The World Health Organisation has raised concerns regarding the disproportionate number of women and children infected during this outbreak. To date, females accounted for 62% (280/450) of overall cases where sex was reported. Of all female cases, 83% (230/277) were aged less than 15 years.
Of these women, at least 18 were pregnant, and an additional seven were breastfeeding or recently delivered at the time of infection. There have been 27 cases among infants less than one year of age, with 70% (19) of these being boys, and 21 fatalities (age-specific case fatality of 78%).
There were also nine cases in infants aged less than one month. Children, less than 15 years of age accounted for 24% (106/447) of cases.
There are likely a multitude of factors contributing towards this disproportionate disease burden observed in women and children. These include exposure within formal and informal health facilities, involvement in traditional burial practices, transmission within family groups (including transmission between mothers caring for children), differences in health-seeking behavior, as well as the impact of ongoing conflict on the underlying population structure in affected areas.
Among those with available information, commonly identified risk factors reported by cases include: having contact to a known case (224/320, 70%), having attended funerals (121/299, 40%) and having visited/admitted to a health facility before the onset of EVD (46/139, 33%). Of note, 46% of female cases (84/181) reported having attended funerals, in contrast to 31% of male cases (37/118).