Health authorities in the Democratic Republic of the Congo (DRC) are investigating a cluster of unexplained deaths in Ekoto Health Area, Basankusu Health Zone, Equateur Province. The initial report on 9 February 2025 documented 24 deaths in a single village, prompting an investigation supported by the World Health Organization (WHO). As of 25 February, a total of 53 deaths have been recorded, with the last occurring on 22 February.1
Epidemiological patterns suggest an unusual event, as initial fatalities disproportionately affected adolescent and young adult males. The rapid progression of illness, with a median time from symptom onset to death of one day, raises concerns about potential causes, including chemical poisoning or a bacterial meningitis outbreak, amid endemic diseases such as malaria.
Enhanced surveillance identified 1,318 individuals meeting a broad working case definition of fever plus one other symptom, reflecting the prevalence of various febrile illnesses in the region. Malaria testing among these suspected cases showed approximately 50% positivity, which is consistent with the region’s hyperendemic status.
Preliminary laboratory investigations ruled out Ebola and Marburg virus diseases. Further testing of blood, urine, and environmental samples, including water, is ongoing to explore possible chemical contamination, such as organophosphate poisoning.
This cluster follows a similar event in January 2025 in Bolomba Health Zone, also in Equateur Province, where 12 cases and eight deaths were recorded. Epidemiological investigations found no evidence linking the two incidents, which occurred approximately 175 kilometers apart in difficult-to-access terrain.
WHO assesses the public health risk to affected communities as moderate but considers national and global risks low. The remoteness of Basankusu, logistical challenges in sample transport, and the region’s lack of healthcare infrastructure hinder response efforts. Further investigations are needed to determine the cause and mitigate potential ongoing risks.
Reference
- Cluster of community deaths in Basankusu, Equateur- Democratic Republic of the Congo. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON557 (Date last accessed: 5th March 2025)
Disclosures: This article was created by the touchINFECTIOUS DISEASES team utilizing AI as an editorial tool (ChatGPT (GPT-4o) [Large language model]. https://chat.openai.com/chat.) The content was developed and edited by human editors. No funding was received in the publication of this article.
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