What we do—and don't—know about the mysterious illness in the DRC
Option 3: A hemorrhagic fever like Ebola
If the outbreak is caused by a viral hemorrhagic fever like Ebola, which spreads from person to person via contact with infected bodily fluids, controlling it will require many more resources, including equipment allowing clinicians to provide intensive care-level treatment to patients while also protecting themselves. The response would also require a lot of people to conduct contact tracing and, if Ebola is the culprit, could involve vaccinating infected people's close contacts. Additionally, because these viruses spread from person to person, there would be a greater chance the infection could spread outside the region where it starts.
The hemorrhagic fever scenario would be more concerning. Between 2014 and 2016, Ebola killed 11,000 people across Guinea, Liberia and Sierra Leone in the largest outbreak of that infection on record; another large outbreak in the DRC led to nearly 2,300 deaths between 2018 and 2020. Multiple smaller outbreaks of related viruses sporadically erupt across the continent, including two active outbreaks in Tanzania and Uganda, the latter of which recently claimed the life of a four-year-old boy . Still, the toolkit for responding to these outbreaks has come a long way: new vaccines – which may soon include one being trialed in Uganda – have dramatically reduced the risk of death due to Ebola infection.
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Gathering information about what people ate, drank, and did before getting sick is a good way to generate ideas for what's causing any outbreak – and that effort is under way in the DRC. The first people involved in the outbreak had reportedly eaten meat from wild bats, which has raised some concern that a hemorrhagic fever virus, endemic in some of these creatures could be the cause of the outbreak.
More definitive information comes from testing samples from affected patients, along with samples from their food, water, and environment. Although it's unclear yet whether spillover caused the current outbreak, moments like this are reminders to Vora that the human threat to ecosystem health ultimately circles back to hurt us. Deforestation and conflict create more opportunities for people to interact with stressed, sickened animals, increasing the risk we'll share their diseases. 'We live in an interconnected world,' says Vora. 'The health of humans depends on the health of animals – and also, nature.'
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