Neurologic Manifestations of the World Health Organization's List of Pandemic and Epidemic Diseases

53 Dead From Mystery Illness Linked To Congo Bat Meal

Health officials scramble to identify disease as cases surge to 431 in western region

A deadly unidentified illness has swept through northwestern Democratic Republic of Congo, claiming 53 lives and infecting 431 people as of February 15. Health authorities are racing to identify the mysterious disease that has spread rapidly through communities, with nearly half of the deaths occurring within just 48 hours of symptoms appearing.

The World Health Organization's Africa office has classified the outbreak as "a significant public health threat" as cases continue to multiply at an alarming rate. The swift progression from symptom onset to death has created urgency among health officials working to control the spread and determine the exact cause.

Tracing the origin

Preliminary investigations have linked the outbreak to three children who consumed bat meat in January and subsequently died. This initial transmission event appears to have sparked the wider outbreak, though researchers are still working to confirm the exact relationship between the bat consumption and the illness.

Health officials have already ruled out known threats such as Ebola and Marburg viruses, which have caused deadly outbreaks in the region previously. This elimination of familiar pathogens has complicated the response, as treatment protocols for known diseases cannot be immediately implemented.

The search for answers

The absence of a confirmed pathogen has created challenges for medical teams responding to the crisis. Without knowing the exact cause, developing targeted treatment approaches becomes difficult, and containment strategies must rely on broader infection control measures.

Laboratory samples have been collected from patients and are undergoing extensive testing both within Congo and at international reference laboratories. Scientists are utilizing advanced diagnostic technologies including genomic sequencing to identify the pathogen responsible for the outbreak.

Regional vulnerabilities

Northwestern Congo presents particular challenges for disease response. The region's remote location, limited healthcare infrastructure, and challenging transportation networks can hamper rapid response efforts. Many communities lack access to basic healthcare facilities, and the movement of patients to treatment centers often requires navigating difficult terrain.

The area has historically faced numerous disease outbreaks, with both endemic illnesses and emerging pathogens affecting populations with limited access to medical care. This current outbreak adds another layer of complexity to an already strained healthcare system.

Cultural factors at play

The consumption of bush meat, including bats, is common practice in many parts of Congo and neighboring countries. Bats serve as both a protein source and sometimes feature in traditional practices. This creates particular challenges for public health officials attempting to reduce exposure risks while remaining sensitive to local customs and food security needs.

Community education efforts must balance the need for immediate risk reduction with long-term sustainability and cultural respect. Simply advising communities to avoid certain traditional food sources without providing alternatives can prove ineffective or even counterproductive.

The broader threat

Zoonotic diseases—those that jump from animals to humans—represent one of the most significant public health concerns globally. Bats in particular serve as reservoirs for numerous pathogens, including coronaviruses, filoviruses like Ebola and Marburg, and various other disease-causing agents.

When human populations encroach on wildlife habitats or consume wild animals, the risk of pathogen spillover increases. Climate change and deforestation have exacerbated these interactions in many regions, including Central Africa, potentially leading to more frequent disease outbreaks.

Response mobilization

Health authorities have initiated emergency protocols to address the outbreak. These include establishing isolation facilities for patients, deploying rapid response teams to affected communities, and implementing enhanced surveillance to identify new cases quickly.

Contact tracing efforts are underway to identify individuals who may have been exposed to infected persons. This process helps contain further spread by ensuring potentially infected individuals are monitored and isolated if symptoms develop.

The WHO has provided technical support and resources to supplement local response capabilities. International partners are also contributing expertise, diagnostic capacity, and emergency supplies to support containment efforts.

Communication challenges

Public health messaging during outbreaks of unknown origin presents particular difficulties. Officials must provide clear, actionable guidance without causing undue panic, while also acknowledging the significant unknowns that exist.

Rural communities often rely on radio broadcasts, community meetings, and local leaders to receive health information. Ensuring these channels deliver accurate, culturally appropriate messages represents a critical component of the response effort.

Misinformation can spread rapidly during disease outbreaks, potentially undermining trust in health authorities and hampering containment efforts. Response teams must actively counter rumors and false information while building community confidence.

