Following confirmation of local Mpox transmission in Punjab, the National Institute of Health (NIH) Islamabad has issued a formal directive to all provinces, stressing immediate, complete, and accurate reporting of Mpox cases and related data, with Punjab remaining the main concern due to serious gaps in surveillance reporting.
The directive, issued on December 30 by the National Command and Operation Centre (NCOC) and the CDC Wing of the NIH, comes after the conclusion of the Public Health Emergency of International Concern for Mpox. Federal officials clarified that while the letter addresses all provinces, it is primarily aimed at Punjab, as other regions are already complying with routine data sharing requirements.
According to the NIH, Mpox still requires enhanced surveillance under the International Health Regulations (IHR) 2005 and national public health laws due to its risk of re-emergence and international spread.
Official data shows Pakistan recorded 57 confirmed Mpox cases between April 2023 and December 31, 2025, including one death. Punjab reported the highest number with 23 cases, followed by Khyber Pakhtunkhwa with 22 cases and one death. Islamabad, Sindh, Azad Jammu and Kashmir, and Balochistan reported fewer cases, while none were detected in Gilgit-Baltistan.
However, federal health officials stated that Punjab’s figures remain largely unverifiable because the province has failed to submit complete laboratory confirmations, exposure histories, and clinical outcomes to the NIH.
Federal authorities expressed particular concern as many cases in Punjab involve local transmission without recent travel history, suggesting possible community spread. Available information indicates transmission among men who have sex with men, a group globally identified as at higher risk during recent outbreaks.
Officials confirmed that two to four Mpox patients are currently under treatment at Mayo Hospital Lahore, but Punjab has not officially shared their clinical or laboratory details with the NIH.
“Mpox is a notifiable disease, and under national and international obligations, every confirmed case must be reported to the NIH,” a senior federal official said, adding that incomplete paper-based reports from Punjab do not meet surveillance standards.
The NIH stressed that genetic sequencing of Mpox samples is essential to identify circulating clades, understand transmission patterns, and fulfill World Health Organization (WHO) reporting requirements. Without proper data from Punjab, Pakistan cannot present an accurate national picture internationally.
Repeated attempts to obtain comments from Punjab’s Directorate General of Health Services received no response.
