TY - JOUR
T1 - Deciphering the etiology of the 2024 outbreak of undiagnosed febrile illness in Panzi, Democratic Republic of the Congo
AU - Wawina-Bokalanga, Tony
AU - Makangara-Cigolo, Jean-Claude
AU - Ola-Mpumbe, Rilia
AU - Lokilo, Emmanuel
AU - Mwakisenda-Tshakotsho, Francois
AU - Delphine, Mbonga
AU - Kahindo, Immaculee
AU - Tshonaka-Nkololo, Alphonse
AU - Vakaniaki, Emmanuel Hasivirwe
AU - Loman, Nicholas
AU - Houben, Sarah
AU - Lumembe-Numbi, Raphael
AU - Kinganda-Lusamaki, Eddy
AU - Ponga-Museme, Ange
AU - Mukota-Nungu, Yero
AU - Kumar, Anuj
AU - Meris, Matondo
AU - Wilkinson, Sam
AU - Colquhoun, Raquel
AU - Kenye, Kelly-Michel
AU - Akil-Bandali, Prince
AU - Amuri-Aziza, Adrienne
AU - Martinez, Gustavo Sganzerla
AU - Kelvin, David J.
AU - Dijkman, Ronald
AU - Hensley, Lisa E.
AU - Kasita, Cris
AU - Kafua-Wemba, Franck
AU - Mwamba, Dieudonne
AU - Subissi, Lorenzo
AU - Hoff, Nicole A.
AU - Peeters, Martine
AU - Rimoin, Anne W.
AU - Mokili, John L.
AU - Lunguya-Metila, Octavie
AU - Nkwembe, Edith
AU - Rambaut, Andrew
AU - Liesenborghs, Laurens
AU - Low, Nicola
AU - Kindrachuk, Jason
AU - Vercauteren, Koen
AU - Edwards, Robert
AU - Kelly, Jenna N.
AU - Mbala-Kingebeni, Placide
AU - Ahuka-Mundeke, Steve
AU - Mumba, Dieudonne
AU - Muyembe-Tamfum, Jean-Jacques
N1 - FTX: CC BY NC ND
© 2026. The Author(s).
PY - 2026/2/18
Y1 - 2026/2/18
N2 - In late 2024, an outbreak of over 400 cases of undiagnosed febrile illness, predominantly presenting as fever and cough, was reported in Panzi Health Zone, southwestern Democratic Republic of the Congo. Here we conducted an epidemiological and laboratory investigation to determine the etiology of the outbreak. Clinical data and specimens were prospectively collected from 108 individuals, of whom 59/108 (54.6%) were female. Children aged <5 years were the most affected (47/108, 43.5%); 14/32 (43.7%) were malnourished. Oro/nasopharyngeal swabs from 96/108 individuals were PCR tested; 26 blood samples were sequenced. Plasmodium falciparum was detected in 56/108 (51.8%) individuals. Co-infections were also detected, with influenza A(H1N1)pdm09 virus in 16/56 (28.6%) and severe acute respiratory syndrome coronavirus 2 in 10/56 (17.9%) individuals. No novel pathogens were detected via metagenomics. Our findings suggest that the outbreak was primarily associated with a surge in malaria cases, with concurrent viral respiratory infections. Increasing decentralized laboratory capacity and strengthening broader health systems remain crucial for faster outbreak detection and investigation.
AB - In late 2024, an outbreak of over 400 cases of undiagnosed febrile illness, predominantly presenting as fever and cough, was reported in Panzi Health Zone, southwestern Democratic Republic of the Congo. Here we conducted an epidemiological and laboratory investigation to determine the etiology of the outbreak. Clinical data and specimens were prospectively collected from 108 individuals, of whom 59/108 (54.6%) were female. Children aged <5 years were the most affected (47/108, 43.5%); 14/32 (43.7%) were malnourished. Oro/nasopharyngeal swabs from 96/108 individuals were PCR tested; 26 blood samples were sequenced. Plasmodium falciparum was detected in 56/108 (51.8%) individuals. Co-infections were also detected, with influenza A(H1N1)pdm09 virus in 16/56 (28.6%) and severe acute respiratory syndrome coronavirus 2 in 10/56 (17.9%) individuals. No novel pathogens were detected via metagenomics. Our findings suggest that the outbreak was primarily associated with a surge in malaria cases, with concurrent viral respiratory infections. Increasing decentralized laboratory capacity and strengthening broader health systems remain crucial for faster outbreak detection and investigation.
KW - Adolescent
KW - Adult
KW - COVID-19/epidemiology
KW - Child
KW - Child, Preschool
KW - Coinfection/epidemiology
KW - Democratic Republic of the Congo/epidemiology
KW - Disease Outbreaks
KW - Female
KW - Fever of Unknown Origin/epidemiology
KW - Fever/epidemiology
KW - Humans
KW - Infant
KW - Influenza A Virus, H1N1 Subtype/isolation & purification
KW - Malaria, Falciparum/epidemiology
KW - Malaria/epidemiology
KW - Male
KW - Middle Aged
KW - Plasmodium falciparum/isolation & purification
KW - SARS-CoV-2/isolation & purification
KW - Young Adult
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=itm_wosliteitg&SrcAuth=WosAPI&KeyUT=WOS:001694685300001&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.1038/s41591-026-04235-7
DO - 10.1038/s41591-026-04235-7
M3 - A1: Peer-reviewed journal articles
C2 - 41708925
SN - 1078-8956
VL - 32
SP - 1374
EP - 1382
JO - Nature Medicine
JF - Nature Medicine
IS - 4
ER -