First case of MPOX in Pakistan increases fears of global spread

Pakistan recorded its first case of MPOX on Friday, a day after a patient was found in Sweden to be carrying a more virulent strain of the virus, a first outside Africa where an epidemic is raging that has prompted the WHO to issue a global health alert.

The resurgence of mpox in the Democratic Republic of Congo (DRC), which is also affecting Burundi, Kenya, Rwanda and Uganda, prompted the World Health Organization to declare a public health emergency of international concern on Wednesday, the highest alarm it can sound.

The Swedish Public Health Agency told AFP on Thursday that it had recorded a case of subtype clade 1b, the same new strain that has been emerging in the DRC since September 2023.

The patient was infected during a visit to “the part of Africa where there is a major outbreak of MPOX clade 1,” epidemiologist Magnus Gisslen said in a statement from the agency.

The strain of the mpox virus causing the case in Pakistan was not immediately known on Friday, Pakistan’s health ministry said in a statement.

“The infected person comes from a Gulf country,” the ministry said.

The Pakistani patient, a 34-year-old man, is being treated in Khyber Pakhtunkhwa province, said Irshad Roghani, the province’s director of public health.

“For genetic sequencing of the strain, we have sent samples to Islamabad,” Roghani added.

More infections likely

After the case was discovered in Sweden, the WHO warned that further imported cases of the new strain in Europe were likely.

The WHO European regional office in Copenhagen is discussing with Sweden how best to handle the case.

“The confirmation of mpox subtype clade 1 in Sweden clearly reflects the interconnectedness of our world […]”It is likely that further imported cases of clade 1 will be recorded in the European region in the coming days and weeks,” the organisation warned.

WHO warns against stigmatizing travelers or countries and recommends “avoiding travel restrictions and border closures” that are ineffective. It urges countries to “work together by sharing data and taking necessary public health measures.”

China announced on Friday that it would strengthen its controls on people and goods entering its territory for a period of six months.

The outbreak is particularly hard on the DRC, a country of about 100 million people. Its health minister, Samuel-Roger Kamba, said in a video this week that the country had recorded nearly 16,000 “potential” cases and 548 deaths this year.

He announced the establishment of a “national strategic vaccination plan” as well as other measures to combat the epidemic.

Formerly called monkeypox—a term abandoned in favor of the more neutral mpox—the virus was discovered in 1958 in Denmark, in monkeys bred for research. It was first recorded in humans in 1970 in what is now the DRC.

MPOX is a viral disease that spreads from animals to humans but is also transmitted through close physical contact with a person infected with the virus.

The disease causes fever, muscle aches and boil-like skin lesions.

The US Department of Health announced on Wednesday that the United States would donate 50,000 doses of the MPOX vaccine to the DRC, as vaccination “will be a critical part of the response to the outbreak.”

For its part, the Danish pharmaceutical laboratory Bavarian Nordic, manufacturer of a vaccine targeting MPOX, said on Thursday that it was ready to produce up to 10 million doses by 2025. Currently, the laboratory has some 500,000 doses in stock.

Bavarian Nordic has also asked the European Medicines Agency to extend the use of its serum to adolescents aged 12 to 17.

There are two subtypes of the virus: clade 1, which is more virulent and deadly and is endemic to the Congo Basin in Central Africa, and clade 2, which is endemic to West Africa.

A global outbreak that began in 2022, involving clade 2b, has caused some 140 deaths out of about 90,000 cases, affecting primarily gay and bisexual men.

The more dangerous clade 1b, currently in circulation, is more transmissible, particularly through non-sexual contact, threatening children.

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