Pakistan: Confirmed monkeypox (mpox) case reported in Pakistan in April

Event

Health officials have confirmed the first case of monkeypox (mpox) in Islamabad, Pakistan, as of April 21. The case was identified in a traveler who had recently returned from Saudi Arabia and exhibited symptoms of the disease. Pakistani health officials reported that there is no evidence of local transmission but have put airports and health facilities on high alert to prevent disease transmission. Health officials have also initiated contact tracing and intensified surveillance efforts. As disease surveillance and contact tracing continue, officials will likely identify additional cases in the coming weeks. This report represents the most up-to-date information as of April 28.

Context

Human-to-human transmission occurs among people in close physical contact, with an increase in recent cases linked to sexual contact. The current outbreak highlights the importance of vigilant safe sexual practices, and mpox can be transmitted while the infected person displays few or no symptoms; however, the risk is currently assessed as low for individuals not routinely engaging with multiple or anonymous sexual partners.

Mpox does not naturally occur in Asia; most cases are reported in West and Central Africa, primarily in the DRC, Nigeria, and Cameroon, among individuals who report contact with wild rodents or other mammals which may harbor the disease.

Mpox is caused by a virus that belongs to the same family as the virus that causes smallpox. However, mpox is not the same as smallpox and does not have the same capacity for rapid human-to-human transmission. Mpox is mainly transmitted to humans through direct contact with the bodily fluids of infected rodents or primates. Human-to-human transmission primarily occurs through close personal contact with an infected individual via respiratory droplets, direct contact with bodily fluids, or indirect contact with lesion material (e.g., contaminated clothing or bedding). Symptoms typically appear 6-16 days after exposure but can develop up to 21 days after exposure. Symptoms generally include fever, headache, muscle aches and backaches, swollen lymph nodes, chills, exhaustion, and a distinctive rash characterized by lesions that progress through several stages before falling off.

Advice

Practice basic health precautions, including frequent handwashing with soap and water, covering the nose and mouth when coughing, and avoiding obviously ill individuals. Avoid overcrowded areas and consider using safe sexual practices, such as physical barriers (condoms), in countries reporting mpox transmission. Seek medical attention if symptoms develop within two weeks of being in affected areas. Vaccines are available but limited.

Resources

US CDC: Monkeypox Factsheet