GENEVA — The United Nations Children’s Fund, or UNICEF, warned Friday that children in Burundi are bearing the brunt of the mpox outbreak, with cases of this deadly, infectious disease spreading at an alarming rate among a young population.

“Of the nearly 600 reported cases, two-thirds are in children under 19. The situation has escalated rapidly, with a more-than-40% increase in cases over the past three weeks,” Dr. Paul Ngwakum, UNICEF’s regional health adviser for Eastern and Southern Africa, told journalists in Geneva via video link Friday.

Ngwakum, who currently is on a visit to Burundi, said, “The fear expressed by the parents and the resilience of communities in the face of this public health crisis” and the rapid escalation of the disease “were striking.”

Speaking from the capital, Bujumbura, he said the rise of mpox among children under the age of 5 is of particular concern as they represent 30% of the reported cases. This, he said, underscores the urgent need for targeted interventions to protect children from becoming infected as schools have reopened this week.

“UNICEF is supporting the Ministry of Education to implement health measures in schools, train staff to recognize early symptoms of mpox and reinforce hand hygiene. We aim to ensure that all children can safely return to school and minimize educational disruptions,” he said, noting that this was “a rapidly evolving situation.”

Even amid the grim situation, he observed that Burundi has had no deaths from mpox, formerly known as monkeypox. He said this provides “an opportunity to end this outbreak in a very short time period.”

“The geographical area is still limited, and with concerted effort from all partners, we can limit the spread, contain the virus, and potentially end the outbreak with no lives lost,” said Ngwakum.

He added that “it was difficult to make firm statements regarding when the outbreak could be brought under control,” both in Burundi and the wider African region, a sentiment echoed by the World Health Organization.

WHO spokesperson Dr. Margaret Harris told journalists, “The response to the outbreak is made more difficult by the context, with insecurity in the affected areas, and concurrent outbreaks of other diseases including measles and chickenpox. WHO is on the ground, working to stop these outbreaks.”

So far this year, the WHO reports there have been more than 25,000 suspected mpox cases and 723 deaths among suspected cases in Africa. The most heavily infected country is the Democratic Republic of Congo, with 21,835 suspected cases and 717 deaths, followed by Burundi with 1,489 suspected cases and no deaths and Nigeria with 935 suspected cases and no deaths.

“Vaccination is going to be a very useful tool, particularly for trying to break the chains of transmission,” Harris said. “But the virus primarily spreads through close personal contact within families. And when people are living in difficult conditions, if they do not have access to the materials, to the soap, to the clean bedding, to the clean clothing, it is very, very difficult for them to not transmit.

“Many of the children who we have seen who have sadly died in the Democratic Republic of the Congo were severely malnourished, had suffered the effects of conflict, and perhaps also had other diseases at the same time. … It may indeed be that this population cannot respond immunologically to yet another threat,” she warned.

While affirming the importance of vaccines in the fight against mpox, UNICEF representative Ngwakum observed that “unfortunately,” the vaccines that are available now “cannot be used for children.”

“I do not want to bank all our interventions on vaccines,” he said. “Vaccines are only one tool that can be used to protect children and communities against mpox. And we are, in addition to vaccines, deploying other different tools” to keep children safe, he said.

UNICEF says it is possible to halt the rapid spread of mpox if agencies act swiftly and have the means in which to do it. The U.N. children’s agency is urgently appealing for $58.8 million to scale up its humanitarian response across six African countries, including Burundi.

“These funds are essential to stop the transmission of mpox, protect children and maintain critical services like education and health care,” said Ngwakum.
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