Congo mystery illness update
Scott McPherson
in influenza and infectious diseases
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It appears that we know as much about the Congo fever as we did before I took a Labor Day break.
From the WHO:
31 August 2007
An outbreak of an unknown illness with a high mortality has been reported from the province of Kasai Occidental, in the Democratic Republic of the Congo. The exact number of cases and deaths is unknown at this time. The clinical features in the majority of cases include fever, headache, diarrhoea or colicky abdominal pain, and vomiting. Over 50% of cases have been in children under 10 years of age.
An investigation team from the Provincial and National Health Ministries, the Institut National de Recherches Biologiques (INRB) and WHO is in the field, and has taken clinical samples for laboratory testing. WHO is mobilizing support for the epidemiological investigation and logistics, including supplies, and water and sanitation and technical partners in the Global Outbreak Alert and Response Network (GOARN) have offered to provide support to the MoH if required.
At the present time, the etiological agent is unknown but the national health authorities have taken a precautionary approach and are implementing measures to improve hygiene, ensure the safety of the water supply, promote safe burial practices and strengthen infection control.
What is noticeably missing from this report is the word "hemorrhagic". Clearly, world public health organizations are rushing reinforcements into the area. But not too quickly, I reckon. From the BBC, and note the victims include medical staff:
More than 100 people have died because of a fever epidemic in the centre of the Democratic Republic of the Congo, health officials say.
Many of the victims are people who have been in contact with the deceased, including medical staff, and who lack equipment to deal with the illness.
The latest victim was a nurse at a local hospital. She died on Thursday after taking care of infected patients.
Health officials say the medical staff had no masks and this put them at risk.
Speaking from Kananga, the capital of West Kasai region, Dr Jean-Constantin Kanow said the illness had first started three months ago, when chickens and pigs started dying - but now people were also affected. (bold mine).
The epidemic was affecting four villages: Kampungu, Makonono, Kaluamba and Mombo.
Funeral rites
Traditionally, people in DR Congo wash dead bodies by hand.
The doctor said that such funeral rites seemed to favour the transmission of the disease.
He said many people who attended the recent funeral of a local chief had also died of fever and dehydration.
The World Health Organisation has sent a team to take blood samples for analysis at laboratories specialising in haemorrhagic fever.
DR Congo's last major Ebola outbreak killed more than 200 people in 1995 in Kikwit, about 400km (249 miles) west of the current outbreak.
But health officials say it is too early to determine if this new epidemic outbreak is indeed a haemorrhagic fever.
Ebola is pretty easy to diagnose, once the lesions begin to form (photo at left). And medical experts in the region are well-trained to spot the disease. And well-motivated: they do not want to wind up like the medical workers who are now infected (and in at least one case, deceased) as a result of exposure to this mystery disease.
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