Previous outbreaks in the region

The Democratic Republic of Congo has experienced numerous disease outbreaks in recent decades. The country reported its first Ebola outbreak in 1976 and has since managed multiple recurrences of the disease, developing significant expertise in containment strategies.

In addition to viral hemorrhagic fevers, the country contends with endemic diseases including malaria, measles, cholera, and various neglected tropical diseases. Each new outbreak strains already limited resources and healthcare capacity.

The cumulative impact of repeated health emergencies has led to the development of specialized response systems, but has also created fatigue among both healthcare workers and affected communities.

Global health security implications

Outbreaks of novel or unidentified pathogens highlight vulnerabilities in global health security. The early stages of an outbreak represent a critical window for containment, before a disease can potentially spread beyond regional boundaries.

International cooperation in disease surveillance, laboratory diagnostics, and emergency response becomes essential when confronting unknown pathogens. The COVID-19 pandemic has underscored the importance of rapid information sharing and coordinated action when addressing emerging disease threats.

The current situation in Congo serves as a reminder that pandemic preparedness requires sustained investment in health systems, particularly in regions where zoonotic spillover events are more likely to occur.

The path forward

As laboratory investigations continue, health officials are focusing on immediate containment efforts while preparing for various scenarios based on potential causes. Clinical management protocols are being adapted as more information becomes available about the illness presentation and progression.

Community engagement remains paramount, with local leaders and traditional healers being integrated into response efforts. Their involvement helps ensure that intervention strategies respect cultural contexts while effectively reducing transmission risks.

Long-term solutions must address the underlying factors that contribute to zoonotic disease emergence, including sustainable alternatives to bush meat consumption, improved wildlife conservation efforts, and strengthened health surveillance systems.

While the exact nature of this illness remains to be determined, the response demonstrates both the challenges and the importance of early detection and rapid action when confronting emerging disease threats. The coming weeks will be critical in determining whether containment efforts succeed in limiting further spread of this mysterious and deadly illness.

Expert Reaction To Disease Outbreak Of Unknown Cause In The DRC

February 26, 2025

Scientists comment to an unknown disease breakout in the Democratic Republic of Congo (DRC). 

Dr Amanda Rojek, Senior Clinical Fellow, Pandemic Sciences Institute, University of Oxford, said:

"The exact cause of these outbreaks is unknown. While there might be one disease that explains all cases, we frequently see situations where there might be a mixture of more common illnesses contributing to case numbers. It is reassuring that tests for Ebola and Marburg virus – two viral haemorrhagic fevers with a high death rate – have returned negative so far.

"Investigations will now be underway to examine the cause of the outbreak – which could include infectious diseases, or diseases caused by exposures to toxic or contaminated substances. Local health care teams will also be trying to identify how cases might be linked to each other.

"The outbreak investigation team will be verifying reports of a bat being consumed by children who later died of their illness because this raises the possibility of a zoonotic disease – that is, a disease spread from animals to humans. However, rumours are often rife early during an outbreak, and so verification of this information is important.

"Scientific research has a crucial role to play in understanding an outbreak of this kind, to ensure that responses are evidence-based, and that national health agencies can make the best possible decisions.

"Support for local health care services will also be very important, because these outbreaks are occurring in a vulnerable area with poor healthcare infrastructure.

 

Dr Zania Stamataki, Associate Professor in Viral Immunology, University of Birmingham, said:

What do we know about the outbreak, potential causes, or modes of transmission?

"The symptoms shown in these infections are different to the alarming infection caused by severe malaria in the DRC in the end of last year, with patients reporting nose bleeds, vomiting blood and internal bleeding. The time from symptom onset to death is 48 hours, which is very alarming.

"We know that the patients tested negative for known haemorrhagic fever viruses such as Marburg and Ebola. Other haemorrhagic fever-causing pathogens are investigated.

"The modes of transmission are unknown. The authorities are also looking at culprits beyond infection, for example poisoning by a toxic agent.

How is the situation being controlled, Are we likely to see more cases in the coming days?

"It is possible that we will see more cases. The incidents are currently correctly treated like an outbreak of infection, but it is not known how infection is transmitted, which makes it more difficult to contain. The best way to contain the outbreak is to isolate patients and stop travel in affected regions to prevent transmission.

"Viral infections can remain silent in the body for days before we start showing any symptoms. This is called the virus "incubation period".  While infected, a person could feel well enough to travel and mix with others in social events, which aids transmission.

