DRC: Child Mpox Cases Surge 75-fold in Worst-Hit Province as Schools Restart this Week

Multimedia available here

KINSHASA, (Sept 02, 2024) – Cases of the potentially deadly mpox virus have skyrocketed about 75-fold in children and young people under the age of 19 in the most severely impacted province in the Democratic Republic of Congo so far this year, Save the Children said.

Health workers are racing to curb the spread of the virus as the new school term starts this week. At the same time, cases in the eastern province of South Kivu are spreading twice as fast in children as in the general population, according to Save the Children's analysis of provincial data for South Kivu from the DRC's Ministry of Health^[1][2]. 

With the delivery of vaccines to DRC and neighboring countries delayed, it is critical that the international community steps up funding so that schools can ensure they have adequate clean water, hygiene and sanitation measures for children in the next few weeks.  Many schools have no running water, disinfectant or soap – basic measures to prevent the spread of disease that can be contracted from contaminated surfaces and objects, Save the Children said.

Save the Children analysis of Ministry of Health data for South Kivu showed that 15 cases of mpox were recorded in the first four weeks of the year, compared to 1,192 cases in the four weeks between Jul 22 and Aug 18 among children and young people^[3]. 

The latest mpox variant, clade 1b, was detected in DRC in September 2023 and recently was found in neighboring countries and other parts of the world. The World Health Organization (WHO) declared the spread of the virus to be a public health emergency of international concern three weeks ago.

To date, about 90% of reported cases of mpox are in the DRC, where it has infected at least 18,000 people and led to 615 deaths, according to the WHO. South Kivu is the epicentre, with almost half (46%) of the country's new cases in the past four weeks (up to Aug 18), the highest of any province in the country. Of this, two-thirds of cases have been in children.

Julien Chabo Byake, Social Behavioural Change Communication Officer with Save the Children in South Kivu, is currently training communities to try to stop the spread of mpox through simple measures such as avoiding handshakes and other close contact with others. He is also working with health authorities to tackle misinformation and guide communities on how to seek proper medical treatment.

Health workers are having to fight socio-cultural stigma around the virus due to a widespread belief that it is spread through sexual contact. Additionally, people are reluctant to seek treatment for fear of isolation from their families and livelihoods. Some people have opted instead to seek help from traditional medicine practitioners or self-medication, which could be fatal.

Recalling a boy of 4 or 5 years old with mpox he met at the hospital, Byake said:

"We saw lesions and rashes covering his body. The child was crying frequently and only wanted to be held by his mother. He had a fever and appeared very exhausted. His mother told us he hadn't been eating, despite being offered his favourite foods, and was losing weight. His eyes were slightly red.

"She was deeply worried and initially thought the illness was due to witchcraft or some form of harm from others [...] There is a lot of misinformation in the community: some people believe this illness doesn't exist, others claim it originated in European labs to reduce the African population, while some think it's witchcraft or a god's punishment for sinners. "

He added that there is also a part of the community that does recognize mpox as a disease, like Ebola and cholera, both of which have also hugely impacted the country.

Greg Ramm, Save the Children Country Director in DRC, said:

"This country has borne the brunt of health crises before – from Ebola to cholera to measles. Enough is enough – this deadly new mpox strain should be the ultimate call for the world to commit to investing in disease control and prevention so that children and families do not suffer needlessly.

"It's high time children in the DRC stopped being another forgotten crisis. The world must also invest in long-term solutions, such as equitable access to vaccines and increased testing capacities."

Save the Children is calling for a substantial injection of funding to implement clean water, hygiene and sanitation facilities in schools and communities so that children can play and learn safely. The organization is also calling for support to increase awareness-raising activities in schools and in the wider community.  This would also help stave off other diseases rife in DRC, such as measles, which killed nearly 6,000 people last year according to MSF^[4].

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. The outbreak is exacerbating an already dire humanitarian crisis, with over 7 million people displaced, primarily due to conflict and a weakened health system.  

###

Notes to editors

[1] Save the Children analyzed provincial data for South Kivu from the DRC's Ministry of Health which showed a prevalence of 48 cases in the first four weeks of 2024 to 1,797 in the four weeks up to Aug 18 (epidemiological week 33) among all age groups. We have estimated cases among ages 0-19 by applying the age breakdown provided by the Ministry of Health for cases in South Kivu notified to the government to the wider suspected caseload in South Kivu which is somewhat larger. Save the Children applied this age disaggregation available for notified cases in South Kivu across the larger suspected case load week by week and estimated that there were 15 cases in the first four weeks of the year among the 0-19 age group, compared to 1,192 cases in the four weeks to Aug 18. Based on notified cases in South Kivu in August so far, currently over two-thirds are among children and young people aged up to 19.

[2] Among all age groups, cases of the virus (based on an analysis of notified cases in South Kivu) have increased around 35-fold in the same time period, suggesting a slower spread than just among the 0-19 age group. Government data on notified cases in South Kivu shows that the share of 0-19-year-olds affected has shown a clear upward trend across 2024.

[3] We have estimated cases among ages 0-19 by applying the age breakdown provided by the Ministry of Health for cases in South Kivu notified to the government to the wider suspected caseload in South Kivu which is larger week to week. Save the Children applied this age disaggregation available for notified cases in South Kivu across the larger suspected case load week by week and estimated that there were 15 cases in the first four weeks of the year among the 0-19 age group, compared to 1,192 cases in the four weeks to Aug 18. Based on notified cases in South Kivu in August so far, currently over two-thirds are among children and young people aged up to 19.

[4] According to a report by MSF: Why measles remains a mass killer in DR Congo - Democratic Republic of the Congo | ReliefWebi