"Undiagnosed" severe disease pseudo-outbreaks in Sub-Saharan Africa: a paradigm of syndemic events.

Several outbreaks of undiagnosed severe disease occurred in the Democratic Republic of Congo over the last year. Although this is not completely unusual, at least one of them raised an international concern until the determinants of the excess death were identified. Far from representing a real threat for people living in wealthy countries, most of these events are context related, and mainly due to a combination of poverty-related conditions, such as malnutrition, historic plagues like malaria, and vulnerability to common respiratory infections. Even though these syndemic events remain usually restricted to well defined geographical areas affected by poor resources, they merit attention since they represent an opportunity to improve health conditions in remote areas and a challenge to strengthen global preparedness against pandemic events.