Congo mining town becomes MPox hotspot as new strain spreads

KAMITUGA, Congo (AP) — Lying on the ground above a pile of dirt, Divine Wisoba pulled weeds from her daughter’s bushes…

KAMITUGA, Congo (AP) — Lying on the ground above a mound of dirt, Divine Wizoba pulled weeds from her daughter’s grave. The 1-month-old girl died of mpox in eastern Congo in August, but Wizoba, 21, was too scared to attend the funeral.

On her first visit to the cemetery, she cried into her shirt over the baby she had lost and worried about the rest of her family. “When she was born, it was like God had answered our prayers—we wanted a girl,” Wisioba said of little Maombi Katengey. “But our greatest joy turned to despair.”

Her daughter is one of more than 6,000 people who officials say have contracted the disease in South Kivu province, the epicenter of the world’s latest MPox outbreak, which the World Health Organization has declared a global health emergency. The new strain of the virus spreads primarily through skin-to-skin contact, including but not limited to sex. A lack of funding, vaccines and information has made it difficult to contain the spread, according to concerned disease experts.

Mpox — which causes mostly mild symptoms, such as fever and body aches, but can cause severe cases with visible blisters on the face, hands, chest and genitals — spread across Africa for years, largely unnoticed, until an outbreak in 2022 that affected more than 70 countries. Globally, the vast majority of cases in that outbreak were gay and bisexual men. But officials note that Mpox has long disproportionately affected children in Africa, and say cases are now rising rapidly among children, pregnant women and other vulnerable groups, with many types of close contact accounting for the spread of the disease.

Health officials have focused on Kamituga, a remote but bustling gold-mining town of about 300,000 that attracts miners, sex workers and traffickers who are constantly on the move. Cases from other parts of eastern Congo can be traced back, officials say, with the first of them coming from the nightclub scene.

Since the beginning of the epidemic a year ago, almost 1,000 people have been infected in Kamituga. Eight people have died, half of them children.

Challenges on Earth

Last month, the World Health Organization said MPox outbreaks could be contained within the next six months with leadership and cooperation from governments.

However, in Kamituga, as the residents say, we live in a completely different reality.

The general hospital is averaging five new cases a day, regularly approaching the limit. Overall, the number of weekly new suspected cases in South Kivu has skyrocketed from about 12 in January to 600 in August, according to provincial health officials.

However, even these estimates are likely underestimated because of the lack of access to rural areas, the lack of access to care for many residents, and the temporary nature of the situation on Kamituga Island.

Residents say they simply do not have enough information about mpox.

Wisoba said that before her daughter fell ill, she herself was infected but did not know it.

Painful lesions appeared around her genitals, making it difficult to walk. She thought she had a common sexually transmitted disease and sought treatment at a chemist’s. A few days later, she went to the hospital with her newborn and was diagnosed with mpox. She recovered, but her daughter developed lesions on her foot.

Almost a week later, Maombi died in the same hospital where her mother was treated.

Wisoba said she didn’t know about the mpox until she got it. She wants the government to invest more in teaching people about protective measures.

Local officials can’t reach areas more than a few miles from Kamitugi to track suspected cases or inform residents. They’re broadcasting radio messages, but they say they don’t reach far enough.

Kasindi Mwenyelwata goes door-to-door describing how to detect mpox — looking for fever, pain or changes. But the 42-year-old community leader said a lack of money means there are no proper materials, such as posters with patient photos, which he believes are more powerful than words.

ALIMA, one of the few aid organizations working on mpox in Kamituga, does not have the funds to set up programs or clinics that could care for about 150,000 people. The organization’s budget is expected to run out by the end of the year, according to program coordinator Dr. Dally Muamba.

If support continues to wane and mpox spreads, he said, “it will have an economic impact, people will stop coming to the area as the epidemic takes its toll. … And as the disease progresses, will resources follow suit?”

Vaccine vacuum

Health experts agree: Vaccines are needed most — even if they will be available only to adults, as emergency authorization has allowed in Congo.

None have reached Kamituga, even though it is a priority town in South Kivu, officials said. It is unclear when or how that will happen. The main road to the town is unpaved — barely passable by car during the current rainy season.

Once they get here, it is unclear whether supply will meet demand among those most at risk and waiting first: health care workers, sex workers, miners and motorcycle taxi drivers.

Congo’s government has allocated more than $190 million for its initial mpox response, which includes buying 3 million doses of the vaccine, according to a draft of the country’s mpox plan widely circulated among health experts and aid groups this month and seen by The Associated Press. But so far, just 250,000 doses have reached Congo, and the government has only provided $10 million, according to the finance ministry.

Most people with mild cases recover in less than two weeks. However, lesions can become infected, and children or people with weakened immune systems are more susceptible to severe cases.

Doctors can make sure the lesions are clean and also give pain medications or antibiotics in case of secondary infections such as sepsis.

However, people who recover can become infected with the virus again.

New strain, lack of understanding

Experts say a lack of resources and knowledge about the new strain is making it difficult to advise people how to protect themselves. An internal report circulating among aid groups and agencies seen by the AP called confidence in available information about mpox in eastern Congo and neighboring countries low.

While the variant is known to be more sexually transmitted, it is unclear how long the virus stays in the body. Doctors recommend that recovered patients abstain from sex for three months, but they acknowledge that number is largely arbitrary.

“The studies have not clarified whether you are still contagious or not… whether you can or cannot have sex with your wife,” said Dr Steven Bilembo of Kamituga General Hospital.

Doctors say they are seeing cases they simply do not understand, such as pregnant women losing their babies. Of the 32 pregnant women infected since January, almost half have lost a child through miscarriage or stillbirth, hospital statistics show.

Alice Neema was among them. From a hospital isolation room, she told the AP she noticed changes around her genitals and a fever — but didn’t have enough money to travel 30 miles (50 kilometers) by motorcycle to get help in time. She had a miscarriage after the diagnosis.

As information comes in, residents say fear is spreading with the new strain.

Diego Nyago said he brought his 2-year-old son, Emile, to the hospital for a circumcision when he became ill and developed a fever.

It was mpox — and today Nyago is grateful that he was already in the hospital.

“I didn’t believe that children could catch this disease,” he said, as doctors gently poured water on the boy to lower his temperature. “Some children die quickly because their families are not informed.

“Those who die are those who stay at home.”

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This article was contributed by AP reporters Jean-Yves Kamale in Kinshasa, Congo, and Maria Cheng in London.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.