Sarah Bagheni had been suffering from a headache, fever, and unusual, itchy skin lesions for days, but she had no idea that her symptoms might be linked to mpox, part of a growing global health crisis. Living in the Bulengo displacement camp in eastern Congo with her husband, Sarah is among the many in the region unaware of the threat posed by mpox, especially in light of a new variant identified by scientists in eastern Congo.
This year, the alarming increase in mpox cases, including the newly identified strain, prompted the World Health Organization (WHO) to declare it a global health emergency. The new variant has already spread beyond the five African countries where it was first detected, with Sweden reporting its first case of the new strain a day after the WHO's announcement. Congo, a central African nation, has seen over 96% of the approximately 17,000 recorded mpox cases globally this year, along with around 500 deaths. However, the most vulnerable populations, such as those in displacement camps like Bulengo, seem largely unaware of the disease and the danger it poses.
Dr. Chris Beyrer, director of Duke University’s Global Health Institute, highlighted the significant challenges in stopping the mpox outbreak in eastern Congo. These challenges include ongoing conflict, illicit mining industries that draw sex workers, transient populations near borders, and deep-seated poverty. The global community, he said, missed several warning signs as mpox has been spreading in Congo and Nigeria since 2017. Although there are effective vaccines, treatments, and diagnostics for mpox, access in regions like eastern Congo remains extremely limited.
The situation in Congo is dire, with a large proportion of cases emerging from displacement camps. Dr. Pierre Olivier Ngadjole, health advisor in Congo for the international aid group Medair, reported that 70% of new mpox cases in the Goma area over the past two months were from displacement camps, with patients ranging from a month-old baby to a 90-year-old adult.
Sarah’s best hope for a diagnosis is at a government hospital two hours away, but this is an unlikely option given her previous amputations, which severely limit her mobility. Congo’s eastern region, home to over 5.5 million of the country’s seven million internally displaced people, is a humanitarian crisis with vast overcrowding and poor living conditions, exacerbating the spread of mpox.
Mpox, which originated in animals, has recently been spreading between people through close physical contact, including sexual contact. In severe cases, individuals develop lesions on the face, hands, arms, chest, and genitals. The new mpox strain, possibly more infectious, was first detected in a mining town in eastern Congo, leading to the country’s worst outbreak to date. Thirteen African countries have reported cases, with four of them, including Burundi, Kenya, Rwanda, and Uganda, linked to Congo's outbreak.
The outbreak is especially concerning due to its impact on young people in Congo. Children under 15 account for 70% of cases and 85% of deaths, a significant shift from the 2022 global outbreak, which primarily affected gay and bisexual men. The spread in Congo now appears to be more prevalent among heterosexual populations.
Despite the widespread nature of the outbreak across all 26 of Congo’s provinces, the country has yet to receive any vaccine doses. Health Minister Samuel-Roger Kamba has called for heightened vigilance from all Congolese. Dr. Rachel Maguru, head of the multi-epidemic center at Goma’s North Kivu provincial hospital, expressed concerns over the lack of drugs or established treatments for mpox. With the region already struggling to manage an influx of displaced people and other diseases like cholera, a larger mpox outbreak could have devastating consequences. Dr. Maguru also noted that for many displaced and impoverished people, basic survival needs like food and shelter take precedence over seeking treatment for mpox, complicating efforts to control the outbreak.