The Democratic Republic of Congo faces the largest mpox outbreak ever recorded, raising concerns about transmission, healthcare capacity, and regional risks. Learn about the epidemic’s origins, spread, and global implications.
The Democratic Republic of Congo (DRC) is grappling with the largest outbreak of mpox, formerly known as monkeypox, in recorded history. Declared an epidemic in December 2022, the viral disease has infected tens of thousands and continues to spread, with new transmission patterns raising alarm among health experts.
The current mpox epidemic began in May 2022 in the eastern Kwango province and has since expanded to 22 of the DRC’s 26 provinces, including the capital, Kinshasa. The epicenter of the outbreak remains in the eastern regions, particularly in the mining town of Kamituga in South Kivu province, where a new strain of the virus has been identified.
Traditionally, mpox has been zoonotic, transmitted from animals to humans. However, this outbreak has seen a significant shift, with the virus spreading primarily through sexual contact. This new mode of transmission is particularly prevalent in Kamituga, where there is a large population of sex workers, many of whom face economic and health vulnerabilities.
As of June 2023, the World Health Organisation (WHO) reported over 21,000 cases and more than 1,000 deaths. In 2023 alone, 14,626 cases and 654 deaths were recorded, with children under five making up 39% of the cases and 62% of the deaths.
Mpox has two primary clades: Clade 1 and Clade 2. Clade 2, involved in the 2022 global outbreak, is less deadly, with a survival rate exceeding 99%. In contrast, Clade 1, predominant in the DRC and the cause of the current outbreak, is more severe, potentially fatal for up to 10% of those infected. The newly discovered strain in Kamituga is particularly concerning due to its novel sexual transmission route and atypical presentation of symptoms, primarily genital lesions, complicating diagnosis and tracking.
The DRC faces significant obstacles in managing the outbreak. Ongoing conflict in the eastern regions, limited healthcare resources, and inadequate testing facilities hinder effective response. Only two laboratories in Kinshasa and Goma are capable of testing, and only 18% of reported cases have been confirmed in labs. Additionally, there is a shortage of treatment kits and vaccines, crucial tools for containing the virus. Public awareness and compliance with isolation measures are low, exacerbated by the stigma surrounding sexually transmitted infections.
The DRC’s geographical position and porous borders with nine countries heighten the risk of regional spread. Neighboring countries like Rwanda, Burundi, Uganda, and Tanzania, as well as Zambia, Angola, the Republic of Congo, the Central African Republic, and South Sudan, face heightened risks due to frequent cross-border movements. Limited healthcare infrastructure in these countries further amplifies the threat of a wider epidemic.
The ongoing mpox outbreak in the DRC presents a complex public health challenge with significant regional and global implications. Addressing this crisis requires a multifaceted approach, including increased healthcare resources, enhanced public awareness, and international cooperation to prevent further spread. As history has shown with diseases like COVID-19, infectious outbreaks do not respect borders, and vigilance and preparedness are crucial to mitigating their impact.
International support, including vaccine donations and healthcare aid, is essential to help the DRC combat this outbreak. Global health organizations and neighboring countries must collaborate to enhance surveillance, provide medical supplies, and raise public awareness to contain the spread of mpox effectively.
