Congo's plague outbreak smaller than initially feared

Mar 2, 2005 (CIDRAP News) An outbreak of pneumonic plague in a lawless part of the Congo appears to be smaller and more geographically limited than was originally feared, according to recent reports.

Reports from the Ituri district in late February indicated at least 61 people had died and hundreds might have been sickened by pneumonic plague, the rarest form of the disease. Poor sanitation and close working conditions in the Zobia diamond mine, which employs 7,000 miners from throughout the region, were thought to have promoted the disease's spread.

Many miners fled the area upon learning of the outbreak. The World Health Organization (WHO), concerned that miners could spread the disease to other regions, sent a team on Feb 25 to begin intensive surveillance.

In a news release yesterday, the WHO said only four probable cases, including one death, and four suspected cases of pneumonic plague had been reported. A retrospective study of cases was ongoing. Thirty-four samples were being tested at the Institut de la Recherche Biomedicale in Kinshasa, the Congo's capital, and team members were following up 113 contacts in the region, the WHO said.

A Reuters story published Feb 28 carried conflicting numbers. Philippe Havet, emergency coordinator for Medecins Sans Frontieres (MSF), told Reuters that investigators had registered 61 new cases of plague, including one death. MSF, a nonprofit organization that was already working in the Ituri district, has created an isolation treatment center.

Havet and a WHO official quoted in the story agreed that the disease did not appear to be spreading very far.

"There were 15 new cases yesterday, but these people are limited to the mine, no further," Havet was quoted as saying. Aid agencies and others have searched for infected miners but report having found none so far, the story said.

Dr. Eric Bertherat, head of the WHO team, also said cases seemed to be restricted to the mine area, according to the report. He said the 61 fatal cases reported initially are being reexamined to confirm the cause of death.

"Although we are finding more cases in Zobia, it seems that, overall, there are less cases than the 400 we originally thought there were," he said.

Pneumonic plague often starts with cough, fever, and discomfort within 2 to 6 days of infection. People develop extreme difficulty breathing as their lungs fill with fluids and can die in as little as 48 hours. This form can spread from person to person via aerosolized bacteria, bypassing the usual route of flea bites or infective materials. But antibiotics can treat the disease and prevent a secondary outbreak.