A mysterious disease with Ebola-like symptoms has emerged in the Democratic Republic of the Congo. According to the World Health Organization, the disease was first detected on January 21, and over the past five weeks hundreds have been infected and more than 50 people have died in the northwest of the country. Health officials are yet to determine the cause of the disease.

Initial investigations suggest the outbreak began in the village of Boloko, where three children died within days of eating the carcass of a bat. The symptoms of the infected include fever, headache, diarrhea, nosebleeds, vomiting blood, and general bleeding—which match the symptoms caused by viruses such as Ebola and Marburg. However, experts have ruled out these pathogens after testing more than a dozen samples from suspected cases.

In early February, health authorities recorded a second cluster of cases and deaths in the village of Bomate, several hundred kilometers away, though there is currently no known link between the clusters. As of February 15, when the WHO last reported on the outbreak, a total of 431 suspected infections had been reported, including 53 deaths. In most cases, the interval between the onset of symptoms and death was only 48 hours.

Samples from 18 cases have been sent to the National Institute for Biomedical Research in the DRC’s capital, Kinshasa, testing negative for the most common pathogens linked to hemorrhagic fever symptoms, although some tested positive for malaria. “The exact cause remains unknown, with Ebola and Marburg already ruled out, raising concerns about a severe infectious or toxic agent,” the WHO wrote in its most recent bulletin on the outbreak, stressing the urgent need to accelerate laboratory investigations, improve the management and isolation of those infected, and increase surveillance and risk communication. “The remote location and weak health care infrastructure increase the risk of further spread, requiring immediate high-level intervention to contain the outbreak.”

Disease outbreaks caused by pathogens in animals transferring to humans—a process known as zoonotic spillover—are becoming more common in Africa. Changing land use and climate change are two major drivers, as they can both increase contact between humans and pathogen-harboring wildlife. According to estimates from the WHO, outbreaks of diseases transmitted from animals to people increased by 63 percent in Africa between 2012 and 2022. The continent has seen multiple outbreaks of mpox in recent years, as well as clusters of Ebola and Marburg cases.

Late last year, another mysterious illness killed more than 70 people in the southwest of the DRC, many of them children. Symptoms in that outbreak were flu-like, and most patient samples tested came back positive for malaria. The outbreak was later attributed to respiratory infections aggravated by malaria.

This story originally appeared on WIRED Italia and has been translated from Italian.

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