommend the following preventive actions:

Ensuring access to safe drinking water by boiling, treating with chlorine, or using bottled water

Proper disposal of human waste

Regular handwashing with soap, especially before eating and after using the bathroom

Safe food handling, including thoroughly cooking food and washing fruits and vegetables

Vaccination in high-risk areas, although vaccines alone are not a substitute for proper hygiene and sanitation practices

What to do if you get cholera

Immediate rehydration is crucial in treating cholera. The WHO recommends:

Drinking Oral Rehydration Salts (ORS) solution to replace lost fluids and electrolytes

Seeking medical care immediately if severe symptoms like frequent vomiting or extreme diarrhea occur

In severe cases, intravenous (IV) fluids may be necessary if oral hydration is insufficient

Treatment

Cholera treatment primarily focuses on rehydration. Antibiotics can also be prescribed in more severe cases to shorten the duration of the illness and reduce the volume of diarrhea. Zinc supplements are also recommended for children to aid recovery. Access to adequate treatment dramatically reduces cholera’s mortality rate to less than 1%, according to the WHO.

Regional impact

Burundi is not alone in facing cholera outbreaks. A recent update from the WHO African Region, as of August, 2023 reported cholera cases across 15 countries. Among the latest outbreaks, six countries—Burundi, Cameroon, Kenya, Mozambique, Uganda, and Zimbabwe—account for over 200 new cases. While the overall trend in the region is declining, WHO and other public health authorities urge countries to bolster surveillance, readiness, and community-based prevention measures, especially around border crossings to limit cross-border infections.

Read more here: Cholera in the WHO African Region

https://iris.who.int/bitstream/handle/10665/373305/AFRO-Cholerabulletin30.pdf