By Stephanie Nebehay

GENEVA (Reuters) – Children under five infected with Ebola in eastern Democratic Republic of Congo are dying at a higher rate than other patients as their parents shun special treatment centers, the World Health Organization (WHO) said on Thursday.

Three out of four of the under-fives, or 77%, are succumbing to the disease, compared with 57% for older youngsters and 67% for all infected people, the U.N. body said in a new analysis of the epidemic – the world’s second worst on record.

Many under-fives are not taken to Ebola treatment centers, known as ETCs, where survival rates are markedly higher, but instead visit multiple healthcare facilities that are not as well-equipped to provide treatment or isolation, the WHO said in a weekly update.

This “may be out of fear of being far from home and without the support of family members”, but could help spread the virus, a form of hemorrhagic fever, it said.

“All cases that may not be adequately isolated, including children under five-years of age, may pose a considerable transmission risk to healthcare workers, patients, and members of the community,” it said.

Children under five are also less likely than older youth to be included on lists of possible contacts exposed to the disease, who require surveillance or vaccination, it said, calling for improved tracing and monitoring.

“More work needs to be done to reduce fear and misunderstanding of ETCs and to reduce any other barriers to access, with a special focus on this age group,” it said.

Under-fives account for 15%, or 300 of the 1,945 cases reported since the epidemic began last August, the WHO said. In all, 1,302 people have died.

Congo’s outbreak has inflicted an unusually heavy toll on children. More than a quarter of the confirmed and probable cases identified as of early April were children under 15, compared to 18% in the last major outbreak in West Africa in 2013-2016, according to figures compiled by the Geneva-based WHO.

Fatality rates for both under and over 5s were in line with those observed in the West Africa outbreak, it said.

(Reporting by Stephanie Nebehay)

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