An unknown illness has killed more than 50 people in the Democratic Republic of Congo (DRC) since January 2025, with hundreds more infected. Health officials are racing to identify the cause as the disease continues to spread through remote villages in the northwestern Équateur province.
The latest outbreak began on January 21, with over 400 people reportedly infected and at least 53 dead as of February 16. According to the World Health Organization (WHO), this marks the second cluster of cases in the province in less than a month.
The first outbreak was traced to Boloko Village, where three children reportedly fell ill after eating a bat carcass. They developed symptoms that rapidly progressed to hemorrhagic signs, including bleeding from the eyes, nose bleeds, and vomiting blood, before dying within 48 hours.
The second, larger outbreak was reported on February 13 in Bomate village, resulting in 45 deaths among 419 cases. Symptoms in both outbreaks include fever, headache, chills, cough, diarrhea, and neck stiffness, with some victims developing hemorrhagic symptoms.
Health experts are particularly concerned about the rapid progression of the illness.
“That’s what’s really worrying,” Serge Ngalebato, medical director of Bikoro Hospital, said of the symptom-to-death time period.
Most victims have died within 48 hours of developing initial symptoms, making the disease particularly dangerous and challenging to treat in the remote region with limited healthcare infrastructure.
Laboratory tests on 12 blood samples from active cases and a swab from a deceased person have tested negative for Ebola and Marburg viruses, two deadly hemorrhagic fevers known to cause similar symptoms. Some samples have tested positive for malaria, but health officials believe another pathogen is responsible for the unusual symptoms and rapid progression.
“Further laboratory testing is critical to identify the causative pathogen,” the WHO reported.
Health authorities are investigating several potential causes, including other viral hemorrhagic fevers, food poisoning, typhoid, and meningitis. The connection to bat consumption in the initial cases has raised concerns about possible zoonotic transmission, as bats are known carriers of various viruses that can infect humans.
This outbreak follows another mystery illness that killed 79 people in December 2024 in the southwest region of the country. That outbreak was eventually attributed to acute respiratory infections complicated by malaria.
The current situation poses significant challenges for health responders. The affected villages are in remote areas with limited surveillance capacity and weak healthcare infrastructure. Access to diagnostic tools and medical supplies is restricted, making it difficult to identify the causative agent and provide appropriate care to patients.
The WHO and local health authorities have deployed rapid response teams to the affected areas to enhance surveillance, improve case management, and collect samples for further testing. Efforts to educate communities about prevention measures are also underway.
The DRC is simultaneously battling multiple health challenges, including an ongoing mpox outbreak and the aftermath of an Ebola outbreak. The country’s healthcare system is already stretched thin, with resources diverted to conflict areas in the eastern part of the country.
Health experts have noted a concerning trend in the region, with animal-to-human disease outbreaks in Africa increasing by more than 60% over the past decade. Climate change, deforestation, and human encroachment into wildlife habitats are believed to be contributing factors to this rise.
For now, local health workers continue to isolate suspected cases and provide supportive care while awaiting definitive answers about the nature of this mysterious and deadly illness.
