MPOX: Five Ways Children are More at Risk

Children are particularly vulnerable to the new strain of the deadly mpox virus that is spreading globally after being declared a public health emergency of international concern by the World Health Organization. 

The most recent data shows that about two-thirds of infections in the Democratic Republic of Congo (DRC) – which currently has about 90% of reported cases - are in people under the age of 15, with more than 321 children dying.

Here are five ways the virus is affecting children: 

1. Children are at higher risk than adults of contracting mpox - with 70% of DRC’s 14,901 cases in children under 15 – and nearly four times more likely to die from mpox than adults [1] [2]. WHO data shows 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. 
    
2. Transmission might be driven by children’s weaker immune systems and/or the fact that children might have more physical contact interactions through play and at school. The virus can spread by any skin-to-skin contact, airborne contact, and even from contaminated surfaces and objects such as bedding, clothing, and cooking utensils. 
    
3. Children may end up at higher risk due to the close resemblance of some of the signs and symptoms of mpox to other common childhood illnesses - such as scabies and chickenpox – leading to late recognition and treatment and delayed diagnosis and treatment.
    
4. Mpox causes fever, rash, and lesions all over the body, as well as severe headaches and fatigue. In severe cases, mpox can lead to sepsis, a life-threatening response to infection that requires immediate specialist medical attention. Some children also develop respiratory problems, have difficulty swallowing, and are at higher risk for secondary bacterial infections. 
    
5. With just a few weeks before children in many countries across the world go back to school, lockdowns or school closures to curb the spread of the virus will have a hugely detrimental impact on children’s learning.

Earlier this week, Save the Children said that newborn babies are contracting the virus in DRC’s overcrowded hospitals.

Dr Revati Phalkey, Global Director of Health and Nutrition at Save the Children, said: “It’s clear from the data: children are more at risk of both contracting and dying from mpox. We know from decades of experience that it is the most vulnerable children who will be worse off - like undernourished children and those living in crowded refugee camps with limited access to clean water, sanitation and hygiene.

"The World Health Organization has said this is an emergency of international concern. It is critical that authorities and donors ramp up control measures, especially efforts to get vaccines to those who need them, in order to save children’s lives."

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 collapsed health system.

Save the Children is also working with the national government in Burundi on a national response plan to the rising number of infections.

[1] CDC Mpox Rapid Risk Assessment (cdc.gov) 
[2] According to data from the National Mpox Working Group (SGI-Mpox), there have been 14,901 suspected cases with 511 deaths so far in 2024, already surpassing the total number of cases in 2023. The total number of M-pox cases in the DRC in 2023 was 14,626, with 654 deaths, according to data from the National Mpox Working Group (SGI-Mpox).