The National Command and Operation Centre (NCOC) issued an advisory on Thursday to ensure preparedness to deal with mpox, formerly called monkeypox, as the country’s first suspected case for 2024 was reported.

Mpox can spread through close contact. Usually mild, it is fatal in rare cases. It causes flu-like symptoms and pus-filled lesions on the body.

The World Health Organisation (WHO) on Wednesday declared mpox a global public health emergency for the second time in two years, following an outbreak of the viral infection in the Democratic Republic of Congo (DRC) that has spread to neighbouring countries.

Health ministry spokesperson Sajid Shah told Dawn.com today that a suspected case was reported from Khyber Pakhtunkhwa.

“The suspected person has arrived from the Gulf. Samples have been collected from the suspect and sent to the National Institutes of Health (NIH) for confirmation,” he said.

Shah said the individual had minor symptoms of the viral infection but contact tracing was being carried out to avoid local transmission and some more samples were being sent to the NIH.

The spokesperson said that all provinces were directed to appoint focal persons so that they could be contacted over mpox-related developments.

“Moreover, Border Health Services has been directed to enhance monitoring at all entry points of the country,” he said.

Meanwhile, an NCOC meeting was held in the NIH on the directions of Prime Minister’s Coordinator on Health Dr Malik Mukhtar.

The meeting was physically or virtually attended by health authorities from across the country.

According to an advisory issued by the forum, mpox was reported in all WHO regions, including 122 countries, with a total of 99,518 confirmed cases and 208 deaths to date.

“While in Pakistan, a total of 11 cases with one death has been reported since first cases detected in April 2023,” it stated.

The NIH said the advisory provided guidelines for dealing with the infection.

It said that people affected could have rash and fever on their face and body with complaints of headache and body aches.

The advisory said a patient would remain infected for two to four weeks. It said that patients infected with Monkeypox should be kept in isolation until recovery.

The NIH asked people to take strict precautions, keep the environment clean and ensure the use of masks by medical staff besides ensuring a hand washing routine.

The UN health agency’s declaration on the virus came the day after the African Union’s health watchdog declared its own public health emergency over the growing outbreak.

Formerly called monkeypox, the virus was first discovered in humans in 1970 in what is now the DRC.

It is an infectious disease caused by a virus transmitted to humans by infected animals but can also be passed from human to human through close physical contact.

In May 2022, mpox infections surged worldwide, mostly affecting gay and bisexual men, due to the Clade 2b subclade.

The WHO declared a public health emergency which lasted from July 2022 to May 2023.

That outbreak, which has now largely subsided, caused some 140 deaths out of around 90,000 cases.

The Clade 1b subclade, which has been surging in the DRC since September 2023, causes more severe disease than Clade 2b, with a higher fatality rate.

Mpox kills 548 in DRC as case recorded in Sweden

The DRC said the mpox outbreak has killed 548 people there this year, as the first case outside Africa of the virus’s more dangerous variant was recorded in a traveller in Sweden.

DRC’s Health Minister Samuel-Roger Kamba said in a video message that the country “has recorded 15,664 potential cases and 548 deaths since the beginning of the year”, with all provinces affected.

The DRC is made up of 26 provinces and has a population of around 100 million.

The most affected provinces are South Kivu, North Kivu, Tshopo, Equateur, North Ubangi, Tshuapa, Mongala and Sankuru, Kamba said.

He said the government had put in place a “national strategic plan for vaccination against mpox”, as well as improving surveillance of the disease at borders and checkpoints.

The minister said that government-level working groups have been set up to boost contact tracing and help mobilise resources to “maintain control of this epidemic”.

Meanwhile, Sweden’s Public Health Agency told AFP that it had registered a case of the same strain of the virus that has surged in the DRC since September 2023, known as the Clade 1b subclade.

“A person who sought care” in Stockholm “has been diagnosed with mpox caused by the Clade I variant. It is the first case caused by Clade I to be diagnosed outside the African continent,” the agency said in a separate statement.

The person was infected during a visit to “the part of Africa where there is a major outbreak of mpox clade I”, state epidemiologist Magnus Gisslen said in the statement.

The agency added: “The fact that a patient with mpox is treated in the country does not affect the risk to the general population, a risk that the European Centre for Disease Prevention and Control (ECDC) currently considers very low.”

The WHO said more imported Clade 1 mpox cases were likely to be confirmed in Europe soon.

“The confirmation of mpox Clade 1 in Sweden is a clear reflection of the interconnectedness of our world … there are likely to be further imported cases of Clade 1 in the European region over the coming days and weeks,” the WHO’s European regional office said in a statement.

Vaccine drive

Separately, global vaccine group Gavi has up to $500 million to spend on getting shots to countries affected by the escalating mpox outbreak, its chief executive Sania Nishtar told Reuters.

The money is available in the organisation’s “First Response” fund, which was set up after global health agencies like Gavi were left behind by high-income countries in procuring vaccines during the early days of Covid-19.

It can be used to respond to health emergencies. The funds are largely left over from money donated by governments and global health funders for the Covid-19 response.

The money for the vaccines is ready to be tapped into, Nishtar said, but there were hurdles to clear, including official requests for vaccines from affected countries, as well as approvals of the vaccines from the WHO.

Gavi and Unicef, which work together to buy vaccines, cannot do so without WHO approving them. On Wednesday, the global health agency said it was hoping to finalise its evaluation of the vaccines by September.

Nishtar said Gavi was also in early talks with the manufacturers of the two mpox vaccines that are widely used, made by Bavarian Nordic and LM Biologics. Official orders can only proceed after approval, she said.

Bavarian Nordic has said it can make 10 million doses by the end of 2025.

“We have already significant capacity in place and can easily handle delivery of all doses needed for the outbreak,” a Bavarian Nordic spokesman said by email.

“But we need someone to buy the doses. None of the organisations have shown interest so far,” he added, without providing details.

LC Biologics said in an email it would cooperate with WHO as much as possible.

In the meantime, Gavi is coordinating with countries like the United States, which has had 50,000 doses available for donation for months. Bavarian Nordic has also donated 15,000 doses.

However, the DRC has yet to make an official request for the shots, which Nishtar said was a delaying factor, along with arranging legal processes and deployment plans for vaccination.

Additional input from APP.