In Congo, a Medical Mystery Offers Clues to the Mpox Epidemic

On September 30, 2023, a worried father brought his 5-year-old son to a hospital in Kamituga, a busy, muddy town carved out of the deep forests of eastern Democratic Republic of the Congo. The boy had a high fever and had oozing sores on his torso and face.

The nurse diagnosed chickenpox. They admitted him to a pediatric ward in a sprawling, low-rise colonial-era brick building and tried to manage his fever.

Days passed, but the child’s health did not improve. The fever rose and the lesions spread, blistering on the soles of her little feet.

Confused, pediatric staff called Dr. Steve Birembo, who was in charge of emergency care. He and his trusted nurse colleague, Fidel Kakemenge, examined the boy, flagged the possibility and quickly ruled it out. It’s not chickenpox, it’s not measles, it’s not rubella, it’s not severe dermatitis — if you had any of the following, you’d probably be better by now.

The spread of the wound meant it wasn’t malaria, typhoid or cholera, a disease that afflicts other children in crowded wards.

“And at some point we said, ‘Maybe it’s mpox?'” Dr. Birembo said. “We’ve never seen it, but we’ve only seen it in books.”