PESHAWAR: Authorities have stepped up screening and surveillance after detection of mpox in a woman in Bara tehsil of Khyber tribal district.

“It is the first case to be detected from the community,” officials told this scribe. The new case, third of the current year, was diagnosed at Public Health Reference Laboratory (PHRL), Khyber Medical University, on Saturday.

The patient, a 35-year-old woman, had gone to tehsil headquarters hospital Dogra in Bara where doctors suspected her of mpox and her sample was sent to laboratory that turned out be positive for the zoonotic ailment.

“The husband of the patient had arrived in Pakistan through Bacha Khan International Airport Peshawar where he underwent routine screening but there were no symptoms of mpox in him at that time because during the incubation period symptoms are not visible,” public health officials said.

Patient has been isolated in Dogra hospital of Khyber tribal district

They said that the woman might have contracted the infection from her husband as the disease was six to 70 per cent spreadable through sexual intercourse. They said that they had also screened two cousins of the same person, who had arrived with him from Jeddah airport of Kingdom of Saudi Arabia, in addition to screening of his six children and parents but none of them showed any symptom of the ailment.

“The woman has been isolated in the same hospital and is being constantly monitored while her husband is negative for the disease,” they said.

Officials said that they had detected 11 cases in Khyber Pakhtunkhwa during the last year but accelerated screening of people, especially when World Health Organisation declared mpox a public health emergency of international concern in August last year. They said that more than 80,000 passengers had been screened at the airport and 45 PCRs tests had been conducted.

They said all patients detected positive for mpox had arrived from United Arab Emirate and Saudi Arabia where the disease was endemic. They said that the staff deployed at the airport and Pak-Afghan border at Torkham was screening each and every suspected person. Anyone having mild symptoms is subjected to PCR, which is carried out free of cost at PHRL.

Officials said that the latest case was detected from the community, therefore, they deployed teams in the area to ensure that all her close contacts were screened and tested if they had symptoms. “So far, we have not recorded symptoms in anyone but surveillance has been escalated and monitoring strengthened to ensure that the disease doesn’t infect people,” they added.

On January 31, health department confirmed mpox case in a five-month-old child on arrival at Bacha Khan International Airport. It was the second case. Later officials screened all the relatives as well as those, who had travelled in the same flight. The female child had arrived with her parents from Qatar.

PHRL has issued guidelines to hospitals, saying mpox is transmitted from animals to humans with incubation period of three to 17 days after inoculation and it begins with a combination fever, headache, muscle aches, back pain, swollen lymph nodes, chills and exhaustion. After initial symptoms, the patient develops a rash, often beginning on the face and then spreading to other parts of the body including palms and soles.

The rash evolves from macules (flat lesions) to papules (raised lesions), vesicles (fluid-filled lesions), pustules (pus-filled lesions), and finally crusts. The lesions eventually fall off.

The disease is transmittable through direct contact with blood, bodily fluids or cutaneous or mucosal lesions of patient and indirect contact through contaminated material such as bedding. It has no specific treatment. The disease is self-limiting.

The WHO recommends avoiding close contact with suspected or confirmed patients, practicing hand hygiene and using personal protective equipment when caring for patients to avoid the disease.

Published in Dawn, February 24th, 2025