The 2024 Central African Republic monkeypox outbreak: implications for pediatric involvement and global health

The global transmission of the Monkeypox Virus in the Central African Republic-2024 (MPXV-CAR-2024) highlights an evolving epidemiological landscape for mpox, characterized by shifts in affected populations and transmission dynamics. While historically mpox primarily affected children in endemic areas, the current outbreak demonstrates a rise in adult cases, predominantly transmitted through sexual contact, particularly among men who have sex with men (MSM). Clinically, mpox presents with fever, lymphadenopathy, and a progressive rash, with children often experiencing more severe symptoms and complications such as secondary infections or encephalitis. The MPXV-CAR-2024 outbreak has placed immense strain on paediatric healthcare systems, particularly in resource-limited settings, where access to specialized care, antivirals, and vaccines is limited. Furthermore, healthcare workers face increased risks, and disruptions to routine healthcare services exacerbate broader public health challenges. Globally, the outbreak underscores the need for strengthened surveillance, equitable access to vaccines and treatments, and robust infection control measures. International cooperation is crucial to addressing disparities in healthcare resources, countering misinformation, and ensuring culturally sensitive public health messaging. The MPXV-CAR-2024 outbreak highlights the need for proactive, coordinated global health efforts to mitigate the impact of emerging infectious diseases. IMPACT: The outbreak demonstrates a significant shift in mpox transmission dynamics, transitioning from predominantly affecting children in endemic regions to widespread adult cases. Children remain disproportionately affected in endemic regions, facing severe complications such as encephalitis and secondary infections, highlighting the critical need for targeted paediatric interventions in resource-limited settings. Disparities in access to vaccines and antiviral treatments have highlighted global health inequities, with low-resource regions facing increased morbidity and mortality. The stigma surrounding sexual transmission of mpox has hindered public health efforts, emphasizing the importance of culturally sensitive and inclusive communication strategies to counter misinformation and improve healthcare-seeking behaviours.