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UNDIAGNOSED FATALITIES - DEMOCRATIC REPUBLIC OF THE CONGO: (BAS
CONGO), HEMORRHAGIC FEVER SUSPECTED, REQUEST FOR INFORMATION
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A ProMED-mail post
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International Society for Infectious Diseases
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Date: Mon 22 Jun 2009
Source: Agence Centrafrique Presse, Xiinhua News Agency report
[in French, trans. Mod.MPP, edited]
<http://www.acap-cf.info/RDC-Une-maladie-non-identifiee-tue-cinq-personnes-dans-la-province-du-Bas-Congo_a2364.html>
An unidentified disease killed 5 people in the province of Bas-Congo,
DRC [Democratic Republic of the Congo]
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5 people out of almost a dozen ill individuals have died within a few
days from an as yet unidentified disease in the village of Mangala,
located some 30 kilometers [19 mi] from the city of Boma, the capital
of the province of Bas-Congo [Kongo Central] in the west of the
Democratic Republic of the Congo (DRC).
The chief medical officer of the Boma health district, Dr Lawrence
Kiphunda Nlandu, who informed the press, reported that 5 cases, of
which only one has survived so far, a man of 35 years, have been
detected in the rural health zone of Boma Bungu, considered the
epicenter of the epidemic, while the other 5 cases were recorded in
the area of health Boma. He mentioned that 2 men, a woman, and a young
man of 14 years of age are currently hospitalized in a local medical
facility and a child of 4 years who succumbed to the disease
[referring to the 2nd cluster mentioned above].
Dr Kiphunda did not provide the incubation period of the disease,
however he mentioned that it is characterized by vomiting of blood
[hematemesis] accompanied by bloody diarrhea [melena or hematochezia]
and blood flow from the nostrils [epistaxis].
Pending assistance from the central government and external partners,
a regimen consisting of a combination of antibiotics, antacids, and
other tonics, as well as transfusion and rehydration was developed,
said the source, adding that samples of blood and stool have been sent
to the INRB (National Institute for Biomedical Research) in Kinshasa.
This disease, whose symptoms are similar to those seen with Ebola
haemorrhagic fever, has created a panic among the population of Boma.
In the DRC, Ebola haemorrhagic fever has already occurred in the
provinces of Equateur in 1976 and 1977 (West), in Bandundu in 1995
(West), in Orientale in 1999 and 2000 (Northeast), and in Kasai
Occidental in 2007 and 2008 (Center).
--
Communicated by:
ProMED-mail
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[The differential diagnosis for a hemorrhagic fever in the Democratic
Republic of the Congo (DRC) would include more "common" etiologies
such as leptospirosis, yellow fever, malaria, Crimean Congo
hemorrhagic fever and dengue hemorrhagic fever, among others.
The more "exotic" viral hemorrhagic fevers such as Ebola, Lassa &
Marburg, while they not been reported from the Bas Congo region of the
DRC, have been reported from elsewhere in the DRC, and from
neighboring Angola. During 2004-2005, there was a major epidemic of
Marburg hemorrhagic fever in Angola. Geographically Boma, DRC is just
at the border with Angola, and the outbreak of Marburg hemorrhagic
fever began in Uige, Angola, which is in the north of the country,
near to the border with the DRC. Outbreaks of Ebola hemorrhagic fever
have been reported in the DRC: in Kasai Occidental province in
2008-2009, in Equateur Province in 2008, in Kasai Occidental province
in 2007, in Bandundu Province (Kikwit) in 1995, in the then Haut Zaire
province (Tandala) 1977, and Equateur province (Yambuku) 1996.
Outbreaks of Marburg hemorrhagic fever have occurred in the DRC: in
Orientale (Watsa) in 2002, and in Orientale Province (Durba) in
1998-2000.
The newswire mentions that patients are being treated with a
"combination of antibiotics, antacids and other tonics, as well as
transfusion and rehydration" suggesting that possible bacterial
etiologies are being considered. More information on this outbreak
and results of epidemiologic and laboratory investigations would be
appreciated.
For a map of the Democratic Republic of the Congo, see
<http://www.lib.utexas.edu/maps/africa/congo_demrep_pol98.jpg>. For
the interactive HealthMap/ProMED-mail map showing Boma, DRC with links
to other recent outbreaks reported on ProMED-mail in neighboring
countries, see <http://healthmap.org/r/00uC>. - Mod.MPP]
[see also:
Ebola hemorrhagic fever - Congo DR (08): (KS), WHO 20090218.0668
Ebola hemorrhagic fever - Congo DR (07): (KS) 20090202.0462
Ebola hemorrhagic fever - Congo DR (06): (KS) 20090124.0315
Ebola hemorrhagic fever - Congo DR (05): (KS) 20090115.0173
Ebola hemorrhagic fever - Congo DR (04): (KS) 20090114.0159
Ebola hemorrhagic fever - Congo DR (03): (KS) 20090111.0113
Ebola hemorrhagic fever - Congo DR (02): (KS) 20090108.0082
Ebola hemorrhagic fever - Congo DR: (KS), WHO 20090102.0013
2008
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Ebola hemorrhagic fever - Congo DR (03): (KS) 20081231.4133
Ebola hemorrhagic fever - Congo DR: (KS), WHO 20081227.4086
Undiagnosed illness - Congo DR (02): (KS), Ebola conf. 20081225.4068
Undiagnosed illness - Congo DR: (Kasai) RFI 20081222.4027
Undiagnosed illness - Congo DR: Kasai Occ, Ebola susp, RFI 20081009.3200
Hemorrhagic fever, fatal - Congo DR: (KA), RFI 20080823.2630
Ebola hemorrhagic fever, suspected - Congo DR (02) 20080702.2017
Ebola hemorrhagic fever - Congo DR: susp., corr. 20080604.1790
Ebola hemorrhagic fever - Congo DR: susp., corr. 20080604.1789
Ebola hemorrhagic fever - Congo DR: susp. 20080603.1779
Hemorrhagic fever, fatal - Congo DR: (KA), RFI 20080823.2630
2007
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Ebola hemorrhagic fever - Congo DR (13): 20071121.3758
Ebola hemorrhagic fever - Congo DR 20070910.2996
Undiagnosed illness - Congo DR (Kasai Occidental): WHO, RFI 20070901.2882
Viral hemorrhagic fever - Congo DR (Kasai Occidental): susp. 20070829.2837
2006
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Ebola, primates - Congo Rep.: 20061208.3462
Ebola hemorrhagic fever - Congo DR: susp. 20060315.0806
2005
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Marburg hemorrhagic fever - Angola (54) 20051108.3269
Marburg Hemorrhagic fever - Angola: confirmed 20050322.0831
Undiagnosed hemorrhagic fever - Angola (05) 20050322.0827
Undiagnosed hemorrhagic fever - Angola: RFI 20050315.0751
2002
----
Marburg hemorrhagic fever - Congo, DR 20020322.3799
2001
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Viral hemorrhagic fever, suspected - Congo, DR (03) 20011210.2991
2000
----
Marburg hemorrhagic fever - Congo, DR (06) 20000331.0477
Marburg hemorrhagic fever - Congo, DR 20000212.0194
1999
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Marburg hemorrhagic fever - Congo, DR (04) 19991209.2137
Marburg hemorrhagic fever - Congo, DR 19990915.1641]
........................................mpp/mj/jw
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