BBC visits mpox clinic as WHO says cases are ‘stabilizing’

Doctors at the epicenter of the mpox outbreak in eastern Democratic Republic of Congo have told the BBC that the number of new infections has dropped significantly since the first batch of vaccines was rolled out last month.

The United Nations World Health Organization (WHO) confirmed to the BBC that new infections appeared to be “stable” in the DRC, but warned that it was too early to talk about the impact of vaccination strain.

Mpox – formerly known as smallpox – is a highly contagious disease and is suspected of having killed at least 900 people in the Democratic Republic of Congo this year.

The news comes ahead of a meeting at which officials will decide whether the outbreak should continue to be considered a global public health emergency.

Other public health experts in Africa have warned the disease is still spreading, with 19 countries on the continent reporting cases.

In September, the BBC visited a clinic in Lwiro, a rural area about an hour’s drive from the city of Bukavu in South Kivu province in eastern Democratic Republic of Congo.

The cases there are linked to a relatively new and more serious strain of mpox called Clade 1b, which appears to spread more easily and cause more severe illness.

Two months ago, we saw community hospitals overwhelmed – with long lines of infected patients, many forced to share beds or mattresses on the floor, and doctors struggling to cope with the number of patients arriving each day. day.

Nurse Emmanuel Fikiri, who has been on the front line of the mpox crisis for months, told the BBC this week: “At the moment, we cannot have more than 60 patients in hospital.”

“This is due to the fact there has been improvement, there is a vaccine against mpox and there is support from a number of partners who have enabled us to care for patients,” he said.

The last time Mr Fikiri spoke to the BBC, he could only speak briefly as he rushed to treat some of the nearly 200 patients then crowded into hospital rooms.

But he is now much more optimistic about the high rate of vaccine uptake in the community – meaning the number of new infections appears to have dropped significantly.

Indeed, when a BBC producer visited Lwiro hospital earlier this week, we found a much quieter scene: long queues of people had left and there were a number of empty beds in the children’s ward.

DR Congo started its mpox vaccination program in October after receiving 265,000 doses donated by the international community.

More than 50,000 people have been vaccinated so far – with the rollout focused on communities most at risk, including towns and villages in eastern DRC.

But experts have noted that mpox appears to disproportionately affect children in the DRC – and they are unvaccinated. Just this week, WHO authorized a vaccine candidate from Japan for children.

Dr Jean Kaseya, head of the Africa Centers for Disease Control and Prevention (Africa CDC), told the BBC: “Of those affected, about 30% are children,” explaining that children children “are also vectors of transmission”.

Another nurse at the Lwiro clinic, Jackson Murhula, warned that it was too early to say for sure that the disease in the community had been defeated – although he was also happy to see things easing.

“Recently, the infection rate started to slow down because initially we were getting 10 or 15 new cases a day, but now we are only getting two or three new cases a day,” he said.

“We cannot confirm that we have completely stabilized the epidemic because cases continue to increase but not like before.”

Among the children being treated this week is three-year-old Atukuzwe Banissa.

He groaned in pain, his eyes closed and his face covered in white spots left by the healing ulcer.

His mother, Julienne Mwinja, 25, said his symptoms began with watery eyes.

She applied eye drops, but within just one day, the boy developed ulcers on his mouth, face and body.

The mother of three told the BBC: “He looked like he had been burned by hot water.”

That’s when she took him to Lwiro hospital, where he was hospitalized for more than a week.

For the doctors at Lwrio, it is heartening that people now tend to visit the clinic as soon as they get symptoms instead of going to traditional healers first.

Dr Samuel Boland, WHO’s mpox incident manager, told the BBC that more than 96% of all new mpox infections are now in the Democratic Republic of Congo, Uganda and Rwanda.

While confirming that the Democratic Republic of Congo has entered a difficult phase, he warned that it is too early to be certain that the outbreak is over.

“In the Democratic Republic of Congo, to some extent we have actually seen the number of mpox cases leveling off, but overall it is still a very affected country,” he said. globally significant”.

In fact, more than 90% of people who died from mpox worldwide this year were in the Democratic Republic of Congo.

Although the exact number remains unclear as there have only been 77 laboratory-confirmed deaths as there are not many testing centers in certain parts of the continent.

“And so there is still a need to make sure that we continue to intervene at pace and scale, even in places where we see that cases may not be escalating at times,” Dr Boland said. This”.

“While overall we may see a change in transmission in some places, we see a change in others – and so we’re not out of the woods yet.”

Vaccination programs have also begun elsewhere in Africa, including in Nigeria and the Democratic Republic of Congo’s neighboring Rwanda.

Dr. Kaseya said Africa CDC has not seen any notable week-to-week changes over the past month in the DRC and cautioned that it is too early to say the mpox outbreak is under control.

With every effort to carry out vaccinations, strengthen surveillance systems and laboratories “maybe from mid-January to February we will start to see a decrease in infections and deaths”.

WHO officials will now assess all the evidence about how quickly the disease is spreading before deciding whether to lower the global alert level.