The new and aggressive strain of the potentially deadly mpox virus is spreading rapidly among children in the Democratic Republic of Congo (DRC) and Burundi, with cases more than doubling since a public health emergency was declared in mid-August, Save the Children said.
The fast-moving clade 1b strain has disproportionately affected children in the DRC – the epicentre of the outbreak – and in Burundi, where they face severe health risks due to hunger, displacement, and limited healthcare. These two countries account for 92% of all mpox cases in Africa this year.
As of 3 November, cases among children in the DRC had increased by over 130% from about 11,300 suspected cases to 25,600, while in Burundi, mpox has risen from 89 confirmed child cases to around 1,100 since the World Health Organization (WHO) declared the outbreak a public health emergency of international concern on 14 August.
The overall risk to the population in the DRC and Burundi remains critically high but particularly to children who are nearly four times more likely to die from the new strain of mpox than adults. Malnourished children in areas with poor sanitation and limited healthcare lacking access to testing and vaccines, are at an even greater risk of contracting and succumbing to the virus.
Mpox causes fever, rash and lesions all over the body, severe headaches and fatigue. Some children develop respiratory problems and in severe cases, mpox can lead to sepsis, a life-threatening response to infection.
According to the Africa Centers for Disease Control and Prevention (CDC), the total number of suspected and confirmed mpox cases across Africa has surpassed 46,000 this year, with over 1,000 fatalities.
“Children are especially vulnerable to mpox—they explore by touch and taste, don’t always understand health guidance, and have weaker immune systems than adults. They need timely information to protect themselves, and parents need the support to get them immediate care if they fall ill. Addressing children’s anxieties and fears about the outbreak and disruptions to daily life is crucial. By promoting supportive prevention practices, we can help children feel secure and prevent any form of discrimination from taking root.”
While the global mpox epidemic in 2022 was curbed through targeted vaccinations for vulnerable groups, similar actions are urgently needed to stop the spread among high-risk communities, particularly in the DRC. This includes comprehensive testing and awareness-raising campaigns about mpox and the availability of vaccines.
Across the DRC, Save the Children is working with communities to disseminate accurate information and counter misinformation, both in person and through mass communication channels. In eastern DRC, our teams are providing medication and isolation tents, beds and bedding for health care centres, personal protective equipment (PPE) for health staff, and training leaders in engagement, communication, and community alert systems for identifying and reporting suspected cases.
In Burundi, Save the Children is working closely with the Ministry of Health and the Department of Emergency Response (COUSP) to strengthen the country’s health system and address the mpox outbreak. Efforts focus on reducing the spread of mpox, especially among vulnerable refugee populations, and enhancing local healthcare capacity to manage the outbreak effectively. Save the Children’s Emergency Health Unit has deployed additional specialists in clinical care, operations, and water and sanitation to work alongside Burundi’s Ministry of Health, ensuring resources and expertise are in place to contain the spread and protect at-risk communities.