Children bear brunt of Congo's worst Ebola outbreak on record

Explainer

The Democratic Republic of Congo is battling its largest and deadliest Ebola outbreak on record, with children bearing a disproportionate burden of the disease.

As of Oct. 15, more than 9,200 cases have been confirmed, while deaths have surpassed 4,400, according to the latest numbers from the D.R.C.'s public health institute.

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Just over a quarter of those deaths are children.

"Children are really impacted by Ebola on so many levels," Amy Mina, a project leader from Canada with Save the Children, told CBC News.

Why are children at such high risk?

Although most cases are among adults, children have a much higher fatality rate, at 60 per cent compared to 40 per cent for adults, the World Health Organization estimates.

"Sixty-one per cent of the children who died of Ebola are under the age of five," Mina said.

Médecins Sans Frontières said on Thursday that the youngest children face the highest risk of death.

"In North Kivu, children have been particularly affected by the current outbreak: 24% of confirmed cases are among children under five years of age," the organization said.

Dr. Joanne Liu, director of the Pandemic and Emergency Readiness Lab at McGill University, says children are already vulnerable to viruses, with fewer reserves to fight off loss of fluids from illness.

How is the outbreak affecting children beyond the disease?

It is estimated that at least 1,900 children have been separated from their caregivers because of Ebola.

UNICEF is operating 12 child-care centres next to treatment centres full of Ebola patients.

"We have children that are completely orphans, so they lost both parents," Lucia Elmi, director of global emergency programs at UNICEF, said last week.

When children contract Ebola, they have to be entirely isolated, interacting only with caretakers dressed in fully protective gear, which can be terrifying for kids, experts say.

"Can you imagine fighting for your life on your own without your parents?" Liu said. "We know that that kind of isolation … creates emotional stress, agitation and irritability in the children."

Children in the region already face high levels of malnutrition and displacement due to ongoing armed conflict.

Mina says school attendance has dropped because many parents worry schools could be transmission sites.

Parents are also avoiding seeking treatment at the hospital for their children for other health issues out of fear of Ebola.

"Children aren't only dying of Ebola," Mina said. "We are seeing a drop in the number of families and children visiting health centres … and children die of malaria, and dysentery and respiratory diseases."

Cholera is also seeing a rise in the west of the country, with more than 51,000 suspected cases reported since the beginning of 2026.

Amid the surge in Ebola, pregnant women are also avoiding clinics, missing prenatal care and choosing to deliver their babies at home.

The UN says, compared to last year, maternal deaths in the region have nearly doubled.

What challenges are hampering the medical response?

Most deaths from Ebola are happening outside of treatment centres, meaning medical workers can't fully track the chains of transmission to stop them.

"They're dying at home, which represents a huge opportunity for more transmission because they're being cared for by their family, their community members," said Stephanie Hoffmann, a project co-ordinator with Doctors Without Borders in North Kivu, D.R.C.

Hoffmann said part of the reason this has gotten so "out of control" is because of the gutting of the U.S. Agency for International Development, a foreign aid program dismantled in 2025.

When USAID was operating in the region, cases of Ebola were detected earlier on, allowing for tracking and isolating, she said.

Stéphanie Hoffmann, project coordinator for MSF in Butembo, stated that most paediatric cases admitted to the Ebola treatment centre in Butembo over the summer had already been hospitalised for other illnesses in several facilities.

She added that it was highly likely that these children contracted the disease inside healthcare facilities.

MSF stressed that strengthening infection prevention and control measures in health facilities is critical.

Are there treatments or vaccines for this strain?

The current outbreak is caused by the Bundibugyo strain, a rare strain of Ebola for which there is no approved treatment or vaccine, although clinical trials are underway.

MSF says children are being left behind in the research of innovative medical tools.

"Ongoing and future studies on Bundibugyo virus, the virus driving this outbreak, must include children," the organization said.

Guyguy Manangama, epidemiologist and deputy director of operations at MSF, stated, "On top of enormous challenges caring for young patients, medical facilities are dealing with a lack of paediatric dosing guidance, and limited availability of child-friendly formulations of investigational medicines."

He stressed that treatments, vaccines and other preventive tools should be evaluated for use in children from the outset of research efforts.

The U.S. announced Friday that it had struck a new deal to supply some of the world's poorest nations with maternal and child health supplies, including Congo, through UNICEF.

The outbreak has also spread beyond Congo's borders, with two deaths in neighbouring Uganda and three confirmed cases in Kenya linked to the outbreak.

With files from CBC News and Peoples Gazette Nigeria