A few days after the federal health minister declared Pakistan “free of monkeypox”, the National Institute of Health (NIH) said on Thursday that the third case of mpox in the country has been detected in Karachi.

In a tweet today, the institute said that the case was reported from Karachi — the first in the city and Sindh — and had been confirmed by the Jinnah Postgraduate Medical Centre (JPMC).

The patient is a young male who recently travelled abroad and was isolated after he showed symptoms of the virus at the Jinnah International Airport, it stated.

The NIH added that the patient has been isolated, while contact tracing was underway.

Meanwhile, Sindh Health Department Spokesperson Mehar Khursheed told Dawn.com that the patient worked as a driver in Jeddah and flew back to Pakistan via Oman.

A rare disease caused by the monkeypox virus, mpox symptoms are similar to but milder than smallpox symptoms. The disease spreads when someone is in close contact with an infected animal or person. It is a droplet infection and enters the body through broken skin, the respiratory tract or through the eyes, nose or mouth, as well as through shared items such as bedding or towels.

Early signs of monkeypox include flu-like symptoms such as fever, chills, headache, muscle aches, fatigue, trunk, lymphadenopathy and chickenpox-like rashes on the hands and face.

According to the NIH, the first two cases of mpox in Pakistan were reported in Islamabad and the patients have now completely recovered.

“The Federal Ministry of Health along with the National Command and Operation Centre (NCOC) was vigilantly monitoring the situation while keeping all the relevant stakeholders on board for ensuring preparedness, timely response, and containment of monkeypox cases in Pakistan,” it added.

Sindh sets up isolation wards

In a statement issued today, the Sindh Health Department spokesperson said that the province had been preparing for mpox ever since the first case was reported in Pakistan.

It stated that all Covid-related precautions would be applied to mpox too as the disease can spread from humans to other humans and from the environment to humans.

Elaborating on the measures taken by the government to prevent the spread of mpox, the statement highlighted that male and female isolation wards had been set up at major hospitals across Sindh.

“Sindh Health Department has established a surveillance group to monitor the mpox situation across the province, airports, train stations, and ports,” it said, adding that precautionary messages had also been sent out to schools, mosques and commercial areas.

The statement further explained that rashes caused by mpox usually fade within 14 to 21 days of appearing, hence, the duration of the patient’s quarantine depended on the emergence and clearance of the rash as it denoted how infectious and contagious the patient was.

“However prevention is the best cure, therefore, please maintain social distancing, and be vigilant of any symptoms of fever, cough, or rashes,” it pointed out.

What is mpox?

WHO describes mpox as zoonosis — “a disease that is transmitted from animals to humans, with cases often found close to tropical rainforests where there are animals that carry the virus”.

The WHO says that the disease can also spread from humans to humans.

“It can be transmitted through contact with bodily fluids, lesions on the skin or on internal mucosal surfaces, such as in the mouth or throat, respiratory droplets and contaminated objects.”

According to a health advisory issued by the WHO last year, “People who closely interact with someone who is infectious are at greater risk for infection; this includes household members, sexual partners, commercial sex workers and health workers.”

The disease was first identified in monkeys kept for research in Denmark in 1958 and hence, was named monkeypox. But last year, the WHO announced that the disease would be renamed to mpox to avoid stigmatisation stemming from the disease’s then-name.

The disease was first discovered in humans in 1970 in the Democratic Republic of Congo, with the spread among humans since then mainly limited to certain West and Central African nations.

But in May 2022, cases of the disease, which causes fever, muscular aches, and large boil-like skin lesions, began spreading rapidly around the world.

The WHO triggered its highest level of alarm on July 24, 2022, classifying it as a public health emergency of international concern, alongside Covid-19.

Dr Javaid Usman, a microbiologist, told Dawn.com that “there is no specific anti-viral treatment for it nor any approved vaccine as of now”.

However, he said, the disease was not usually fatal but could be so in rare cases when a person developed complications like pneumonia or an infection of the brain called encephalitis.

Dr Usman said a mpox “patient has to be kept in isolation and the health care provider should wear gloves and mask to avoid the chances of infection” But, he again stressed, the disease was not usually fatal and people should not panic following its detection.