Summarize this content to 2000 words in 6 paragraphs Goma, Democratic Republic of the Congo – Just four months after the World Health Organization (WHO) declared a global health emergency over mpox – which has overwhelmed health systems in Democratic Republic of the Congo this year – a new mystery flu-like illness that’s killed dozens of people has raised fears among many Congolese.
Forty-year-old Denise Kabeya lives in the Panzi area in DRC’s western Kwango province – where health authorities say most cases of the unknown disease have emerged since October.
That month, Kabeya’s 12-year-old daughter Diane fell ill.
“My beloved little one had headaches, runny nose, no appetite and was physically weak,” Kabeya told Al Jazeera by telephone. “I thought it was malaria and typhoid fever,” she shared, explaining that those diseases are endemic in the region.
When Diane developed a blocked nose, Kabeya hoped the worst was over and that she would make a speedy recovery, as was usually the case when she developed such symptoms. But the child complained about more aches and pains, and eventually passed away from her illness in late October.
Between October 24 and December 11, there were 514 cases of the undiagnosed disease reported in eight of the 30 health areas in Panzi health zone, according to figures from the local health authorities.
Earlier this week, the WHO, which has sent experts to the region to investigate the cause of the outbreak and help with the response, said more than 30 people had died in hospitals from the disease.
There were another 44 deaths recorded in remote communities in Panzi, Congolese Minister of Health Roger Kamba said last week.
Kamba said the outbreak was first reported in October, with the alert level raised to high at the end of November.
Most of the cases and deaths are in children under 14, national health authorities said, with children under five presenting with the majority of cases.
Because so little is known about this mystery disease, it is difficult to know why children are so vulnerable, experts said. Al Jazeera reached out to the WHO branch in the DRC for further details, but was told that investigations are still continuing to understand the reasons.
‘Rural and remote’
Speaking at a media conference last week, Kamba said that the disease is flu-like.
“Respiratory distress was noted in some children and some other people who died,” Kamba, said, noting that some patients were anaemic, which was the cause of some of the deaths linked to the disease.
Cases of severe malnutrition have aggravated the disease in some children, according to local sources in Panzi, information also corroborated by the national Ministry of Health.
“Symptoms are flu-like. Patients suffer from high fever, headaches, coughing, runny nose and aches and pains,” Serges Zenga, an attending physician in the Kenge health zone, near Panzi, told Al Jazeera.
This week, WHO Director-General Tedros Adhanom Ghebreyesus said laboratory samples from infected people were being collected and tested. So far, most of the samples had tested positive for malaria, he said, but added that it was possible more than one disease was involved.
Meanwhile, the remoteness of the epicentre of the outbreak, as well as a lack of infrastructure, was jeopardising the fight against the disease.
Teams of laboratory technicians, epidemiologists from the Health Ministry and some of the Congolese government’s partners, including the WHO, are already deployed in the field, with a view to identifying the disease and reinforcing efforts to combat it.
But located some 700km (435 miles) away from DRC’s capital, Kinshasa, the Panzi health zone is “rural and remote” and difficult to access, the WHO said – a feat made tougher by poor road conditions.
“We sent a team into the field. The team took two days to reach the area because the road is very bad in the rainy season,” Kamba said.
Additionally, rural Panzi lacks testing capacity, meaning that samples have to be taken to laboratories in Kikwit, more than 500km (310 miles) away.
The WHO said limited diagnostics in the region have delayed the identification of the underlying cause of the outbreak. However it added that its teams were helping with patient treatment, risk communication and engagement with the community as the health crisis continued.
Meanwhile, on the ground, medics say there are huge difficulties in caring for patients who are bedridden at Panzi hospital.
“We don’t have resuscitation kits such as oxygen condensers, we don’t have treatment centres and isolation facilities, and we don’t even have electricity; [there is] scarcity of communication tools and internet,” Dr Rufin Mukuwa, a doctor at the Panzi general referral hospital, told Al Jazeera.
Fears and calls for vigilance
Speaking to Al Jazeera by phone from Kenge, the capital of Kwango province, some residents said they feared the outbreak spreading from remote Panzi into their communities.
“We’re worried that the provincial authorities haven’t taken preventive measures to prevent this disease from spreading to other areas,” resident Emile Yimbu complained.
He called for the reinforcement of epidemiological surveillance measures to contain the disease within a well-defined zone, and lessen its consequences.
Prosper Kiswemba, a local councillor in Kenge, is also worried about how end-of-year travel plans in the region may affect the potential spread of the disease.
Kiswemba said hygienic measures such as temperature sampling and the installation of hand-washing stations along arterial roads leading to Panzi needed to be reinforced, lest the disease spread further.
Meanwhile, one local health expert who spoke to Al Jazeera on condition of anonymity, said they feared the disease may be zoonotic in origin.
Even though national and global health bodies have not announced any animal-related links, the expert said: “Most of the people I’ve interviewed personally admit to having been in contact with certain wild animals a few days before falling ill.”
To be safe, he said people should be cautioned about reducing contact with wild animals.
Another health crisis
As the mystery disease spreads, patients in Panzi health zone are also suffering from a number of other diseases, including typhoid fever and measles, doctors said.
The timing of this new outbreak has some local health facilities overwhelmed, a local medical source told Al Jazeera.
Mukuwa at Panzi general hospital, however, sees the outbreak as a worrying but surmountable challenge.
“We are receiving numerous cases, varying between 15 and 20 patients a day,” he said.
He sees some symptoms of the disease – like respiratory issues – as being similar to those of COVID-19, and said patients at the hospital are being treated according to the signs and symptoms they present with.
“For example, we use azithromycin, amoxicillin or spiramycin for respiratory complications. If patients come in with headaches, we use paracetamol to relieve them,” he explained.
This has brought some relief, he said, while investigations into the outbreak continue.
Two years ago, Panzi suffered an epidemic of typhoid fever. The area also has high levels of malnutrition and low vaccination coverage, meaning children are vulnerable to a range of diseases, the WHO’s Tedros said this week.
This new disease comes as doctors in the DRC are still tackling the ongoing mpox epidemic, with at least 40,000 cases recorded and more than 1,000 deaths reported.
