Doctors Without Borders Intervenes in Plague Outbreak in Congo

February 22, 2005, Kisangani – Two Doctors Without Borders/Médecins Sans Frontières (MSF) teams have been dispatched to the area around Buta in the northeast of the Democratic Republic of Congo (DRC) in response to an outbreak of pulmonary plague. An exploratory mission carried out between February 14 and 16 found 93 cases of the lethal disease in the Dingila health zone, which includes Zonia, Kana, and Mambenge.

Reports have indicated that the epicenter of the outbreak is in the town of Zobia, around 120 miles from the town of Buta. One MSF team will focus on Zobia, while the second will follow the main routes. This second team will identify and treat those that have recently fled Zobia due to violence and fear of contracting plague.

The disease is a form of plague that primarily attacks the lungs. While it is endemic to this region of the DRC, the current outbreak is unusual in the number of people affected. Pulmonary plague is virulent, spreading between humans through airborne transmission (such as coughs and sneezes) and is quickly fatal. The incubation period ranges from 24 to 72 hours and death through asphyxiation comes within one day.

“Plague is caused by the Yersinia Pestis bacteria and primarily affects wild animals such as rats,” says Alain Decoux, head of mission for MSF in the DRC. “Since transmission to humans often occurs due to bites from infected fleas, a commonly held belief is that the way to stop the spread is to exterminate the rat population. In fact this worsens the situation as it deprives the fleas of their blood supply, which means that they are more likely to seek out alternatives such as humans.”

Plague can easily be cured through a simple course of antibiotics, provided that the patient is found in time. But breaking the chain of transmission is difficult to accomplish because sufferers need to be strictly isolated during the period of their illness. “Doing so in severely underdeveloped areas, such as around Buta, is a major challenge,” says Decoux.

According to Decoux, “While plague is relatively easy to treat, the nature of the region affected makes the work of MSF much more difficult. The fact that Zobia is a diamond producing area results in a high level of insecurity. Clashes between forces in the area coming as recently as February 14 affect the MSF teams as well as causing the population to scatter widely. The result is that plague sufferers are hard to identify in time.”