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Democratic Republic of Congo is experiencing its largest outbreak of mpox


Mpox, previously known as monkeypox, is rare in the U.S., but the Democratic Republic of Congo is in the midst of its largest outbreak ever recorded, and most cases are in children. NPR's Gabrielle Emanuel reports.

GABRIELLE EMANUEL, BYLINE: Mpox cases typically pop up in remote villages deep in the rainforest. Placide Mbala-Kingebeni says it can take days to get to those communities. Often, his trip requires a short flight from the capital, then a boat or a car.

PLACIDE MBALA-KINGEBENI: It's sometime better to drive on a motorcycle because you find, like, big trees have fallen in the forest. Sometimes you have to dig under the trees.

EMANUEL: Mbala-Kingebeni is at the University of Kinshasa's medical school. He's been working on mpox for more than a decade, and he says something new is happening. His country is seeing a sharp rise in the number of suspected cases. This matters because the strain of mpox in the DRC is especially deadly, and almost 90% of the deaths this year have been in kids.

MBALA-KINGEBENI: Kids usually go to the forest to hunt small animals like small rodents, gambian rats, porcupine and so on.

EMANUEL: The virus then jumps from the animal to the kid. And the child can bring the virus home, where it continues to spread. Some cases are mild, others severe - fever and painful lesions.

ANNE RIMOIN: There is certainly a risk of dying from it or having long-term consequences.

EMANUEL: Anne Rimoin is an epidemiologist at UCLA. I caught her while she was at the airport in Kinshasa. She's been working with the national lab there to understand the outbreak. She says, in the DRC, there are no treatments, and there's no rapid test. That means 90% of cases are never confirmed.

RIMOIN: You're trying to parse out, well, is this mpox? Is this measles? Is this chickenpox? What is it exactly?

EMANUEL: So far this year, there are thousands of suspected mpox cases and hundreds of deaths. But in a country of a hundred million people, Rimoin says it still feels relatively rare, and people aren't panicking as much as they're concerned and perplexed.

RIMOIN: There are a lot of questions. Is this related to more virus circulating in animals? Is there some change in the virus that makes it more transmissible?

EMANUEL: But it's not just the spike in cases. There's another mpox mystery. The virus is appearing in places it's never been before. Jean Nachega is an epidemiologist at the University of Pittsburgh. He says mpox is showing up in cities and in the eastern part of the country.

JEAN NACHEGA: Where there is thousands of workers, working in this mining setting.

EMANUEL: He says some of those mine workers are getting mpox and so are the sex workers. The transmission here is worrisome because this deadlier strain of the virus is doing something new - it's spreading sexually.

NACHEGA: This population is highly mobile. It's just a matter of time, if nothing is done, that the transmission crossed the border in the African region and, again, globally,

EMANUEL: During the global outbreak that ended last year, vaccines were available in wealthier places like the U.S., Europe and Japan. Rosamund Lewis is with the World Health Organization.

ROSAMUND LEWIS: The vaccines themselves had not yet been licensed in the DRC or in Nigeria or any other African country.

EMANUEL: According to the WHO, there's very little data on how the vaccine would work in children and in a country with health issues like malnutrition. Lewis says, the good news is there's a lot of scientific expertise in the DRC, and the international community is beginning to pay attention to this expanding mpox outbreak.

Gabrielle Emanuel, NPR News. Transcript provided by NPR, Copyright NPR.

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