Deadly disease spreading in Congo may be malaria: Can this common disease mutate and become so deadly?

Days after a mysterious disease that killed 50 people in Congo, health officials have said it could be malaria. The condition that is spreading in the northwest Democratic Republic of Congo could also be food poisoning, the officials have told news agency Reuters.
At least 943 people have also fallen sick and 52 died in Equateur province, with symptoms ranging from fever and fatigue to vomiting and weight loss, Dieudonne Mwamba, director general of the National Institute of Public Health, said. "For now, our diagnosis is malaria, and we also suspect food poisoning," Mwamba told Reuters.
" The Democratic Republic of the Congo is facing multiple public health and humanitarian crises. In its northwestern Équateur Province, two clusters of cases and deaths from an unknown disease have emerged, resulting in hundreds of cases and dozens of deaths," the World Health Organisation (WHO) had said in a report released on February 16.
The primary clinical manifestations include fever, chills, headache, myalgia, body aches, sweating, rhinorrhea, neck stiffness, cough, vomiting, diarrhoea, and abdominal cramps. Close to half of the deaths occurred within 48 hours of symptom onset.
The WHO report said that children had consumed a bat carcass prior to onset of signs and symptoms.
"There are five villages that are affected ... The diagnostic is more pointing toward malaria," Ngashi Ngongo from the Africa Centres for Disease Control and Prevention (Africa CDC) said in a press briefing via video link.
The World Health Organization said it was stepping up surveillance and will work with local health authorities to conduct further investigations.
The outbreak was identified on January 21, 2025. The samples were collected from a deceased individual in Danda Village, were tested at the Provincial Laboratory in Mbandaka using GeneXpert. All samples return negative results for Ebola virus. 10 days later, after further testing the specimens were negative for Zaire ebolavirus and Marburg virus by PCR.
Yes, malaria can mutate, and this ability plays a significant role in its survival and potential lethality. Malaria is caused by Plasmodium parasites, primarily Plasmodium falciparum, which is responsible for the most severe form of the disease. These parasites have evolved mechanisms to resist treatment and adapt to different environments, which makes them harder to control.
When malaria parasites are exposed to antimalarial drugs, they can undergo mutations in their genetic makeup, allowing them to develop resistance. For example, Plasmodium falciparum has shown resistance to chloroquine, artemisinin, and other antimalarial drugs over time. This resistance makes treatment less effective, leading to higher morbidity and mortality rates, especially in regions with limited access to healthcare.
In addition to drug resistance, the malaria parasite's ability to mutate helps it evade the immune system. It can alter its surface proteins, making it difficult for the body’s immune system to recognize and attack it effectively. These mutations contribute to the parasite's survival and enhance its ability to cause severe illness, which can lead to death, especially in vulnerable populations such as children, pregnant women, and immunocompromised individuals.