PESHAWAR: Health department has started imparting training to laboratory staff, doctors and field workers on identification of suspected mpox patients and collection and transportation of their specimen to Public Health Reference Laboratory as the disease has killed people in Sindh recently.
Khyber Pakhtunkhwa has strengthened its mpox preparedness and response through a three-day training conducted by Public Health Reference Laboratory (PHRL) in collaboration with UK Health Security Agency (UKHSA) for field and laboratory staff.
UKHSA country head Dr Asif Bittani on the occasion said that his organisation would continue support in that regard.
The director of PHRL, Dr Yasar Mehmood Yousafzai, said that the training focused on early identification of suspected mpox cases, correct sample collection, packaging and transportation, laboratory sample processing and timely result reporting.
Experts fear local transmission of the infection
“This capacity-building activity is important because the province is now facing a more complex mpox situation, with evidence suggesting that transmission is no longer limited to imported cases,” he said.
According to consolidated provincial figures, Khyber Pakhtunkhwa has reported 28 laboratory-confirmed mpox cases from August 2024 to April 2026. In 2026, eight confirmed cases have been reported, including one death. The most recent reported case was detected on April 16, 2026, in a one-and-a-half-month-old male infant. It has been considered locally transmitted case based on available epidemiological information.
In the earlier phase, many confirmed cases in KP were associated with international travel, particularly travel from Gulf countries. More recently, however, cases without clear travel history have been detected in the province.
Some cases appear to be imported while others are secondary or locally acquired. This changing pattern suggests that local transmission is becoming epidemiologically significant and requires close monitoring.
The available case line-list supports this shift. Mpox cases have been reported from multiple districts and referral points including Peshawar, Mardan, Nowshera, Orakzai, Lower Dir, Lakki Marwat, North Waziristan, Kohat, Khyber, Swabi, Abbottabad, Bannu and Chitral.
Earlier, cases were more often travel-associated while later entries include patients with no clear travel history, household exposure or unclear exposure source. This pattern is consistent with PHRL’s communication to health department. The communication said that early detections were mostly imported while more recent cases often lacked travel history or had unascertainable exposure history, raising concern for possible local or community transmission.
“An important laboratory finding in KP is the detection of both Clade-I and Clade-II mpox infections. This mixed clade pattern increases the importance of molecular surveillance, case investigation and integration of laboratory findings with district level field epidemiology,” said Dr Yasar.
He said that it also highlighted the need to avoid assuming that all cases were linked to one source or one route of introduction. At national level, KP’s situation should be interpreted as part of a wider concern in Pakistan, he added.
Sindh and Punjab have also reported mpox cases in 2026, with reports of deaths and suspected local transmission in Sindh. This indicates that Pakistan’s mpox situation is no longer simply a matter of isolated imported infections. Provincial surveillance systems, public health laboratories, hospitals and field teams must therefore work in a coordinated manner.
Globally, mpox remains under active surveillance of World Health Organisation (WHO). The multi-country situation report, prepared by WHO on April 30, 2026, covering global data up to March 31, 2026, said cases were registered across multiple regions, with Africa contributing the largest share of recent confirmed infections.
This global context is relevant for Pakistan because travel-associated introductions can still occur, while local transmission may continue once the virus enters susceptible household or community networks.
PHRL continues to provide real-time PCR testing for mpox. Suspected cases should be sampled according to national guidance and referred through designated channels. Preferred specimens include lesion swabs from fresh vesicles, pustules or crusted lesions. Samples should be properly labelled, accompanied by clinical and exposure history and transported using triple packaging and cold chain at 2–8°C.
Dr Yasar said that PHRL had also advised that clinicians should document travel history, contact history, relevant exposure history and complete contact details of suspected patients when referring samples.
Published in Dawn, May 18th, 2026
