A mysterious disease that infected at least 592 people and killed over 140 has apparently been identified as an aggressive strain of malaria. The disease, emerged in Panzi, Democratic Republic of Congo, but seemed to also spread to other countries. And it was difficult to assess because of the remoteness of the area and the lack of laboratory equipment. Now, the Democratic Republic of Congo’s health ministry says the disease is an aggressive form of malaria.
Colorized electron micrograph showing malaria parasite (right, blue) attaching to a human red blood cell. The inset shows a detail of the attachment point at higher magnification. Credit: NIAID
A diagnosis delayed by isolation
The WHO coined the term “Disease X” in 2018 to raise awareness of the threat posed by unanticipated pathogens. Every time there’s a new, threatening, and unknown disease, it’s called “Disease X” until researchers figure out what it is.
In this case, influenza, COVID-19, malaria, and even a new pathogen were considered plausible. Last week, the World Health Organization (WHO) sent a team of epidemiologists and doctors to help. The team conducted investigations and collected samples from the patients.
The initial rapid tests came back positive for malaria, but the tests needed to be confirmed in laboratories. The closest labs with the required facilities were in the country’s capital, Kinsashasa.
The journey to Kinshasa is grueling. Poor infrastructure and dangerous conditions can stretch the trip to two or more days. For a region dealing with a potentially fatal disease, such delays can mean the difference between life and death.
Malaria remains one of the deadliest diseases in the world. The WHO’s World Malaria Report 2023 revealed a troubling surge: 11 million more cases in 2023 compared to 2022, bringing the total to 263 million cases globally. Deaths topped 597,000, with African children under five making up the majority of victims.
Several factors contribute to this spike. Pesticide resistance among mosquitoes — malaria’s primary carriers — has rendered traditional control methods less effective. Climate change has expanded mosquito habitats, allowing them to thrive in regions previously unaffected. Meanwhile, armed conflicts disrupt healthcare services, making it harder to diagnose and treat cases promptly.
In addition, malaria is notorious for its deceptive symptoms. Early signs like fever, chills, fatigue, and nausea can easily be mistaken for flu, gastroenteritis, or hepatitis. In aggressive strains, complications escalate quickly. Jaundice, severe anemia, organ failure, and even death can occur if the disease isn't caught early.
The tragedy of malaria is that it is both preventable and treatable. Anti-malarial drugs can cure the disease within two weeks if administered promptly. Early diagnosis is critical to preventing severe illness and death. In most urban centers, the tools for this exist. But in isolated regions like Panzi, reaching treatment in time is a gamble.
Vaccines can help
There is still good news, however. Two new vaccines — RTS,S and R21 — have been approved for use in children under five. These vaccines have shown promise in reducing severe malaria cases. The DRC began rolling out RTS,S in October 2023, a historic step toward curbing the disease’s deadly toll.
Reaching remote villages like Panzi remains a challenge. Thick jungle, lack of transportation, and the ongoing conflict make vaccine distribution a logistical nightmare. While urban centers are beginning to see the benefits of vaccination, remote communities are still left behind. For Panzi and villages like it, the promise of vaccines is still a distant hope.
Efforts to combat malaria must go beyond treatment and vaccination. Tackling the root causes — such as poverty, conflict, and the effects of climate change — is essential. Investment in better infrastructure, including roads and health facilities, can dramatically reduce response times in future outbreaks.
We've seen during the COVID-19 pandemic that diseases have no borders, and one pathogen in one country can affect the entire planet. Every outbreak, whether it’s an aggressive malaria strain or a new virus, tests the global health community’s preparedness.
Dr. Andrei Mihai is a geophysicist and founder of ZME Science. He has a Ph.D. in geophysics and archaeology and has completed courses from prestigious universities (with programs ranging from climate and astronomy to chemistry and geology). He is passionate about making research more accessible to everyone and communicating news and features to a broad audience.
