An unidentified illness is spreading across the Democratic Republic of the Congo (DRC), capturing the attention of healthcare professionals across the globe. There have been 406 recorded cases of the illness, which causes symptoms like body ache, fatigue, headache, fever, cough, and runny nose.

Undiagnosed disease – Democratic Republic of the Congo. World Health Organization. December 8, 2024.

Breathing issues and anemia occur as well. These symptoms may sound vague, but the illness has led to 31 deaths, the World Health Organization (WHO) reports. 

The unnamed disease largely affects children under 5 years of age, especially those who are malnourished. It seems to have cropped up in late October 2024 in the Panzi health zone in the Kwango Province of the DRC, an area described by the WHO as rural and remote, with limited access to food. 

Identifying the cause of the illness has proven challenging since the affected region is hard to get to by road and there isn’t much access to diagnostics in the far reaches of the DRC. According to Health Policy Watch, one of the causes of diagnostic delay comes down to “limited laboratory capacity means that samples have to be transported to the national reference laboratory in [the capital of] Kinshasa.”

Cullinan K. Still No Clarity About Mystery Disease in DRC, But All Severe Cases Are Malnourished. Health Policy Watch. September 12, 2024.

The journey between the capital city from the affected areas is nearly 500 miles and takes about 48 hours due to poor roads and rainy weather. 

The teams on the ground say that other diseases—acute pneumonia, influenza, COVID-19, measles, and malaria—are being looked at as “potential causal factors with malnutrition as a contributing factor.”

The DRC is no stranger to severe disease, with HIV, tuberculosis, malaria, ebola, mpox, and typhoid fever having gripped areas of the country.

CDC. CDC in the Democratic Republic of the Congo. November 8, 2024.

According to Voice of America, Norman Matara, MD, Secretary-General of the Southern African Association of Doctors for Human Rights, has been urging people living in the DRC to stay calm—and hygienic.

Mavhunga C. Doctors want urgent action on DRC’s yet-to-be identified case outbreak. Voice of America. December 6, 2024.

“We also encourage governments to strengthen their surveillance at ports of entries, so that unusual illnesses can be reported to health authorities. We also call for a coordinated approach led by the African CDC so that we can quickly identify this disease and prevent further loss of lives through a global outbreak,” Matara said.

Could this disease be the next COVID-19? 

Ashley L. Drews, MD, a system epidemiologist and Medical Director of Infection Prevention and Control at Houston Methodist Hospital, adds, “Until we know for sure what is causing this illness and how it is transmitted, it remains speculation as far as whether this could be the next COVID-19.” 

That said, Dr. Drews says the fact that case numbers are not exponential is cause for cautious optimism. David A. Schwartz, MD, MS Hyg, FCAP, a member at the College of American Pathologists,adds that a quick and accurate diagnosis is key right now in order to help guide isolation and create treatments or preventative aid, such as vaccines. 

What to tell patients

For patients who travel the globe (particularly the affected area) and are worried about what this disease may mean, Dr. Schwartz says there are protocols in place: “If the symptoms are similar to those producing the mystery disease in another country, the patient may be housed in a specially designed isolation unit in a tertiary care medical center where specialised laboratory testing for a wide variety of infectious agents can be rapidly performed, and where advanced treatment can be implemented in case symptoms become more severe or life-threatening.”

If physicians are not able to make a definitive diagnosis, then supportive care for the symptoms and signs of the disease should be given,” Dr. Drews says. “For example, transfusions can be given for severe and symptomatic anemia, and supplemental oxygen can be given for shortness of breath if oxygen levels are low.”