Islamabad: A joint investigation into a suspected Mpox outbreak in Sindh’s Khairpur district has been launched by a high-level team of epidemiologists, laboratory scientists and infection prevention experts, as federal authorities express concern that the provincial government remains in a state of denial despite laboratory confirmations and a rising number of cases among neonates and adults.
Officials confirmed that the team, comprising experts from the National Institute of Health (NIH) Islamabad, Sindh Health Department and Dow University of Health Sciences, has been dispatched to Khairpur and Sukkur to conduct field investigations, collect samples, assess infection prevention and control practices, and recommend urgent containment measures.
The visiting team includes epidemiologists to trace transmission patterns, virologists and laboratory specialists for confirmatory diagnostics and genomic analysis, and infection prevention and control (IPC) experts to evaluate lapses in healthcare settings.
The move follows mounting pressure from federal health authorities after multiple suspected and confirmed cases continued to surface in Khairpur and adjoining areas, including infections among newborns. At least seven neonatal deaths have already been reported in the district, with several of them testing positive for Mpox in laboratory investigations conducted by two independent facilities, raising serious alarm within national health circles.
Despite these confirmations, officials at the Ministry of National Health Services said the Sindh government has yet to formally acknowledge the outbreak, a stance that has drawn criticism from federal authorities who warn that delayed recognition and reporting could worsen the situation and undermine containment efforts.
A senior federal health official said the situation has been taken up at the highest level, with Prime Minister Shehbaz Sharif directing immediate coordination between federal and provincial authorities, strengthening of surveillance systems and urgent measures to prevent further spread of the virus.
“The federal government has offered full technical support, including laboratory confirmation, genomic sequencing and outbreak investigation, but timely data sharing and transparency from the provinces is critical,” the official said, adding that withholding information could compromise both national response and international obligations.
A formal communication from the NIH’s Centre for Disease Control had already warned Sindh authorities that laboratory-confirmed cases in Khairpur indicate a potential outbreak requiring urgent and coordinated response. The letter highlighted the unusual detection of infection in an infant, raising the possibility of vertical transmission, a rare but serious development that requires detailed epidemiological investigation.
The NIH also reminded provincial authorities of Pakistan’s obligations under the International Health Regulations (2005), under which timely detection and reporting of outbreaks to the World Health Organization is mandatory. Officials cautioned that delays or concealment could affect Pakistan’s global health standing and hinder international support mechanisms.
On the ground, local authorities in Sukkur and Khairpur have begun limited response measures. Commissioner Sukkur Division, Syed Abid Saleem Qureshi, visited Gambat where officials briefed him on the formation of rapid response teams. According to district officials, three teams have been constituted in each taluka under the supervision of assistant commissioners, with members including health officers, veterinary doctors and representatives from local government and education departments.
Officials said these teams have been tasked with conducting field visits, ensuring implementation of infection prevention protocols at public and private healthcare facilities, and submitting daily situation reports to the deputy commissioner. Authorities have also been directed to establish emergency control rooms and improve public awareness through lady health workers and local administrative staff.
However, health experts say these measures may be too little and too late if the scale of the outbreak is not fully acknowledged. Clinicians in Khairpur, Gambat and surrounding areas have reported clusters of children presenting with symptoms consistent with Mpox over the past several weeks, indicating that transmission may already be occurring at the community level.
A separate team from Dow University has also conducted independent field visits and sample collection, reinforcing concerns that the outbreak is larger than officially reported. Federal officials privately acknowledge that gaps in disease surveillance, weak coordination and reluctance to share data have allowed the situation to evolve unchecked.
“There is clear evidence of ongoing transmission, including among highly vulnerable populations such as newborns. The priority now is to determine the true scale of the outbreak and contain it before it spreads further,” another official said.
With the NIH-led team now in the field and international reporting obligations looming, health authorities say the coming days will be critical in assessing whether Pakistan can contain what is increasingly being viewed as a serious and potentially escalating public health emergency.
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