WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 07: 10 - 16 February 2025
Data as reported by: 17:00; 16 February 2025
...
Democratic Republic
of the Congo
Unknown Disease
431 cases
53 Deaths
12.3% CFR
EVENT DESCRIPTION
On 13 February 2025, health authorities in the
Democratic Republic of the Congo reported a new
cluster of cases and deaths due to an unknown disease
in Bomate Village, Basankusu Health Zone, Équateur
Province, in the country’s northwest. This marks the
second cluster of cases and deaths from an unknown
disease in the province in less than a month.
The latest outbreak in Bomate Village was initially
reported to provincial health authorities on 9 February
2025. Initial reports indicated 32 cases with 20
community deaths, occurring between 30 January and
9 February 2025. As of 15 February 2025, ongoing
investigations and surveillance activities had identified
419 cases with 45 deaths (CFR 10.7%). The primary
clinical manifestations include fever, chills, headache,
myalgia, body aches, sweating, rhinorrhea, neck
stiffness, cough, vomiting, diarrhoea, and abdominal
cramps. Close to half of the deaths (48.9%, n=22)
occurred within 48 hours of symptom onset.
Specimens from thirteen cases, including 12 blood
samples from active cases and one swab from a
deceased individual, were collected and sent to the
National Institute of Biomedical Research (INRB) in
Kinshasa for analysis on 11 February 2025.
Test results
released on 13 February 2025, showed that all samples
were negative for Ebola and Marburg viruses by
polymerase chain reaction (PCR). Differential diagnosis
under investigation include malaria, viral haemorrhagic
fever, food or water poisoning, typhoid fever, and
meningitis.
This outbreak follows an earlier cluster of cases and
deaths reported to Équateur provincial health authorities
on 21 January 2025 from Boloko Village, Bolomba Health
Zone. Preliminary investigations traced the outbreak’s
origin to three community deaths among children
under five years old in Boloko Village between 10 and
13 January 2025. The affected children reportedly
developed fever, headache, diarrhoea, and fatigue,
which later progressed to haemorrhagic signs and
symptoms, including subconjunctival haemorrhage,
epistaxis, and haematemesis, before succumbing to the
illness. Reports indicate that the children had consumed
a bat carcass prior to onset of signs and symptom.
Between 15 and 22 January 2025, four additional deaths
occurred in the same village among children aged 5
to 18 years, all presenting with similar clinical features.
On 22 January 2025, during field investigation, an
additional fatal case with epidemiological links to the
previous deaths in Boloko Village was identified in a
nearby Village, Danda Village, along with four active
cases (three in Boloko and one in Danda). The active
cases were observed with signs and symptoms of fever,
vomiting, diarrhoea, fatigue, abdominal pain, myalgia,
and headache, with three showing haemorrhagic signs
such as epistaxis, haematemesis, and melena. By 27
January 2025, a total of 12 cases with 8 deaths, had
been reported in Boloko Village, which recorded 10
cases with 7 deaths, and Danda Village, which recorded
2 cases with 1 death.
On 22 January 2025, blood specimens collected from
the four active cases, as well as a post-mortem swab
from the deceased individual in Danda Village, were
tested at the Provincial Laboratory in Mbandaka using
GeneXpert. All samples return negative results for Ebola
virus. On 31 January 2025, further testing at the National
Institute of Biomedical Research (INRB) in Kinshasa
confirmed that all specimens were negative for Zaire
ebolavirus and Marburg virus by PCR.
As of 15 February 2025, a total of 431 cases with 53
deaths (CFR 12.2%) have been reported across the
two health zones in Équateur Province. Bolomba Health
Zone has recorded 12 cases with 8 deaths (CFR 66.7%)
while Basankusu Health Zone has recorded 419 cases
with 45 deaths (CFR 10.7%). The exact circumstances
of exposure have not yet been established in both
outbreaks. Additionally, no epidemiological links have
been established between the cases in the two affected
health zones. Metagenomic sequencing and additional
investigations are ongoing to determine the cause of
illness and deaths in the two health zones.
PUBLIC HEALTH ACTIONS
The outbreak has been officially notified to the national
level by the provincial health authorities. A joint meeting
involving local health authorities and partners was held to
assess the situation and plan response actions. A team
from the provincial level was dispatched to the affected
health zones to support investigation of the situation and
provide critical supplies.
With support from WHO and health partners some critical
medical supplies and commodities for case management,
laboratory testing, and infection prevention and control
are being dispatched to the affected health zones.
Case investigations and active case search are
ongoing in the affected areas, including in communities,
churches, and health facilities. Cases are being line
listed. Health teams, supported by WHO, are conducting
field investigations in Bomate, while 84 community health
workers have been briefed to enhance case detection
across multiple areas.
The investigation team has collected and shipped 18 samples from the two affected health zones for analysis, all of which
tested negative for Ebola and Marburg at INRB Kinshasa by PCR. Further laboratory investigation, including metagenomic
sequencing are ongoing.
Local health facilities in Basankusu and Ekoto are overwhelmed, only able to provide clinical services to the extent possible
to some of the patients. Isolation rooms have set up at Basankusu and Ekoto Health Centres to accommodate affected
individuals. Infection prevention and control measures include decontaminating isolation rooms and installing handwashing
stations at isolation sites to reduce transmission risk.
In Bolomba Health Zone, risk communication and community engagement efforts included multiple sensitization meetings
with leaders and residents of affected and neighbouring villages, as well as training sessions for community health workers on
active case search and surveillance reporting. In Basankusu Health Zone, awareness activities included community briefings,
advocacy with religious leaders, local radio broadcasts on preventive measures, and targeted discussions in villages to
promote early detection and care-seeking behaviour.
SITUATION INTERPRETATION
The situation in Équateur Province presents significant public health risk, with two clusters of an unknown disease causing
high morbidity and mortality. The overall case fatality ratio (12.2%), particularly high in Bolomba Health Zone (66.7%),
and the rapid disease progression raise concerns about a severe infectious or toxic agent. With Ebola and Marburg
ruled out, further laboratory testing is critical to identify the causative pathogen. The lack of clear epidemiological links
between the two health zones may suggest separate health events. The remote geography and limited healthcare
infrastructure exacerbate response challenges, with overwhelmed health facilities struggling to manage cases.
Despite ongoing response efforts, significant gaps remain, including limited laboratory capacity, unclear transmission
dynamics, and weak surveillance. Infection prevention measures, while initiated, may be inadequate if the disease is
highly transmissible. Strengthening case management, expanding epidemiological investigations, and enhancing risk
communication are essential. Urgent support is needed to reinforce health services, accelerate diagnostic testing, and
engage communities to prevent further transmission, improve early detection and reporting.
View/Open
OEW7-1016022025.pdf (3.843Mb)
https://iris.who.int/handle/10665/380529
