Goma — About 15,000 suspected cases have been identified in DRC so far this year which has already surpassed the total number from 2023 [1] and the virus is spreading to other countries in Africa. Authorities, health workers and aid groups are racing against time to curb the spread of the deadly disease in a country already embroiled in a humanitarian crisis and with one of the most fragile healthcare systems in the world.
Both cases and deaths are more prevalent in children than adults, Save the Children said.
The rapid spread of the virus in DRC - which has reportedly about 90% of all cases - is putting a strain on an already fragile health system that is still reeling from past outbreaks of Ebola and COVID-19 and a scarcity of staff and medical supplies. In some health centres around Goma, patient intake is 4,000% higher than their capacity, Save the Children said.
Jacques, an epidemiologist and mpox expert with a Save the Children partner in South Kivu province, DRC, said:
"The worst case I've seen is that of a six-week-old baby who was just two weeks old when he contracted mpox and has now been in our care for four weeks. He got infected because hospital overcrowding meant he and his mother were forced to share a room with someone else who had the virus, which was undiagnosed at the time.
"He had rashes all over his body, his skin was starting to blacken, and he had a high fever. His parents were stunned by his condition and were scared he was dying."
Children are at higher risk than adults of contracting the virus, also known as Monkeypox, with 70% of DRC's 14,901 cases in children under 15 [2] [3], and 39% of cases in children under five [4], according to the World Health Organization (WHO).
Children in the DRC are also nearly four times more likely to die from mpox than adults, with WHO data showing that the case fatality ratio for children under the age of one is 8.6%, compared to 2.4% in people aged 15 and over. Of the deaths reported by May 2024, 62% were children under 5 years old, the same data shows.
The WHO will meet on Wednesday to discuss whether the mpox outbreak in Africa is a global public health emergency.
The latest mpox variant, clade 1b, was detected in DRC in September 2023 and has now been traced in neighbouring Rwanda, Uganda, Kenya, and Burundi.
The Africa Centre for Disease Control and Prevention (CDC) is also considering if the virus's rapid spread in DRC and across borders constitutes a public health emergency.
Mpox causes fever, rash and lesions all over the body, severe headaches and fatigue. Some children also develop respiratory problems and have difficulty swallowing, and are at higher risk for secondary bacterial infections. In severe cases, mpox can lead to sepsis, a life-threatening response to infection that requires immediate specialist medical attention.
Save the Children said the close resemblance of some of the signs and symptoms of mpox to other common childhood illnesses - such as scabies and chickenpox - might be leading to late recognition and treatment, contributing to transmission and worse outcomes due to delayed diagnosis and treatment.
Additionally caregivers have to fight socio-cultural stigma around the virus due to a widespread belief that it is spread only through sexual contact. In fact, the virus can spread by any skin-to-skin contact, airborne contact in proximity - like COVID-19 - and even from contaminated surfaces and objects such as bedding, clothing, and cooking utensils.
Greg Ramm, Save the Children Country Director in DRC, said:
"Children and families in the eastern DRC are in shock. Their lives have already been blighted by years of conflict, displacement, and some of the highest rates of hunger in the world. The health system is already collapsing under the strain of soaring rates of malnutrition, measles and cholera coupled with the residual impacts of past Ebola and COVID-19 outbreaks.
"To add a new deadly virus that is aggressively attacking children to the mix is a cruel stroke of fate. As we've seen time and again, it's the already disadvantaged children who are most at risk. Surrounding Goma in eastern DRC are three IDP camps where some 354,000 children are crammed into tents in unsanitary conditions, with limited access to clean water, healthcare and adequate nutrition. The deadly mpox can zip from tent to tent.
"With the humanitarian response in the country already woefully underfunded [6], this is the critical hour for international donors to step up to curb the spread of this disease, support health services and prevent more deaths of innocent people. We need to see a rapid ramp-up of vaccines and capacity increase to do this locally. We have just a few weeks before children go back to school - we must stop the spread now."
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In DRC, Save the Children is responding to the mpox outbreak in North Kivu and South Kivu through water, sanitation and health services support, including providing PPE and training leaders in engagement, communication, and community alert systems for identifying and reporting suspected cases.
Save the Children is also working with the national government in Burundi on a national response plan to the rising number of infections.
Save the Children has worked in DRC since 1994 to meet humanitarian needs linked to the arrival of refugees and the displacement of populations due to armed conflict in eastern provinces. Save the Children has scaled up its humanitarian response to support existing care systems, training local leaders and communities to prevent and respond to exploitation and abuse, and ensuring access to healthcare through mobile clinics. It is also helping children access basic education by building classrooms, training teachers, and distributing learning materials.
