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638 cases of plague recorded in 2022 in Ituri

Kinshasa, march 6th, 2023 (CPA).- 638 cases of plague, including 14 deaths, were recorded in 2022 in the province of Ituri, in the north-east of the Democratic Republic of Congo (DRC), according to a report by the epidemiological surveillance department of the general direction of the fight against the disease of the Ministry in charge of Public Health, Hygiene and Prevention, sent to CPA on Monday.

The lethality (mortality) rate of plague, which remains an endemic disease in Ituri, is 2.1%. Ituri is the only province in DRC to have recorded cases of plague in 2022. « The main focus of the plague outbreak in Ituri was the Rethy health zone with 625 cases, while three other cases were reported in the Aru health zone, » the report said.  The Rethy outbreak was functional throughout the year. It is an area located at altitude (over 2,000 m).

From 2020 to 2022, 10 health zones in Ituri reported plague cases. These are the health zones of Biringi, Rethy, Aru, Aungba, Linga, Logo, Rimba, Kambala, Fataki and Drodro.

DRC experienced plague outbreaks in 2005 in Banga in Bas-Uele province, in 2006 in Wamba in Haut-Uele province and in Linga and Rethy in Ituri, in 2007 in Rimba in Ituri and in 2014 in Logo and Mahagi in Ituri.

Plague is a bacterial zoonosis caused by Yersinia pestis, usually found in small mammals and the fleas that parasitise them. People infected with Y. pestis often show symptoms after an incubation period of 1-7 days. There are 2 main clinical forms: bubonic plague and pneumonic plague. The former is the most common and is characterised by a painful swelling of the lymph nodes, the « buboes ».

Plague is transmitted from animals to humans by the bite of infected fleas, by direct contact with infected tissue and by inhalation of infected respiratory droplets. Plague can be very serious in humans, with a case-fatality rate of 30% to 60% for the bubonic form and is almost always fatal in the pulmonary form if left untreated.

Antibiotic treatment is effective against the plague bacteria, so early diagnosis and treatment can save lives.

According to the WHO, from 2010 to 2015, there were 3,248 cases of plague worldwide, of which 584 were fatal. The top 3 endemic countries today are Madagascar, the Democratic Republic of Congo and Peru.

Throughout history, plague has been responsible for widespread pandemics with high mortality. Known as the « black death » in the 14th century, it caused over 50 million deaths in Europe. Nowadays, plague can be easily treated with antibiotics and is prevented by the application of standard precautions.

Infected individuals usually present with an acute fever and other non-specific systemic symptoms after an incubation period of 1-7 days (sudden onset fever, chills, headache, body aches, weakness, vomiting and nausea).

Bubonic plague is the most common form, caused by the bite of an infected flea. The bacillus, Y. pestis, enters the body when bitten, passes through the lymphatic system and reaches the nearest lymph node where it replicates. The result is an inflamed lymph node with painful tissue tension: the so-called « bubo ». In the advanced stage, the inflamed nodes eventually ulcerate and fester. Human-to-human transmission of bubonic plague is rare. Bubonic plague can progress and spread to the lungs; this is known as pneumonic plague, the most severe form of plague.

Pneumonic plague is the most virulent and also a rare form of the disease. The incubation period can be as short as 24 hours. In case of pneumonic plague, the person can transmit the disease to others through respiratory droplets. If not diagnosed and treated early, this form can be fatal. However, cure rates are high if detected and treated in time (within 24 hours of the onset of symptoms).


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