Karachi: At least nine children with strong clinical suspicion of Mpox have been reported from Khairpur and adjoining areas of upper Sindh over the last 10 days, but provincial health authorities are allegedly trying to suppress information and bypass national institutions by sending samples to a private laboratory for diagnosis.
Officials in the Sindh health department confirmed that multiple children presenting with unusual skin lesions have been reported from Khairpur district, including one case brought to the outpatient department of the Gambat Institute of Medical Sciences on Friday, raising serious concerns about a possible Mpox outbreak.
In a formal communication issued by the Directorate General Health Services Sindh, the laboratory manager at Aga Khan University has been requested to facilitate priority testing and confirmation of suspected Mpox cases reported from Khairpur.
Doctors in Khairpur, Gambat and parts of Larkana said children with unusual skin lesions are being brought to the Gambat Institute of Medical Sciences and private clinics, with symptoms that do not resemble common infections such as chickenpox or measles and are instead clinically consistent with Mpox.
Despite the emergence of multiple suspected cases, federal health authorities, including officials at the National Institute of Health, have expressed ignorance of any confirmed outbreak, raising concerns about a possible breakdown in disease surveillance and reporting.
According to officials and documents, the Sindh health department has sought urgent laboratory support from the Aga Khan University laboratory for testing of suspected Mpox cases instead of utilising the available diagnostic capacity at NIH Islamabad or the Dow University of Health Sciences, both of which have established capability to confirm Mpox.
The move has triggered criticism from public health experts, who say diverting samples away from national reference laboratories limits transparency and undermines a coordinated response to infectious disease threats.
A senior health official confirmed that at least nine suspected cases have been identified in Khairpur district, including one child brought to the outpatient department of Gambat Institute of Medical Sciences on Friday, with similar cases being reported from surrounding areas.
“The clinical presentation strongly suggests Mpox. These are not routine viral infections we see in children,” a pediatrician in Gambat said, adding that cases are increasing and causing concern among clinicians.
However, instead of initiating a transparent outbreak response, sources allege that officials within the Directorate General Health Sindh and its Field Epidemiology and Laboratory Training Programme have instructed healthcare providers not to share information with the media or federal authorities.
Health professionals familiar with the situation claim that doctors in both public and private facilities have been informally advised to avoid reporting suspected cases, a move they say is aimed at preventing public disclosure of the outbreak.
“This is not the first time such an approach has been taken. There is a pattern of delaying or downplaying outbreaks, which ultimately costs time and lives,” a public health expert said.
The lack of information sharing appears to have extended beyond national institutions. Officials said representatives of the United States Centers for Disease Control and Prevention based in Islamabad had sought details regarding possible Mpox cases in Sindh, but federal health authorities were unable to provide any information due to the absence of formal reporting from the province.
“This kind of disconnect between provincial and federal systems makes disease control extremely difficult,” a senior official in the health ministry said.
Earlier, confusion had already emerged when officials at Dow University of Health Sciences said they had not received any samples from Khairpur or Gambat, despite claims from local authorities that specimens had been dispatched for testing.
Experts warn that such delays and lack of coordination can significantly hamper containment efforts, especially in regions like upper Sindh where children are already vulnerable due to underlying health challenges.
Parts of Larkana and surrounding districts have previously reported a high burden of HIV among children, and health experts caution that compromised immunity could make them more susceptible to infections like Mpox and lead to more severe outcomes.
“There is an urgent need for transparent reporting, rapid testing and coordinated response. Any attempt to suppress information during an outbreak only increases the risk of spread,” a health official said.
Unverified reports of child deaths linked to the illness have also surfaced, though no official confirmation is available. Experts say weak surveillance systems and absence of routine postmortem examinations in rural areas make it difficult to determine the true extent of the outbreak.
While the Sindh health department maintains that samples have been sent for testing and results will be shared, the decision to rely on a private laboratory and the lack of communication with national authorities have raised serious questions about transparency.
With suspected cases rising and confirmation still awaited, doctors on the ground warn that failure to acknowledge and respond to the situation openly could allow the infection to spread further among children in vulnerable communities.
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