A mother holds her child suffering from mpox at the mpox isolation unit of the UNICEF-supported Kavumu Hospital in South Kivu province, Democratic Republic of the Congo (DRC), on July 23, 2024

Children's Health

Amid Mpox Surge, UNICEF Readies Response

August 16, 2024

A different, deadlier form of the virus formerly known as monkeypox is killing children in countries across Africa. As of mid-August, the number of confirmed cases was near 100,000. In the Democratic Republic of the Congo, the epicenter of the crisis, the outbreak is disproportionately impacting children — more than half of reported cases are children under age 15. The World Health Organization has declared a public health emergency of international concern. What UNICEF is doing to support containment and prevention efforts.

Public health emergency declared, children at highest risk of death

UNICEF is supporting the World Health Organization and other partners to help contain an outbreak of a form of mpox that is particularly dangerous for children.

So far, the majority of cases in children are being reported in the Democratic Republic of the Congo, with some cases being reported in neighboring countries Burundi, Kenya, Rwanda and Uganda.

Cases are also rising in Central African Republic (CAR), Cameroon, Chad, Nigeria, Cote d'Ivoire and Liberia. UNICEF staff across the West and Central Africa and Eastern and Southern Africa regions are on alert.

The WHO declared the outbreak a public health emergency of international concern on Aug. 14, echoing a similar statement by the Africa Centers for Disease Control and Prevention on Aug. 13.

Previous outbreaks categorized as public health emergencies of international concern: Ebola and COVID-19.

The DRC is the epicenter of the crisis, with children under age 15 representing 56 percent of mpox cases reported in the country. So far this year, 8,772 children have been infected and 463 have died.

One-year-old Gabriel joyfully plays with his mother Sarah outside their home in Kamanyola, South Kivu province, Democratic Republic of the Congo, on July 24, 2024. Gabriel survived mpox at the UNICEF-supported Kamanyola Hospital. — Gabriel, 1, who survived mpox, with his mother, Sarah, outside their home in Kamanyola, South Kivu province, DRC, on July 24, 2024. “Gabriel had a fever, then a rash appeared on his body three days later," Sarah said. "I went to a dispensary in my church, where the nurse referred me to Kamanyola Hospital for treatment. When he came out of the hospital, our house was disinfected.” © UNICEF/UNI624797/Benekire

The outbreak adds one more burden on children and families already living through ongoing conflict and displacement, cholera and polio outbreaks and malnutrition, UNICEF Regional Director for West and Central Africa Gilles Fagninou said.

“The evidence indicates that children, especially those malnourished or affected by other illnesses, are the most vulnerable to catching and dying from this strain of mpox," Fagninou said. "Protecting them must be the top priority.”

Children, especially those malnourished or affected by other illnesses, are the most vulnerable to catching and dying from this strain of mpox. Protecting them must be the top priority. — Gilles Fagninou, UNICEF Regional Director for West and Central Africa.

Mpox, previously called monkeypox, is a viral zoonotic disease — caused by a virus transmitted to humans from animals. It occurs primarily in tropical rainforest areas of Central and West Africa and is occasionally exported to other regions. Symptoms are similar to those that were seen in smallpox patients, though less severe.

As UNICEF and WHO point out in their joint flyer about the disease: Even though some people may be more at risk than others, it is important to remember that anyone, anywhere, can get monkeypox. Read the flyer.

Children suffer the highest mortality rate.

In making the declaration, WHO Director-General Tedros Adhanom Ghebreyesus said: "The emergence of a new clade of mpox, its rapid spread in eastern DRC, and the reporting of cases in several neighboring countries, are very worrying. On top of outbreaks of other mpox clades in DRC and other countries in Africa, it’s clear that a coordinated international response is needed to stop these outbreaks and save lives.”

A coordinated international response is needed to stop these outbreaks and save lives. — World Health Organization Director-General Tedros Adhanom Ghebreyesus

Medical experts are urging action to accelerate access to testing, vaccines and therapeutic drugs in affected areas. Public information campaigns are also needed to reduce stigma associated with the virus. All of these activities are part of UNICEF's mandate focused on children's health.

Children appear to be particularly susceptible to the new variant of the mpox virus that is driving this latest outbreak. The mpox outbreak in 2022 was largely among adults; the current outbreak is markedly different in that it is affecting large numbers of children.

Children who are malnourished or otherwise suffering from poor health, their immune systems compromised, are at greater risk of dying of diseases, including mpox.

Mpox is related to smallpox. Immunization against smallpox was discontinued after smallpox was eradicated in 1980. There are safe and effective vaccines that protect against mpox, but they have not been routinely given to children. UNICEF is currently collaborating with vaccine partners on an emergency vaccination strategy in response.

Innocent Murula, a UNICEF-supported community outreach worker, uses his megaphone to raise community awareness about mpox in Kamanyola, South Kivu province, DRC, on July 25, 2024. “We received training on how to fight this epidemic. We raise awareness in public places, especially markets, because that's where people gather,” Murula said. “The community is afraid and calls us as soon as they have symptoms, and we refer them to the hospital.” © UNICEF/UNI624801/Benekire

How UNICEF is responding to the mpox emergency

UNICEF is working in partnership with the WHO, Africa CDC and civil society organizations to prepare and implement a comprehensive response to the upsurge in mpox cases.

UNICEF DRC has been implementing preventative measures since early this year and is now working with government partners on a cross-sectoral response that includes:

risk communication and community engagement: establishing ways for communities to share information on infections and protection and safety measures, training community leaders and workers
infection prevention and control: enhancing capacities of hygienists, supporting household decontamination, providing hygiene supplies to health care facilities
medical and nutritional care: distributing emergency health kits to facilities handling mpox patients, installing tents to create additional treatment space, providing support to patients' families
mental health and psychosocial support: addressing stigma and discrimination
integrated outbreak analysis: improving data quality and availability, strengthening health systems
coordination: supporting information sharing with partners and evidence-based strategic plans

UNICEF is also collaborating on a three-phase vaccine response strategy with Gavi, the Vaccine Alliance and other partners.

“The current upsurge of mpox in parts of Africa ... is an emergency, not only for Africa, but for the entire globe," Dimie Ogoina, Chair of the emergency committee of independent experts behind the WHO's Aug. 14 declaration. "Mpox, originating in Africa, was neglected there, and later caused a global outbreak in 2022. It is time to act decisively to prevent history from repeating itself."

UNICEF in West and Central Africa urgently needs flexible emergency funding to address growing needs in the DRC, scale up preventative measures in other countries throughout the region and mitigate a catastrophic impact elsewhere.

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Learn more about mpox and how it threatens children.

Learn more about what UNICEF is doing for children in the Democratic Republic of the Congo.

TOP PHOTO: A mother holds her child, who is suffering from mpox, at UNICEF-supported Kavumu Hospital in South Kivu province, Democratic Republic of the Congo (DRC), on July 23, 2024. To deal with the recent surge in mpox cases, the hospital converted its cholera treatment center into an mpox patient isolation unit. With funding from USAID, UNICEF is supporting the hospital with medicines and also provided a tent to extend capacity. "Most patients are children under 15, and, unfortunately, these patients are also suffering from malnutrition," said Dr. Charles Masiya, head of the hospital. Despite all the support from UNICEF, Masiya added, "We are overwhelmed, and we majorly lack resources.” © UNICEF/UNI624806/Benekire

HOW TO HELP

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