• Man returned from Saudi Arabia
• Suspected patient with virus symptoms isolated in Karachi

ISLAMABAD / PESHAWAR: Pakistan has reported another case of mpox, taking the total number of cases to three since August 14, when the disease was declared an international emergency by the World Health Organisa­tion (WHO).

While a passenger who arr­ived in Peshawar from abroad, tested positive, another who arrived in Karachi was isolated for showing symptoms of the virus.

According to officials, both had returned from Saudi Arabia.

National Health Services (NHS) Ministry spokesperson Sajid Shah told Dawn that two persons who landed at Pesha­war’s Bacha Khan International Airport were isolated for showing symptoms of mpox on Thursday.

Their samples were sent to the Public Health Reference Lab (PHRL) at Khyber Medical Uni­v­ersity, one of which retu­rned positive on Friday.

The 51-year-old pat­ient has been isolated at Services Hospital, Khy­ber Pakhtunkhwa Pub­lic Health Director Dr Irshad Ali Roghani told Dawn.

According to reports, the patient, hailing from Orakzai district, had returned after performing Umrah.

The authorities have started tracing people with whom the patient might have come in contact to stop local transmission.

Suspected case in Sindh

The suspected patient in Karachi landed at the Jinnah International Airport from Jeddah, according to the health authorities in Sindh.

He has been admitted to the Sindh Infectious Diseases Hospital and Research Centre and is said to be in a stable condition, according to a senior doctor at the hospital.

The patient has rashes and raised red lesions on the skin that can be caused by infections, allergies or drug reactions,“ the doctor added.

His samples have been sent to the Dow University of Health Sciences for analysis, and the result will be available within two days, he added.

If confirmed, this will be the first case of mpox to be reported in Sindh.

‘Best surveillance system’

In a statement, Prime Mini­s­ter’s Coordinator on National Hea­lth Ser­vices Dr Malik Muk­htar Ahmad Bharath lauded the Border Health Service (BHS) for identifying suspected patients and said the system of monitoring and surveillance of disease in Pakistan was one of the best in the world.

“BHS has been screening all incoming passengers to avoid the chances of local transmission.”

The federal and provincial governments have been collaborating to stop the virus’s spread, and the NHS ministry has been “ensuring strict vigilance and surveillance”.

‘Less severe strain’

According to Mr Shah, the ministry’s spokesperson, the global mpox virus strain has been categorised into two primary clades: clade I and clade II.

The global outbreak from 2022 to 2023 was predominantly linked to clade II, which is known to cause milder symptoms compared to clade I.

The strain in Pakistan has been classified as clade IIb, a subclade of clade II, according to the official.

“Currently, the ongoing outbreak in the Democratic Republic of the Congo is primarily associated with clade Ib (a subclade of clade I),” he said, adding that as of now, there have been no reported cases of clade I in Pakistan.

In KP, from where all three mpox cases have been reported, authorities have increased vigilance at airports and set up isolation facilities in hospitals.

The KP public health director told Dawn that so far, all three patients had contracted the viral infection abroad. “There is no local infection, but we continue to focus on screening the people who have symptoms.”

He added that the three patients were in isolation and recovering rapidly.

Hospitals across KP have been alerted to isolate suspected patients and send their samples to the Khyber Medical University’s PHRL for testing.

Dr Irshad added that tests were now being done in the province as opposed to earlier when specimens were sent to the National Institute of Health in Islamabad.

It helped reduce the time between receiving the samples and giving results, he added.

Prof Ziaul Haq, the Khyber Medical University (KMU) vice chancellor told Dawn that the laboratory was being further strengthened to not only deal with mpox but also other diseases.

Prof Haq added that the laboratory had also trained operators who are now working in 12 labs in the province.

The health department had established these labs with the technical assistance of the PHRL when Covid-19 was at its peak in KP, he added.

Now, these labs are being used to detect mpox and other viruses, he said.

According to a document released by the National Institute of Health, mpox is an infectious disease which spreads via close contact and tends to cause flu-like symptoms and pus-filled skin lesions.

Faiza Ilyas in Karachi also contributed to this report

Published in Dawn, September 1st, 2024