How likely is it that this disease will spread across borders, potentially into the UK?

"Infections know no borders and do not respect country lines. People travel and infections travel with them, either hitching a ride in a person or in animal carriers, so one cannot exclude spread outside of a country's borders. In the UK and in other countries we need to remain vigilant and watch for symptoms. Symptoms of a haemorrhagic fever-type disease should be reported to the UK Health Security Agency via a registered medical practitioner.  

Given the large number of deaths and rapid transmission how concerned should we be?

"This outbreak, as well as previous outbreaks in the DRC are of significance to the rest of the world and we need to keep a close eye and assist with diagnosis and treatment. The large number of deaths of children and young people may be worsened by malnutrition and pre-existing conditions like malaria, that could weaken the immune system.

Could the pathogen have come from a bat, and what might this tell us of the nature of the outbreak?

"There are reports of three children eating a dead bat, so people rightly ask if this outbreak could be due to a bat-related virus infection. It is unwise to seek contact with dead bats, given that they are natural reservoirs of deadly viruses. Bats carry many viruses that have previously jumped to infect humans and cause severe diseases, including viruses such as Ebola, Marburg, Nipah, Hendra severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory coronavirus (MERS-CoV) and SARS-CoV-2, which caused the COVID-19 pandemic. If the infection originated from a virus that came from a bat, this tells us that it is unlikely that we have pre-existing immunity to this new infection for humans, so we are unprotected, we suffer severe disease and even death. If the virus is similar to other viruses infecting humans, like the covid-causing virus was similar to some common cold coronaviruses, some people may stand a chance to show less severe symptoms and recover."

Dr Michael Head, Senior Research Fellow in Global Health, University of Southampton, said:

"At time of writing, there is a huge amount of uncertainty about this outbreak.

"Outbreaks like this will happen many times around the world.  Typically, such outbreaks are brought under control relatively quickly. However, here, it is concerning that we have hundreds of cases and over 50 deaths, with haemorrhagic-fever like symptoms widely reported among those cases.

"Tests have so far proven negative for Ebola and other similar viruses, but results are known for a relatively small number of cases. Tests are never 100% accurate, and it is likely that with increased testing, we will have a confirmed pathogen in some of those samples.

"The lack of healthcare infrastructure in the DRC means the public health response is more complicated.  However, the country has had mpox and Ebola outbreaks in recent, so they are experienced at addressing infectious disease epidemics."

Prof Paul Hunter, Professor in Medicine, University of East Anglia (UEA), said:

"This is another cluster of fatalities in one of the poorer African countries. These are not rare. We saw another such cluster in DRC last November/December time. That last one turned out to be malaria and the was likely more severe as a result of increased malnutrition.

"So far I am not aware of much information about the current problem other than it is in the northwest of the country there are apparently two separate clusters in the area.  The earlier cluster was reported in 21 January 2025 and is centred on Boloko Village in Bolomba Health District. The more recent cluster is in Bomate Village in Basankusu Health Zone and this was reported on the 9th February. No link is known between these two clusters. So far test results are negative foe Ebola and Marburg.

"The only other bit of information is that in the earlier cluster some of the children who died had apparently consumed bat carcasses. But the relevance of that is not yet known.

"What is causing these two clusters is not yet known or indeed whether the same thing is responsible for both. It is certainly possible that we have a similar issue to last autumn with malaria and malnutrition. But we need to wait the results of ongoing investigations to know the cause."

Declared interests

Dr Amanda Rojek "None"

Dr Michael Head "None"

Prof Paul Hunter "None"

For all other experts, no reply was received for our request for DOIs. 

Measles Death Of Unvaccinated Child In Texas Outbreak Is 1st Fatality In US In A Decade

An unvaccinated school-aged child in Texas has died of measles, the first death associated with an outbreak in the western part of the state that has infected more than 100 people.

Lubbock city spokesperson Lauren Adams confirmed the death to ABC News on Wednesday.

In a press release, the Texas Department of State Health Services (DSHS) said the child was hospitalized in the northwestern city of Lubbock last week and tested positive for measles.

MORE: Measles cases are rising in US as Texas outbreak grows. Should we be concerned?

