As the World Health Emergency has declared the recent outbreak of monkeypox (mpox) a public health emergency, children in the Democratic Republic of Congo (DRC) are among the most affected, with the country accounting for nearly all of the recorded cases this year.

The country has seen over 450 deaths, and approximately 75 percent of cases observed by medics involve children under the age of 10, according to the BBC. This high rate of infection among young children is largely due to their less developed immune systems.

Dr. Pierre-Oliver Ngadjole, from the charity Medair, told the BBC that overcrowded conditions in camps for those displaced due to regional conflict are contributing to the rapid spread of mpox. The virus spreads through close contact, and children in the camps frequently play together without observing social distancing measures. 

“You can also see in the households, they even spend the night in the same bed. You can find three, four, five children. The transmission is present on a daily basis,” Dr. Ngadjole explained.

At a clinic in Munigi, five to ten new cases of mpox are being admitted each day. Fortunately, there have been no deaths at this clinic, primarily because patients are seeking medical care in the early stages of the disease. However, at a hospital in Kavumu, which has treated 800 patients since June, there have been eight deaths, all involving children under five years old.

Many people in the DRC are currently displaced due to rebel groups operating in the eastern part of the country, forcing them to live in camps with poor sanitation, which has allowed mpox to spread. The recent outbreak in the country is linked to a strain called Clade 1, which is also spreading to neighboring countries.

The DRC currently lacks vaccines and is hoping to receive supplies from the US and Japan. However, even when vaccines arrive, distribution will be limited, and vaccination is just one method of controlling the outbreak.

“The [easiest] action to put in place is to improve the hygiene,” Dr. Ngadjole said. “When we improve the hygiene at household level, when we improve the hygiene at community level, it’s very easy to decrease the risk of transmission.”