Early this December, health officials in the Democratic Republic of the Congo (DRC) alerted the world to a mysterious flu-like illness that claimed the lives of dozens over the past few months. In light of these alarming reports, the World Health Organization (WHO) launched an investigation in collaboration with local health authorities.

On December 17, the DRC's health ministry confirmed that the cause of the illness was severe malaria, exacerbated by malnutrition. As reported by Reuters, the case count reached a staggering 592, with the initial cases dating back to October. However, the situation took a turn on December 19, when a man from the affected region succumbed to symptoms aligned with hemorrhagic fever. This distressing development raised concerns that malaria and malnutrition might not be the only health threats at play.

As of now, 37 deaths have been recorded in healthcare facilities, with an additional 44 deaths reported in local communities under investigation. The estimated death toll has fluctuated between 67 and 143.

Experts have weighed in on the complexities of diagnosing the ongoing health crisis. Benjamin Mordmüller, a leading researcher at Radboud University Medical Center in the Netherlands, remarked on the challenges health officials face. “At any point, about 50% of people in similar regions are carriers of malaria parasites without showing symptoms,” he explained. This complicates the process of identifying the exact cause of illness and mortality in this region, especially among children under 14, who have been most affected.

Data indicates that malaria is a significant public health concern in the DRC, with over 27 million infections and more than 24,000 deaths reported in 2022 alone. The endemic nature of malaria makes it a plausible, albeit not the only, cause of the current outbreak. In regions like Kwango province, many individuals carry malaria parasites yet remain asymptomatic due to varying levels of immunity.

Diagnosing malaria relies heavily on accurate testing, but in the rural Panzi health zone—a remote area requiring a grueling 48-hour journey from Kinshasa—laboratory facilities are severely lacking. The rainy season also complicates travel and increases the mosquito population, further heightening malaria transmission rates. “The rainfall during this season creates perfect conditions for mosquitoes to breed,” Mordmüller noted.

Compounding the issue, symptoms such as coughs and runny noses have been reported. While these symptoms can accompany malaria, they may also suggest the presence of another infection, potentially linked to the shortage of nutritional resources in the region. The interplay between malnutrition and malaria remains poorly understood, with one theory positing that malnutrition could either worsen malaria's impact or suppress its symptoms.

Food insecurity in the Kwango province has worsened significantly in recent months, partly attributed to climate change impacting agricultural yields. Reports from the WHO indicate a deteriorating nutritional landscape that has alarming implications for public health in the region.

Efforts to mitigate the crisis are underway, with medications and diagnostic tests being dispatched to the Panzi health zone. However, logistical challenges such as inadequate mobile and internet connectivity hinder effective communication and support. As the WHO’s Director-General noted, multiple diseases may be contributing to the health crisis, raising concerns about the potential for a yet-to-be-identified viral outbreak.

As the health situation in the DRC continues to develop, experts remain vigilant. The combination of malaria, possible viral infections, and ongoing malnutrition presents a multi-faceted challenge that requires urgent action. The international community watches closely, eager for a resolution to this tragic public health emergency.