United Nations agencies concerned by mpox spread in Congo’s refugee camps

World Health Organisation has declared the virus a global public health emergency

A woman who was cured of mpox shows her scars from the virus at a camp for internal displaced persons in Mudja, Democratic Republic of Congo. Photograph: Moise Kasereka/EPA

United Nations agencies have raised the alarm about the spread of mpox in Democratic Republic of Congo’s refugee camps where people are more susceptible to infection because of depleted immune systems and cramped living conditions.

The World Health Organisation (WHO) has declared mpox a global public health emergency, after an outbreak in the Democratic Republic of the Congo spread to neighbouring countries and a new form of the virus, clade Ib, triggered concerns about the speed of transmission.

More than seven million people are uprooted across Congo, which has one of the highest displacement levels in the world, including those fleeing internal conflicts and disasters and those arriving from Rwanda, Burundi and South Sudan.

The UN refugee agency, UNHCR, said that some 42 suspected mpox cases have so far been reported in refugee camps and transit centres in South Kivu, eastern Congo where there are nearly two million internally displaced people and refugees.

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“For those fleeing violence, implementing many of the mpox measures is a tremendous challenge,” Dr Allen Maina, Public Health Chief for UNHCR, told a press briefing. “They have no space to isolate when they develop symptoms of the disease,” he added, saying that infected individuals were opting to distance themselves from crowded shelters to sleep in the open to protect others.

Congo has had more than 18,000 suspected mpox cases and 615 deaths this year, according to the WHO.

Mpox, which causes flu-like symptoms and pus-filled lesions, is sexually transmitted but can also spread through close contact with an infected person.

While it is not clear yet if they are the new, seemingly more contagious clade Ib strain, WHO spokeswoman Margaret Harris said South Kivu is an area where this variant was mostly circulating.

"(People) are already very stressed, hungry, terrified, displaced. So there's an immunological deficit, an immunological weakness which makes them more likely to become ill with anything they get, including mpox," she said at the same press briefing. An unknown number of mpox cases, including among children, have also emerged in North Kivu displacement camps.

Dr Maina said the focus should be on disease prevention and improving camp conditions.

Spain will donate 500,000 doses of the mpox vaccine, or 20 per cent of its stockpile, to combat an outbreak of the disease in Africa, the Health Ministry said in a statement on Tuesday. It added that Madrid has urged the European Commission to propose that all EU member states donate 20 per cent of their respective stock of the vaccine.

“It makes no sense to stockpile vaccines where there is no problem, and now is the time to prove it,” the ministry said. Spain’s donation consists of 100,000 vials, enough to provide 500,000 doses.

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