Deciphering the etiology of the 2024 outbreak of undiagnosed febrile illness in Panzi, Democratic Republic of the Congo
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.
Authors
- Jenna N. Kelly (ORCID: https://orcid.org/0000-0001-7265-2233)
- A. Rambaut
- Anuj Kumar (ORCID: https://orcid.org/0000-0002-8814-3625)
- Robert A. Edwards (ORCID: https://orcid.org/0000-0001-8383-8949)
- Samuel Wilkinson (ORCID: https://orcid.org/0000-0002-6944-5927)
- S Ahuka-Mundeke
- Raphaël Lumembe-Numbi
- John L. Mokili (ORCID: https://orcid.org/0000-0002-3461-580X)
- Edith Nkwembe
- Laurens Liesenborghs (ORCID: https://orcid.org/0000-0001-5616-8548)
- Octavie Lunguya-Metila
- Gustavo Sganzerla Martinez (ORCID: https://orcid.org/0000-0002-7656-0579)
- M. Peeters
- Sarah Houben
- Emmanuel Hasivirwe Vakaniaki (ORCID: https://orcid.org/0009-0006-0795-7157)
- Rilia Ola-Mpumbe
- Koen Vercauteren
- Ange Ponga-Museme
- Immaculée Kahindo
- Kelly-Michel Kenye
- Adrienne Amuri-Aziza
- Eddy Kinganda-Lusamaki
- Cris Kasita
- Lorenzo Subissi
- Jason Kindrachuk
- Franck Kafua-Wemba
- Nicole A Hoff
- Alphonse Tshonaka-Nkololo
- Matondo Meris
- Jean-Jacques Muyembe-Tamfum
- Ronald Dijkman
- Jean-Claude Makangara-Cigolo
- Emmanuel Lokilo
- Prince Akil-Bandali
- Anne W. Rimoin
- Mbonga Delphine
- Yero Mukota-Nungu
- Lisa E. Hensley
- Raquel Colquhoun
- Tony Wawina-Bokalanga
- David J. Kelvin
- Nicholas Loman
- François Mwakisenda-Tshakotsho
- Dieudonné Mwamba
- Placide Mbala-Kingebeni
- Dieudonné Mumba
Institutions
- University of Bern (CH)
- Ministry of Public Health (CD)
- Dalhousie University (CA)
- Inserm (FR)
- University of California, Los Angeles (US)
- Flinders University (AU)
- Université de Montpellier (FR)
- San Diego State University (US)
- Izaak Walton Killam Health Centre (CA)
- Federal Department of Home Affairs (CH)
- University of Kinshasa (CD)
- Center for Grain and Animal Health Research (US)
- World Health Organization (CH)
- National Institute of Biomedical Research (CD)
- Institute of Social and Preventive Medicine (CH)
- Institut de Recherche pour le Développement (FR)
- University of Manitoba (CA)
- Instituut voor Tropische Geneeskunde (BE)
- University of Birmingham (GB)
- University of Edinburgh (GB)
- KU Leuven (BE)
Publication Details
- Journal
- Nature Medicine
- Published
- 2026-02-18
- DOI
- https://doi.org/10.1038/s41591-026-04235-7
- Primary Topic
- Malaria Research and Control
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- U.S. Department of Defense
- U.S. Department of Agriculture
- University of Bern
- Institut de Recherche pour le Développement
- Australian Government
- Ministerul Cercetării, Inovării şi Digitalizării
- International Development Research Centre
- Research Nova Scotia
- National Institutes of Health
- Centers for Disease Control and Prevention
- Canadian Institutes of Health Research
- National Institute of Diabetes and Digestive and Kidney Diseases