In Congo, the number of Mpox patients has been increasing for more than two years. Recently, the situation has worsened further in the past few months, with mutations that allow human-to-human transmission being observed. Additionally, there have been reports of suspected infections among refugees living in the conflict-prone North Kivu Province.
What exactly is happening in Congo? How is Médecins Sans Frontières (MSF) responding to this new emergency? Dr. Louis Albert Machin, the medical coordinator for MSF in Congo, shares his insights.
1. Infection Causes Rash and Pain
Originally, Mpox began to spread in Central Africa and West Africa in the 1970s. It then rapidly spread worldwide between 2022 and 2023, with cases confirmed in 110 countries so far.
When infected with Mpox, individuals develop rashes and pain. Supportive care is needed to properly address these symptoms and prevent further complications. Most cases can recover within a month with appropriate treatment. However, if left untreated, it can be fatal.
2. Surge in Patients in Congo
Mpox has been endemic in 11 of the 26 provinces in Congo for many years. However, the number of patients has surged dramatically in the past two years, leading the Congolese health authorities to declare an outbreak in December 2022. In 2023, there have already been over 14,600 suspected cases of infection, resulting in 654 deaths.
As of 2024, the situation has worsened further. Between January and mid-July, there have already been more than 12,300 suspected cases, covering 23 provinces. This year alone, over 479 people have died. According to the World Health Organization (WHO), the estimated number of Mpox deaths in 2022 was 89 globally, making this year particularly alarming.
3. Accelerating Spread of the Outbreak
In addition to this mutation, there is another worrying development: Mpox has been confirmed in refugee camps around Goma in North Kivu Province. This area is densely populated and poses a significant risk, especially as many people frequently cross the border into Congo. It is essential to be aware of the risk of an explosive spread of the Mpox outbreak.
Finding cases, monitoring patients, and providing treatment are necessary processes, but these are not sufficiently established in Congo. The lack of vaccines exacerbates the situation. In some areas, Mpox is perceived as divine revelation or witchcraft. In such cases, even if public health measures are implemented, people may not adhere to them. We need to enlist the cooperation of local leaders to change the awareness of the community.
MSF is mobilizing staff to protect people in high-risk areas through vaccination.
4. Urgent Need for Vaccine Supply
The Congolese government has already approved two types of vaccines. However, they are currently working to obtain these vaccines, and they are not yet available. Negotiations are being made with several countries, and regions where vaccines should be prioritized for distribution are being identified. We hope that a sufficient quantity of vaccines will be supplied to Congo as soon as possible.
5. MSF Provides Medical Assistance in Multiple Provinces
We have been conducting multiple aid activities in response to the Mpox outbreak in Congo. In 2021, we conducted emergency aid activities in the Mai-Ndombe Province, and between 2023 and 2024, we began emergency aid activities in the Equateur Province. We are expanding activities as the situation demands.
South Kivu Province
Since mid-June, a part of the MSF team has been providing support in the Ubiri health zone of South Kivu Province. They are treating severe cases at the general referral hospital, providing outpatient care for mild cases, and isolating patients suspected of infection.
Additionally, we are conducting clinical management training for medical staff and engaging in awareness-raising activities for infection prevention. In just five weeks, we have treated over 420 patients, of which 217 were severe cases. We are also working on supplying treatment and sample collection kits to hospitals.
North Kivu Province
In Goma, North Kivu Province, we have initiated investigative activities for Mpox. We are conducting epidemiological surveillance to investigate, aggregate, and monitor the occurrence of the disease. Awareness-raising activities are also being carried out. Furthermore, we are working to ensure that local medical facilities can properly implement triage, isolation measures, and patient management.
Equateur Province and Sud-Ubangi Province
We have also begun activities in two regions in northwestern Congo: the Bikoro health zone in Equateur Province and the Budjala health zone in Sud-Ubangi Province. Both aid activities are expected to continue over the coming months.
In both regions, we will conduct training for medical staff on treatment methods for Mpox and mental health care. Additionally, we plan to engage in epidemiological surveillance, infection prevention measures, and community awareness activities. It is especially crucial to approach people who have previously been difficult to engage, such as persons with disabilities.
In Budjala, under MSF support, 329 patients received treatment from mid-June to mid-July. In Equateur Province, we will also collaborate with health authorities to conduct research aimed at deepening understanding of the virus’s dynamics and infectious disease control measures.
6. More Resources and Vaccines are Essential
Above all, vaccines are essential. There are many people in Congo living under conditions of high infection risk: residents of outbreak areas, healthcare workers, sex workers, and refugees in camps. To protect them, a sufficient supply of vaccines must be urgently delivered to Congo.