How Pakistan’s Peshawar has emerged as mpox ‘epicentre’

Mpox has been declared a global health emergency for the second time in two years.

A new form of the virus, clade lb, has triggered global concern as it seems to be spreading quickly and little is known about the strain.

The virus has spread to several countries outside Africa.

This includes Pakistan, which reported its fifth mpox case on Sunday.

According to Geo News, the neighbouring country’s Peshawar city is emerging as the “epicentre” of the virus.

Number of mpox cases in Pakistan

The latest patient, a 47-year-old man tested positive after being isolated by Border Health Services staff on August 29, according to Pakistan’s National Health Service (NHS) Ministry spokesperson Sajid Shah.

He had returned from an unnamed Gulf country. According to Wion News, the man was reportedly isolated at the Bacha Khan International Airport for showing symptoms akin to the mpox virus.

“This is the fifth mpox case reported this year (in the country) and the fourth since WHO declared mpox a global health emergency,” said Federal Director General of Health Dr Shabana Saleem on Sunday, as per ANI.

All other cases have been reported from the predominantly tribal Khyber Pakhtunkhwa province.

On August 28, a 51-year-old man who returned from Saudi Arabia was isolated in Peshawar for a similar reason, according to Pakistan’s Dawn report.

The ‘epicentre’ of mpox

The latest mpox case has raised concerns about the virus’s spread from travellers arriving from the West Asia.

Saleem said, “The virus’s re-emergence in Peshawar raises serious concerns about its transmission and demands immediate action.”

“Peshawar appears to be turning into an epicentre for mpox cases. This trend is alarming, and we are doubling our efforts to prevent further spread.”

Saleem also expressed the need for vigilance and highlighted that all recent cases have involved individuals with a history of travel to the Gulf.

No cases of the clade lb strain of the disease have been diagnosed, as per Reuters.

Measures taken

Authorities have ramped up measures to contain the virus, with stringent screening protocols now enforced at all airports, as reported by Geo News.

“We are not taking any chances. Effective screening systems are operational across the country,” Saleem assured, noting the government’s commitment to safeguarding public health.

Federal and provincial health officials are also coordinating closely to monitor the situation, ensuring that all necessary steps are taken swiftly.

“We are working round the clock to ensure all preventive measures are in place and effective. The Ministry of Health is continuously monitoring the situation, and we are prepared to respond to any developments immediately,” the Federal Director General of Health added.

The rise in mpox cases in Peshawar has triggered concerns among health experts and the public alike.

There have been calls for increased awareness and stricter travel guidelines, according to Geo News.

The federal director general of health urged the public to remain vigilant and to comply with health advisories, particularly those returning from high-risk regions.

“Public cooperation is crucial in preventing the spread of mpox,” she warned, adding, “Together, we can curb this virus before it takes a firmer hold.”

The situation in other Asian countries

Mpox has been spreading rapidly to other countries.

On August 22, a disease control official in Thailand confirmed the first mpox case of the clade Ib strain. According to Reuters, it was a 66-year-old European man who had arrived from an African country where the disease was spreading.

Singapore has also detected 13 cases of mpox Clade 2 infections this year. All mpox infections in the city-state have been the “less severe” Clade 2 infections, the health ministry said.

The Philippines has confirmed two more mpox virus infections of the milder clade 2 variety, bringing the number of active cases to three. The newly confirmed cases were a 37-year-old male in Metro Manila who had rash on his body and was brought to a government hospital, and a 32-year-old male from the capital who had skin lesions on his body.

The three cases this year mean the Philippines has had 12 laboratory-confirmed cases since July 2022.

Other countries on alert

India has no reported cases of mpox, however, the country is on high alert.

The health ministry has directed heightened vigilance at all international airports and land ports, particularly those bordering Bangladesh and Pakistan.

To ensure effective management of any potential monkeypox cases, the ministry has designated three central government-run hospitals in New Delhi and approved three indigenously developed kits for detecting mpox.

Soon after the second case was reported in Pakistan, China also amplified its surveillance at ports of entry. Aircraft and vessels carrying containers, as well as cargo, arriving from nations and areas with mpox cases will also be sanitised, as per local news.

Similarly, Japan and South Korea are also on alert.

Latest developments on mpox

Mpox is a viral infection caused by the monkeypox virus, which belongs to a genus of viruses called Orthopoxvirus.

The Orthopoxvirus family consists of the variola virus, which causes smallpox, the cowpox virus, and the vaccinia virus.

The common symptoms of mpox include skin lesions, fever, headache, muscle and back pain, low energy, and swollen lymph nodes.

The disease spreads through physical contact with an infected person, materials or animals.

The United Nations Children’s Fund (UNICEF) has issued an emergency tender to secure mpox vaccines for crisis-hit countries in collaboration with the Gavi vaccine alliance, Africa CDC and the WHO, the organizations said in a joint statement on August 31.

Depending on the production capacity of manufacturers, agreements for up to 12 million doses through 2025 can be made, according to the statement. Under the tender, UNICEF will set up conditional supply agreements with vaccine manufacturers. This will enable UNICEF to purchase and ship vaccines without delay, once financing, demand, readiness and regulatory requirements are confirmed.

Earlier in August, the WHO declared mpox a global public health emergency following an outbreak of the viral infection in the Democratic Republic of Congo that spread to neighbouring countries.

More than 18,000 suspected cases of mpox have been reported in Congo so far this year with 629 deaths, while over 150 cases have been confirmed in Burundi, WHO Director-General Tedros Adhanom Ghebreyesus said.

With inputs from agencies