The Democratic Republic of Congo (DRC) is facing a health crisis in the remote Panzi health zone in Kwango province, where an undiagnosed disease has infected more than 400 people and killed at least 31, mostly malnourished children under the age of five. The mystery “disease X”—which may or may not be a new disease—causes symptoms such as fever, headache, cough, runny nose, and body aches. The World Health Organization said at a press conference on Tuesday that 10 of the 12 samples tested positive for malariabut there may be more than one disease. The outbreak has raised serious questions about the DRC’s ability to effectively respond to health emergencies in isolated areas.
Accessing Panzira is a formidable challenge, with poor road infrastructure requiring a multi-day journey from Kinshasa, the nation’s capital. “This is a really far-fetched definition,” says Placide Mbala, head of virology and epidemiology at DRC’s National Institute of Biomedical Research. He explained that limited connectivity and delayed sample collection have hampered diagnostic efforts. The samples initially collected were not suitable for analysis, but a team from the DRC’s Ministry of Public Health has now collected higher quality samples, says team member Mbala.
A complex response hampered by uncertainty
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The DRC Ministry of Health, supported by the WHO and the African CDC, has deployed a multidisciplinary team to investigate and respond to the outbreak. But the delay in confirming a pathogen has complicated efforts to implement targeted interventions. “It’s hard to have a specific answer when you don’t know exactly what the pathogen is,” said Mbala. Instead, it has focused on isolating patients, communicating risks and taking general preventive measures while providing supportive care to affected individuals.
Although the deployment of health workers has improved the situation, delays in action have drawn criticism. Mbala emphasizes that the issue is not a lack of diagnostic capacity, but logistical challenges. He acknowledges that the outbreak also highlights systemic vulnerabilities, including vast geographic barriers, weak infrastructure and recurring violence, that plague DRC health crises.
ThankGod Ebenezer, founder of the African BioGenome Project research effort, emphasizes the critical link between animal and human health, particularly in the context of zoonotic diseases. He explained that most diseases affecting humans—including HIV/AIDS, SARS, and likely COVID—came from other animals, highlighting the importance of understanding genetic diversity to maintain biodiversity and prevent transmission.
“When it comes to disease X in the DRC, one thing we often forget is that most diseases come from animals. There is transmission from animals to humans. And what that means is that we often don’t make peace with nature,” says Ebenezer. He also stated that human interference with biodiversity creates vulnerabilities for animals. that allow diseases to spread to humans and that genomics can play a vital role in combating this. “We can use genomics and biodiversity genomics to maintain genetic diversity, transmission to avoid and ensure that we are not (invading) biodiversity conservation space,” he added.
Global support and local resilience
International organizations, including the WHO and the African Centers for Disease Control and Prevention, are playing a crucial role in logistics and field research. Their support has allowed resources to expand to Panzi, although uncertainty about the pathogen involved has limited the scope of support they can provide. Basic communication has also been a key element of the response, with local leaders urging calm and educating communities about preventative measures. “The Ministry of Health is working to understand the situation and has sent its best people to investigate,” says Mbala.
The DRC’s response is based on extensive experience managing outbreaks such as Ebola and mpox. Mbala expresses confidence that the country’s seasoned public health workers can leverage this expertise to quickly contain the outbreak. “If we include all the experienced people who have coordinated past responses, we should be able to manage that effectively,” he says.
American scientific He spoke with Mbala about the outbreak and the response. (The interview took place before the WHO confirmed that many of the samples had tested positive for malaria.)
(Following is an edited transcript of the interview.)
Can you provide an update on the current situation of Disease X in the Democratic Republic of the Congo?
The outbreak began in the remote Panzi health zone in southwestern DRC, an area difficult to reach due to poor roads and a lack of reliable communications. The region is strongly affected by malnutrition, and the population is weaker. Initial media reports put the death toll at more than 100, but our team’s initial investigation confirmed 27 deaths, 17 of which were children under the age of five.
What measures are currently in place to manage the outbreak?
The focus is on isolating affected patients, communicating risks and implementing general preventive measures. We are providing relief aid such as basic medicines and assistance to the affected population. After analyzing high-quality samples, we hope to adapt the answer more effectively.
Despite strong diagnostic capabilities for DRC, why has there been a delay in identifying the pathogen?
The delay stems from the remote location of the outbreak and the lack of clear initial information. It wasn’t until the media highlighted the issue that action was accelerated. It’s not a matter of not having diagnostic skills, it’s about quickly mobilizing teams to such isolated areas.
Has national and international attention improved the response?
Yes, the situation has improved significantly since the Ministry of Health deployed a multidisciplinary team to investigate. Delays in response can create a perception of impossibility, however, even when the real problem lies in logistical and bureaucratic obstacles.
How are international organizations such as the WHO and Africa’s CDC contributing to the response?
Their support has mainly been logistical, ensuring that research teams can reach the site and carry out fieldwork. But since the pathogen (has not been fully identified), it is difficult to provide targeted support beyond the management of general outbreaks.
What role does basic communication play in outbreak control?
Communication is critical. The Ministry of Health asks for calm and asks the public to remain calm as experts are investigating the situation. Educating local populations on preventive measures and maintaining trust are key components of the response.
From an epidemiological perspective, how does this outbreak compare to other disease outbreaks in the DRC?
The DRC faces frequent outbreaks due to its large size, difficult infrastructure and ecological conditions. Although this outbreak presents unique challenges, the country has extensive experience in responding to health crises. By leveraging this expertise, we are confident in our ability to quickly contain this outbreak.
Why do such outbreaks happen again and again in the DRC?
It is a combination of factors: geography, lack of infrastructure, malnutrition and weaknesses in the health system. In addition, insecurity in some regions complicates outbreak response and broader health interventions.
What are the next steps for having disease X?
Once we analyze the samples and understand the pathogen, we design a targeted response plan. In the meantime, our teams will continue to provide support and improve risk communication to effectively manage the situation.
