Many of the Democratic Republic of Congo’s overcrowded hospitals are battling to treat babies as young as two weeks old who have caught a mutated mpox strain that’s spreading rapidly in the central African country, according to Save the Children.

Health systems in eastern DRC, where transmission is highest, were extremely fragile even before this outbreak. Past outbreaks of Ebola and Covid-19 and a scarcity of staff and medical supplies further complicate efforts to contain the disease, Greg Ramm, Save the Children’s country director in the DRC, said in a statement.

This mpox variant was first reported in DRC less than a year ago and there have been more than 500 deaths related to the infection in 2024 alone.

Renewed fighting in the country has increased the number of displaced people living in crowded camps, with malnutrition rates climbing. HIV co-infection, which cuts the body’s ability to fight disease, raises the risks.

In some health centers patient intake is 4,000% higher than their capacity, Save the Children said. The bulk of DRC’s almost 15,000 cases are in children under the age of 15, with 39% in children under five, according to the World Health Organization.

Mpox causes fever, rash, and lesions all over the body, as well as severe headaches and fatigue. Some children also develop respiratory problems, have difficulty swallowing​, and in severe cases develop sepsis, a life-threatening response to infection that requires immediate specialist medical attention.

“The close resemblance of some of the signs and symptoms of mpox to other common childhood illnesses — such as scabies and chickenpox — might be leading to late recognition and treatment, contributing to transmission and worse outcomes due to delayed diagnosis and treatment,” Save the Children said.

Medical staff are also fighting stigma based on a “widespread belief” that mpox is spread only through sexual contact, the organization said.

Africa Centres for Disease Control and Prevention is expected to declare a public health emergency of continental security later on Tuesday, while a panel of advisers convened by the World Health Organization meets Wednesday to help determine whether the deadly outbreak constitutes an international emergency.

If either declare mpox an emergency, it will prompt countries in the region to share timely information on mpox’s spread, including surveillance at borders, and will also help the agencies better tap financial aid, accelerate research and development of diagnostics and increase vaccination drives.