‘Disease X’ takes 31 lives in Congo: What we know about this virus

A mysterious virus, named Disease X, has spread across the Panzi health zone in Kwangi Province, Democratic Republic of Congo (DRC), resulting in 406 reported cases and 31 deaths between October 24 and December 5, 2024. The case fatality rate stands at 7.6 percent. Earlier reports from the World Health Organization (WHO) had indicated a range of 79 to 143 deaths, but this has since been updated to 31 confirmed fatalities. The disease manifests with flu-like symptoms, including fever, headache, runny nose, cough, and body aches. Among the 31 deaths, a significant number of victims are children, particularly those under the age of five.

The exact cause of the outbreak remains unknown, with the outbreak still ongoing. WHO is investigating several potential causes, including acute pneumonia (respiratory tract infection), influenza, Covid-19, measles, malaria and hemolytic uremic syndrome caused by E. coli. Malnutrition is also believed to be a contributing factor. The cases and fatalities may be linked to multiple coexisting diseases.

Disease X cases and where it has spread

Cases of Disease X have been reported in nine out of the 30 health areas in the Panzi health zone: Kahumbulu, Kambandambi, Kanzangi, Kasanji, Kiama, Mbanza Kipungu, Makitapanzi, Mwini Ngulu, and Tsakala Panzi. The majority of cases (95.8 percent) are concentrated in the Tsakala Panzi (169 cases), Makitapanzi (142 cases), and Kanzangi (78 cases) health areas.

In the Panzi health zone, children aged 0-14 years make up 64.3 percent of all reported cases. Within this group, children aged 0-59 months account for 53 percent, those aged 5-9 years represent 7.4 percent, and 10-14-year-olds account for 3.9 percent of cases. Females constitute 59.9 percent of the total cases. Among the 31 deaths, 71 percent are children under the age of 15, with 54.8 percent of the fatalities occurring in children under five. All severe cases have been reported to be malnourished. Among the 145 cases in individuals aged 15 and older, nine have died. Most deaths have occurred in village communities.

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What is Disease X?

Disease X is a term coined by the World Health Organization (WHO) in February 2018 to represent a hypothetical, unknown pathogen that could potentially cause a future epidemic. WHO uses this term for any unidentified infectious disease that has the potential to spread rapidly, leading to an epidemic or even a pandemic. At present, the outbreak of Disease X in the Democratic Republic of Congo (DRC) is considered a moderate threat at the national level, with low regional and global risk. However, these risk assessments may change as more information becomes available about the disease’s cause and spread.

What are the symptoms of Disease X?

According to WHO, common symptoms of Disease X include fever (96.5 percent), cough (87.9 percent), fatigue (60.9 percent), and a runny nose (57.8 percent). Apart from this, headache is also one of the common symptoms of it. In fatal cases, the primary symptoms include difficulty breathing, anemia, and signs of acute malnutrition.

What causes Disease X?

Disease X refers to a hypothetical illness caused by an unknown pathogen, or ‘pathogen X,’ that could lead to a pandemic or epidemic. The World Health Organization (WHO) uses this term to prepare for the emergence of new infectious agents that might cause widespread outbreaks. This pathogen could be any type of microorganism, including bacteria, viruses, parasites, fungi, or prions. Experts anticipate that Disease X would likely be a zoonotic disease—transmitted from animals to humans—and probably caused by an RNA virus, originating in areas with a high potential for sustained transmission, according to the Society for Healthcare Epidemiology of America.

What do we know so far about Disease X?

Disease X, a mysterious flu-like illness, emerged around the time when the risk of influenza transmission typically rises. The ongoing outbreak in Congo has claimed 31 lives and infected nearly 406 people. The situation remains concerning, particularly given the global impact of the COVID-19 pandemic, which recently forced widespread border closures and halted economic and social activities. The World Health Organization (WHO) warns that Disease X has the potential to trigger large outbreaks, epidemics, or even pandemics.