Page 36 - Jan-March 2025

| TOPICAL TROPICAL

By: DICK STOCKLEY (The Surgery Uganda)

MYSTERY DISEASE IN CONGO
MYSTERY DISEASE IN CONGO

S I write in mid December this is the hottest are immunosuppressive conditions so both
Atrending subject in the world of tropical together could make them more susceptible to
disease. By the time you read it, the disease may severe illness from another infectious disease, that
have been long ago diagnosed, explained and is not causing deaths in well fed older children
tucked away as another outbreak in a remote part and adults. It may be a surprise that we can have
of Africa. No matter. It won’t be the last. Mystery mystery diseases that are still not diagnosed after
diseases still arise. It may take all the resources 2 months despite a full mobilisation of CDC and
of the specialists in WHO and CDC to get to the WHO. Surely modern medicine has lab tests that
bottom of them. It takes time, it’s complicated, and can tell us what’s wrong in just a few days?
will happen again.
Actually no. I can remember 2010 when an
This is from the WHO in December ...as of 5 unknown disease started causing deaths in
December 2024, Panzi health zone in Kwango districts around Gulu. CDC were quick to respond
Province has recorded 406 cases of an and began tracking down the deaths. The first
undiagnosed disease with symptoms of fever, cluster were in those who attended the funeral
headache, cough, runny nose and body ache and of the first case of Ebola so of course Ebola was
31 deaths (Case Fatality Ratio or CFR of 7.6%). uppermost in our minds. They tested everyone
It goes on to say that although 80% of the cases with fever and I remember my colleague in
tested positive for malaria, malaria alone could not Entebbe telling me that “all the 20 causes of fever
be responsible for the outbreak. All the reported you would expect” were prevalent in the district.
deaths were malnourished and almost all under Eventually they established that the outbreak
5. This is no surprise as in an area such as Kwango was due to yellow fever. It took 6 weeks: but I was
Congo, children are going to be bitten by an assured that in such circumstances this was a very
infected mosquito five or six times every night. quick result. In Congo the prevailing consensus
They have partial immunity: so although they at this time is the outbreak is a new flu-like illness
are constantly exposed, their immune system with many factors combining to cause deaths in
prevents them developing the full-blown disease. a vulnerable population. I also noted that it was
They will sometimes have enough parasites reported the first cases were diagnosed as” malaria
floating around to make a positive malaria rapid and typhoid”. These 2 “mystery outbreaks” 15
test but they are not sick. Malaria and malnutrition years apart tell us a lot about health care and the

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