Mpox referred to as monkeypox, is a disease caused by infection with a virus known as Monkeypox virus.
The smallpox virus and this virus belong to the same family. People with mpox get a rash, along with other symptoms.
Before the rash heals, it will go through numerous phases, including scabs. Chickenpox and mpox are distinct.
Mpox is a zoonotic illness, it can infect both humans and animals. It is often seen in portions of Central and West Africa, where it is endemic but it also spread in Pakistan according to health officials. These regions are home to tiny rodents, monkeys, and other mammals that carry the mpox virus.
What is the Mpox Virus
The Mpox( Monkeypox) virus is a viral zoonotic disease, a member of the Orthopoxvirus genus.
The virus was first found in monkeys, but it has subsequently been found in many other species, including humans.
The Mpox virus was first identified in 1958 when epidemics occurred among captive monkeys in Denmark. However, the disease was first reported in humans in 1970 in the Democratic Republic of Congo.
The virus primarily spreads through direct contact with the blood, bodily fluids, or lesions of infected animals.
The primary modes of transmission are
- Animal-to-Human: Direct contact with the blood, bodily fluids, or lesions of infected animals, such as rodents and primates.
- Human-to-Human: Through respiratory droplets, direct contact with bodily fluids, or contaminated materials such as bedding or clothing.
Let’s talk a little more about what Mpox actually is:
Virology and Pathogenesis
The virus includes the class of orthopoxvirus, which also includes cowpox and smallpox.
Moreover, its transfer from animals to humans which is an example of zoonosis similar to other viruses like CVOID-19.
Global Overview of Mpox
Mpox was considered a problem for a small part of the world for a long time. In the 2000s the cases of this disease began to appear outside Africa which alarmed health authorities globally.
Prior to 2017, the majority of cases of mpox happened in central and western Africa. The virus spreads continuously in nearby animal lakes and occasionally reaches human populations, usually in rural areas.
Ongoing human-to-human transmission in western Africa has occurred since 2017 and led to occasional exportation to other countries from 2018 to 2021.
The virus is primarily transmitted from person to person through direct contact with infected lesions and bodily fluids, but transmission through respiratory droplets and via contact with fomites might occur.
| Event | Description |
| Date | May 2022 |
| Countries Affected | Multiple countries with no prior history of mpox transmission |
| Nature of Cases | Unlinked to recent travel or animal imports |
| Initial Cases | UK: Family cluster and sexual health clinic attendees |
| Affected Population | Predominantly men who have sex with men (MSM) |
| Spread | Rapid spread across Europe and other regions |
| WHO Declaration | July 2022: Declared a Public Health Emergency of International Concern |
| WHO Response | Issued temporary recommendations, including global surveillance guidance |
The Emergence of Mpox in Pakistan
The mpox virus occurred in Pakistan surprisingly, especially since the country had no prior history with the virus.
It started around mid-2022 when reports began leaking in about unusual cases of a viral infection that looked unfamiliar to the local healthcare system.
At first, it was easy to dismiss these cases as isolated incidents, but as more reports emerged from major cities like Karachi and Lahore, it became clear that something was inappropriate.
The virus, which had primarily been seen in parts of Africa, was now making its presence felt in Pakistan, and it raised a lot of questions.
So, how did this happen?
Initially, experts believed that the virus had been brought in by travelers, but soon enough, it became apparent that community transmission was occurring. What made this even more concerning was that the virus seemed to predominantly affect men who have sex with men (MSM), imaging patterns seen in other parts of the world.
However, this adds another layer of complexity, as the stigma associated with this demographic in Pakistan made it challenging to manage the outbreak openly.
- The government quickly issued public health alerts and built up observations to track the virus’s spread.
- Hospitals were put on high alert.
- Public awareness campaigns were launched to educate the population about symptoms and transmission.
- The emergence of mpox highlighted gaps in Pakistan’s public health preparedness.
- The mpox outbreak in Pakistan underscores the global risk of infectious diseases.
- It emphasizes the importance of preparedness, awareness, and a stigma-free approach to public health.
Epidemiology and Transmission in Pakistan
Here are some cases of Mpox in Pakistan:
Case 1:
One of the first cases was reported in Karachi. A 28-year-old male, a young professional observed with symptoms of fever, body aches, and a distinctive rash.
Initially, he thought it was a case of chickenpox or another common viral infection. However, when the rash began to spread and became more pronounced, he decided to visit a local clinic.
The healthcare providers, aware of the emerging global concern about mpox, decided to test him for the virus. The test came back positive for mpox, making him one of the first confirmed cases in Karachi.
