In the Democratic Republic of Congo (DRC), children are bearing the brunt of a rapidly escalating mpox outbreak, with new figures revealing a surge in infections and fatalities. The DRC is currently struggling to contain a more lethal strain of mpox, known as clade one, which has been spreading unchecked for many years. The World Health Organization (WHO) has reported alarming statistics, indicating that in 2023 alone, over 14,600 cases and 901 deaths occurred in the country, compared to 5,600 cases and 213 deaths in 2022.

Disturbingly, the data also underscores that children under 15 years old account for 65 percent of cases and 75 percent of deaths. These children are believed to contract the disease through transmission while playing with one another. "What we are seeing is an acceleration of an existing disease that has long been ignored," warns Dr. Rosamund Lewis, the WHO's technical lead for mpox. She further expresses concern that the outbreak has not yet reached its peak, and due to surveillance challenges, there may be a significant number of unreported cases.

The potential for mpox to spread beyond central Africa is causing mounting concerns. The virus has already infiltrated 23 out of 26 provinces in the DRC and is now gaining a foothold in major cities like Kinshasa, the capital. A Kinshasa-based doctor involved in the national response emphasizes the risk of adopting the clade one variant across borders, especially if more cities become infected. They state, "As long as the DRC continues to report cases, the world will not be safe."

Mpox has a long history in the DRC, with the first known human case detected in the northwest region in 1970. The disease initially resembled smallpox, which had been eradicated from the area due to a successful vaccination campaign. However, since the discontinuation of smallpox vaccinations over three decades ago, immunity to mpox has gradually decreased. Modeling from the Pasteur Institute in Paris demonstrates that mpox immunity dropped from around 85 percent in the early 1980s to 60 percent in 2012.

The shift in patterns of spread is causing alarm as mpox advances towards urban areas. Symptoms of mpox include fever, muscle aches, fatigue, swollen lymph nodes, and distinct skin lesions. Children have been particularly affected due to their vulnerability and close contact while playing. The lack of widespread vaccination campaigns and limited diagnostic facilities exacerbates the challenges of containment.

Efforts to educate communities about mpox symptoms and infection control have been initiated, but the vast size of the country and constrained resources pose significant obstacles. Accessing healthcare is difficult for many, especially those unable to afford fees or living far from medical facilities. This, coupled with underreporting and reliance on traditional medicine, contributes to mpox being underestimated and its spread unchecked.

The Kinshasa-based doctor emphasizes the need for a strong, coordinated response, coupled with sufficient funding, to control the outbreak within the DRC and safeguard the global community. The urgency to address the mpox crisis is underscored by the threat of the clade one strain spreading beyond central Africa. Comprehensive vaccination strategies and improved healthcare access, along with international support, are crucial in preventing further escalation and eventual containment of this deadly disease.