Islamabad: Despite recording the highest number of Mpox cases in the country, most of them involving local transmission with no recent travel history, Punjab’s health authorities are not sharing detailed case data with federal authorities, particularly the National Institute of Health (NIH) Islamabad, raising serious concerns about disease surveillance, outbreak control and international reporting, federal health officials said on Wednesday.
According to official figures available with the federal health ministry, Pakistan has reported a total of 57 confirmed Mpox cases between April 18, 2023 and December 31, 2025, including one death.
Punjab accounts for the highest number with 23 confirmed cases, followed by Khyber Pakhtunkhwa with 22 cases and one death, Islamabad with six cases, Sindh with three, Azad Jammu and Kashmir with two and Balochistan with one case, while no cases have been officially reported from Gilgit Baltistan.
However, federal officials say that Punjab’s numbers remain unverified because detailed information has not been formally shared with the centre.
Senior officials in the federal health ministry said that the lack of information from Punjab was particularly worrying because a significant proportion of cases reported from the province involve local transmission, indicating that Mpox is circulating within communities rather than being limited to imported infections.
They said the available information suggests that local transmission is underway in Punjab, especially among men who have sex with men (MSM), a group known globally to be at higher risk during recent Mpox outbreaks.
Federal officials confirmed that at least two to four new Mpox patients are currently under treatment at Mayo Hospital Lahore. However, they said the provincial authorities have not officially shared clinical details, exposure histories or laboratory data of these patients with the centre, making it difficult to assess the scale, pattern and risk of further spread.
They disclosed that Punjab’s health department has informally approached the federal government for support, including requests for Mpox testing kits, antiviral medicines such as tecovirimat and updated clinical management guidelines. Despite these requests, officials said Punjab has not formally communicated complete case details, line lists or epidemiological investigations, which are essential for national surveillance and response planning.
“Mpox is a notifiable disease and, under national and international health regulations, every confirmed case must be reported to the National Institute of Health for surveillance purposes,” a senior federal official said. “Unfortunately, the ‘big brother’ is not providing data on Mpox or other notifiable diseases to the centre, which undermines the entire disease surveillance system.”
Federal health officials stressed that genetic sequencing of the Mpox virus is critically important to determine the circulating clade, understand transmission dynamics and assess whether the virus has undergone any significant changes. They said such sequencing also enables Pakistan to meet its international obligations, including timely reporting to the World Health Organization.
“Without samples and detailed data from Punjab, we cannot carry out sequencing or present an accurate national picture to WHO,” an official added.
Officials further pointed out that all other provinces, as well as federal territories such as Azad Jammu and Kashmir and Gilgit Baltistan, regularly share Integrated Disease Surveillance and Response (IDSR) data with the centre. Punjab, they said, does not routinely share IDSR data and instead occasionally sends a paper listing a few diseases, which does not meet surveillance standards and is not considered proper or timely communication.
In view of the situation, the federal government has decided to formally write to Punjab’s Secretary Health, seeking immediate provision of complete Mpox case data and regular sharing of information on all notifiable diseases. Officials said the letter would emphasise the legal and public health importance of data sharing to prevent further spread and ensure coordinated national action.
Senior epidemiologists at the Directorate General of Health Services Punjab were approached repeatedly for comments and details on the Mpox cases, including ongoing treatment at Mayo Hospital, but did not respond till the filing of this report.
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