Guinea-Bissau's mpox outbreak has a new demographic twist: more than half of the reported cases are children, because nothing says 'public health crisis' like targeting the youngest and most vulnerable. The national outbreak, declared on 4 July, came just over a week after a 27-year-old woman became the first confirmed case in the west African nation. Since then, there have been seven confirmed and 46 suspected cases, with half of those patients being children - 16 of them under the age of four.

Unicef, in a statement on Thursday, warned that the country's fragile health surveillance systems mean the virus is likely spreading undetected, putting even more children at risk. Sandra Martins, Unicef's deputy representative in Guinea-Bissau, noted, 'This is the first time mpox cases have been reported in Guinea-Bissau, making even a small outbreak a major public health event.' Because when you've never seen the disease before, even a small number of cases feels like a big deal.

Mpox, an infectious viral disease transmitted through close contact, has caused over 2,000 deaths among tens of thousands of cases across east, central, and west Africa since January 2024. Health workers say the Clade variants in Guinea-Bissau match those in neighbouring countries, keeping the cross-border transmission risk high. Most confirmed cases are in the Bissau autonomous sector, which includes the capital, with one case in the nearby Biombo area. No deaths have been reported yet - knock on wood.

Dr Magda Robalo, a former health minister who led the Covid-19 response, emphasized that to close 'the biggest gaps in the health system right now,' increased surveillance and frontline capacity are essential. 'Even though the numbers are small, new cases have appeared intermittently over several weeks, which means transmission is ongoing,' she said, adding that the situation is far from over.

Meanwhile, the country is juggling infrastructure challenges and the aftermath of the military's suspension of last November's presidential election. As if on cue, Bissau had no electricity all Thursday due to petrol scarcity since the weekend. Because when you're fighting a disease, what you really need is a power outage.

Public health labs in the region lack equipment for epidemics but have institutional knowledge from past crises. In Guinea-Bissau, community health workers have launched a door-to-door awareness campaign with megaphones and translated leaflets, supported by the health ministry and international agencies. These grassroots efforts are vital for building public trust, especially after the country suspended a controversial US-funded trial on hepatitis B vaccinations for newborns earlier this year over ethical concerns.

With primary schools set to reopen in September, the urgency is palpable. Because nothing says 'back to school' like an ongoing mpox outbreak and a health system held together with duct tape and hope.