A day after Pakistan reported its first case of mpox, a viral zoonotic disease, the Ministry of National Health Services (NHS) said on Wednesday that there was “no evidence” of localised transmission.

On Tuesday, a patient from Saudi Arabia tested positive for the virus, prompting authorities to beef up measures at airports and set up isolation wards in hospitals. The patient, deported from Saudi Arabia, arrived in the country on April 17 with symptoms of the disease.

According to sources in the ministry, the patient is a resident of Mandi Bahauddin and had been working as a driver in Jeddah.

Patients infected with the disease commonly show symptoms such as a rash, fever, sore throat, headache, muscle aches, back pain, low energy and swollen lymph nodes.

According to the World Health Organisation (WHO), symptoms usually begin within a week but can start 1–21 days after exposure.

In a press release issued today, a copy of which is available with Dawn.com, NHS spokesperson Sajid Shah said that the disease had been declared a public health emergency in July 22 last year by the WHO.

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He said that mpox was a viral zoonotic disease caused by a pox virus and was contagious, adding that it could be transmitted from infected animals to humans or from infected humans to others humans via close contact and droplets

“As of now, a total of around 87,000 laboratory confirmed cases and 119 deaths have been reported from 111 countries globally. The number of cases reported weekly at the global level peaked in August 2022, and since then, the cases have been steadily declining,” the spokesperson said.

Shah said that in Pakistan, a total of 22 samples from suspected cases were referred from different parts of the country since May 2022. Subsequently, polymerase chain reaction (PCR) tests were carried out at the National Institute of Health (NIH) in Islamabad, he said.

“First case has been confirmed by NIH from travellers who arrived recently in Pakistan and has been isolated at the Pakistan Institute of Medical Sciences (Pims) hospital along with others who are being investigated,” he said.

“As there is no evidence of localised transmission of mpox as of now in Pakistan, the risk of international spread of disease from Pakistan remains low. The WHO does not recommend any restrictions on trade on the current available information regarding mpox outbreaks,” Shah added.

The health ministry spokesperson said that advisories had been issued to enhance the screening of inbound passengers at all international airports.

“The NIH, provincial health departments and Border Health Services at all airports [as well as] district health authorities at Islamabad and provinces have been advised to ensure surveillance through laboratory diagnostics, contact tracing, rapid identification of suspected cases and clusters of infections as well as the source of infection in order to provide optimal clinical care, isolate cases to prevent further transmission, identify, manage and follow-up contacts to recognise early signs of infection, identify risk groups for infection and for severe disease, protect frontline health workers, and tailor effective control and prevention measures,” he said.

Shah assured the nation that the health ministry and the National Command and Operation Centre (NCOC) — which has set up a control room to deal with mpox cases across the country — were “vigilantly” monitoring the situation while keeping all relevant stakeholders on board for ensuring preparedness, timely response and containment of cases.

CAA issues guidelines for airports

Meanwhile, the Civil Aviation Authority (CAA) said that certain steps had been implemented at all airports across the country in light of the guidelines issued by the Border Health Services (BHS).

In a statement, CAA Public Relations Officer Saifullah said that the managers of all international airports were holding regular meetings with other agencies to make measures for preventing and controlling the disease as effective as possible.

“In the event of a suspected mpox passenger on a flight, the passenger will not use the normal route to exit the airport,” he said. “The airline will carry out the passenger’s immigration while undertaking precautionary measures, including wearing gloves and masks.”

He added that the BHS and airline staff would then transport the patient to the hospital in an ambulance.

“In case of a high number of suspected or confirmed cases, the airline will be responsible for transferring the patients to quarantine facilities while BHS will provide support,” Saifullah said.

He said that in case the situation involved deportees, the airline would inform the BHS three hours prior to landing.

He further said that suspected or confirmed cases should be moved to the back of the plane and should be seated with an empty seat between them.

“Ground handling agencies are providing masks and gloves to wheelchair handlers,” the CAA PRO said. “Baggage handlers are disinfecting luggage as it arrives through fumigation.”

He further added that the luggage area, medical inspection area, Federal Investigation Agency counters, corridors, escalators, and all adjoining areas were being sprayed with disinfectant.

“BHS is already present at the airports and will soon be deployed in cargo areas,” Saifullah said. “Porters will be wearing gloves and masks while trolleys are being washed regularly with soap and water.”

He assured that the BHS and CAA were ensuring the disinfection of staff lifts and handrails, adding that the authority was closely monitoring the disposal of aircraft waste under pre-defined standard operating procedures.