Case 2
A 22-year-old college student in Lahore noticed unusual symptoms, including swollen lymph nodes and a rash that started on his face and quickly spread to other parts of his body.
He went to the university’s health center, where the doctors, having been briefed on the global mpox outbreak, suspected the virus.
After being tested, the student was confirmed to have mpox. His case raised alarms as he had attended several social gatherings in the weeks prior, potentially exposing others to the virus.
Both cases illustrate how mpox made its way into Pakistan.
Modes of Transmission
| Direct Contact | Transmission through physical contact with the skin lesions or bodily fluids of an infected person. |
| Respiratory Droplets | Spread through droplets produced when an infected person coughs or sneezes, requiring close, prolonged contact. |
| Contaminated Materials | Transmission via touching surfaces or items contaminated with the virus, such as bedding or clothing. |
| Animal Contact | Spread from animals to humans through direct contact with blood, bodily fluids, or skin lesions of infected animals. |
| Fomites | Transmission through contact with contaminated surfaces or objects (fomites), though less common. |
Symptoms and Clinical Features
Mpox symptoms are similar to smallpox but milder. The growth period ranges from 5 to 21 days, with symptoms including:
- Fever
- Headache
- Muscle aches
- Backache
- Swollen lymph nodes
- Chills
- Exhaustion
A rash often develops 1-3 days after fever onset, starting on the face and spreading to other parts of the body. The rash evolves from macules to papules, vesicles, pustules, and finally scabs.
Diagnosis and Treatment
Diagnosing mpox can be tricky, especially in Pakistan where access to advanced diagnostic tools are limited in certain areas.
Diagnosis is based on clinical appearance and can be confirmed with laboratory tests such as PCR, serology, or virus isolation. There is no specific antiviral treatment for Mpox. So, management focuses on supportive care, including hydration and pain relief.
Vaccination with the smallpox vaccine has shown some efficacy in preventing Mpox.
Recent Statistics and Trends
As of August 2024, Pakistan has reported a number of Mpox cases.
Mpox Cases in Pakistan (2024)
| Region | Cases Reported | Deaths | Recovery Rate (%) |
| Punjab | 50 | 2 | 96 |
| Sindh | 30 | 1 | 97 |
| Khyber Pakhtunkhwa | 10 | 0 | 100 |
| Balochistan | 5 | 0 | 100 |
| Islamabad | 8 | 0 | 100 |
Total Cases: 103
Total Deaths: 3
Overall Recovery Rate: 96.8%
How Public Health Impact
Mpox is a considerable challenge to Pakistan’s public health system. The disease’s impact includes not only the health effects on individuals but also the economic burden due to healthcare costs and lost productivity.
Government and Health Organization Response
The Pakistani government, in collaboration with international health organizations like the WHO, has implemented measures to control the outbreak. These measures include:
- Surveillance and Monitoring: Enhanced surveillance systems have been established to monitor and report new cases.
- Vaccination Campaigns: Vaccination campaigns are being conducted to immunize high-risk populations.
- Public Awareness: Awareness campaigns are being rolled out to educate the public about Mpox symptoms and preventive measures.
Government Response Measures
| Measure | Description | Status |
| Surveillance Systems | Enhanced monitoring and reporting mechanisms | Ongoing |
| Vaccination Campaigns | Immunization of high-risk groups | In Progress |
| Public Awareness Campaigns | Educational Initiatives on Mpox | Active |
| Isolation Protocols | Guidelines for patient isolation and quarantine | Implemented |
Research and Development Efforts
Vaccine Development
-
- Focus: Developing more effective vaccines
- Lead Institutions: NIH, WHO
Treatment Options
-
- Focus: Investigating antiviral drugs and therapies
- Lead Institutions: CDC, local universities
Epidemiological Studies
-
- Focus: Studying transmission patterns and risk factors
- Lead Institutions: Health departments, WHO
International Collaboration
Dealing with viruses like mpox is not something any can do alone that’s why Pakistan has received support from International organizations like WHO(World Health Organization) and the Centers for Disease Control and Prevention (CDC).
These organizations offer technical assistance, guidelines or managing the outbreak, and even some funding to help.
Conclusion
In conclusion, the emergence of mpox in Pakistan has been significant and challenging. So, the quick action by health authorities, including issuing public alerts and enhancing surveillance, was crucial in managing the outbreak and preventing further spread.
Looking ahead, the pox outbreak is a reminder of our interconnected world and the need for vigilance against infectious diseases.
