Global Alert and Response (GAR)

1999 - Suspected viral haemorrhagic fever in Democratic Republic of Congo - Update

05 May 1999

Disease Outbreak Reported

An outbreak has been reported in the Watsa zone, in the northeastern part of the country. Clinical features include fever, severe headache, lassitude, gastrointestinal bleeding and agitation, but according to the health care workers who have looked after many of the patients, haemorrhagic features are not the norm. Death has generally occurred 5-6 days after onset. The first cases are believed to have taken place in January 1999, however there are indications that since 1994, there have been multiple small outbreaks of apparently similar illness in the vicinity of Durba, hence the locally-used description of "Durba syndrome". Durba, the site of pit gold-mining operations, is situated about 20 km from Watsa. Up to 3 May, 68 cases have been recorded, with 63 deaths (case-fatality rate 93%). Most of the cases have occurred in gold miners, and a few in the general community. The chief medical officer of the zone was among the fatalities, but it seems that secondary spread to family contacts or health care workers has been a rare event.

Staff from the WHO Regional Office for Africa and a joint team from Médecins sans frontières (Belgium and the Netherlands) have arrived in the area. Clinical samples collected from 5 patients have been sent to a reference laboratory for diagnostic testing and an epidemiological investigation is under way. An isolation unit has been set up in Durba, and local health care personnel are being instructed in preventive and protective measures, as well as in case management. This report is preliminary, and updated information will be provided as soon as it becomes available.

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