As of Wednesday, 124 cases of measles have been confirmed associated with the outbreak, according to data from DSHS.

Almost all of the cases are in unvaccinated individuals or individuals whose vaccination status is unknown, and 18 people have been hospitalized so far, DSHS said.

A person's body is covered in a rash, measles in this undated stock photo.

Natalya Maisheva/Getty Images

Children and teenagers between ages 5 and 17 make up the majority of cases with 62, followed by 39 cases among children ages 4 and under.

The outbreak began in Gaines County, which has become the epicenter, with 80 cases confirmed among residents, according to DSHS.

The outbreak has since spread to several counties in the region and is "suspected" to have spread into New Mexico, according to New Mexico Department of Health (NMDOH). Nine cases have been confirmed in Lea County, which borders Texas. Of the nine cases, four are among children, according to NMDOH.

"This death underscores the real danger of measles -- it's a severe disease that can take lives despite being preventable with vaccination," said Dr. John Brownstein, an epidemiologist and ABC News contributor. "Every new case is a reminder of why vaccination is critical. Tragically, with an outbreak of this scale, a fatal case was not unexpected, especially among those unvaccinated. Given how contagious measles is, we anticipate more cases in the coming weeks."

Dr. Lara Johnson, a pediatrician for nearly two decades and the chief medical officer at Covenant Children's and Covenant Health, said she never expected to be working in the midst of a measles outbreak.

"This is the first time I've had any professional experience with a measles outbreak," Johnson told ABC News. "I saw one travel-related case when I was in medical school, very briefly, but at that time, back in around 2000, we really thought that we'd eradicated measles from the United States and didn't have any anticipation of seeing any outbreaks here."

MORE: MMR vaccine rates are lagging amid a rise in measles cases. Experts blame a discredited study.

Johnson says her health system has had about 20 unvaccinated patients hospitalized in this outbreak over the last several weeks. Most have been kids admitted due to difficulty breathing associated with pneumonia, but so far, they have not had cases of encephalitis, or inflammation of the brain.

Dr. Ari Brown, a pediatrician in Austin and spokesperson for the American Academy of Pediatrics, told ABC News, "We've been getting numerous calls at our office," about whether their kids and babies can get a measles shot early.

"I've seen measles, and it's horrible," Brown said. "Those kids are super sick, and you've seen it once, and you can't unsee it."

During Wednesday's Cabinet meeting, Health and & Human Services Secretary Robert F. Kennedy Jr. Responded to a question about the outbreak, saying the agency was following the cases in Texas.

Kennedy appeared to downplay the outbreak, noting there have been four outbreaks so far this year compared to 16 last year. However, the number of cases in Texas alone amounts to nearly half of the 285 cases confirmed in 2024.

"It's not unusual; we have measles outbreaks every year," he said.

Kennedy also claimed the reason the children were hospitalized was for quarantine purposes. Johnson said during a press conference on Wednesday that children are not hospitalized for quarantine.

The MMR vaccine for measles, mumps or rubella at Logan Square Health Center in Chicago in 2019.

Antonio Perez/Chicago Tribune/Tribune News Service via Getty Images, FILE

Measles is one of the most contagious diseases known to humans. Just one infected patient can spread measles up to nine out of 10 susceptible close contacts, according to the Centers for Disease Control and Prevention (CDC).

Health officials have been urging anyone who isn't vaccinated to receive the measles, mumps, rubella (MMR) vaccine.

The CDC currently recommends people receive two vaccine doses, the first at ages 12 to 15 months and the second between 4 and 6 years old. One dose is 93% effective, and two doses are 97% effective. Most vaccinated adults don't need a booster.

Measles was declared eliminated from the U.S. In 2000, due to the highly effective vaccination program, according to the CDC. However, vaccination rates have been lagging in recent years.

About 93% of kindergarteners nationwide received select routine childhood vaccines, including the MMR vaccine, for the 2022-23 school year, according to a November 2023 CDC report.

This is about the same as the previous school year, but lower than the 94% seen in the 2020-22021 school year and the 95% seen in the 2019-2020 school year, prior to the COVID-19 pandemic. The latter percentage had been the standard for about 10 years.

ABC News' Youri Benadjaoud and Dr. Jade Cobern contributed to this report.

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