Pakistan decides to approach WHO for mpox vaccine

ISLAMABAD: The National Institute of Health (NIH) Islamabad has decided to request World Health Organisation (WHO) to provide vaccine for the prevention of Monkeypox (Mpox) after two people, who had returned from Saudi Arabia were found infected with Monkeypox, officials in the National Health Services, Regulations and Coordination (NHS,R&C) said on Wednesday.

“During National Command and Operation Center (NCOC) meeting held on Wednesday to discuss Monkeypox situation in the country, it was decided that WHO would be requested for a sizeable quantity of Monkeypox vaccine to vaccinate healthcare providers and infectious diseases experts who would be on the frontline to deal with the confirmed and suspected cases of the infectious disease”, an official of the NHS, R&C told The News.

Health institutions and establishments were put on high alert throughout Pakistan after two persons were found infected with Mpox (Monkeypox) in the who had arrived in Islamabad on April 17, 2023, from the Kingdom of Saudia Arabia (KSA). Isolation wards and filter clinics were established in major cities of the country including Islamabad, Rawalpindi, Lahore, Karachi and Peshawar to deal with any suspected cases of the Monkeypox disease.

The NHS official said the issue of Monkeypox cases were discussed in detail at the NCOC meeting Wednesday at NIH Islamabad where it was decided that a formal request would be made to the WHO for provision of Monkeypox vaccine for the healthcare providers and frontline workers so that they could be prevented from the disease.

The official said as per WHO and US Center for Disease Control and Prevention (CDC) guidelines, persons who work in settings where they may be exposed to Mpox, or orthopoxviruse in a laboratory are part of an orthopoxvirus and health care worker response team need to be vaccinated with two-doze vaccine.

“At the moment, Mpox vaccine is not available because we did not have any cases but now when we have detected its cases, it is important that we have the vaccine to immunize our vulnerable people and experts”, the NHS official added.

On the other hand, officials in Sindh and other provinces said they had established Rapid Response Teams on district levels to keep an over suspected cases of Mpox and to send the samples of the suspected persons to the NIH Islamabad as well as isolating the suspected and confirmed patients.

According to the WHO, Mpox is an infectious disease caused by the Monkeypox virus. It can cause a painful rash, enlarged lymph nodes and fever. Most people fully recover, but some get very sick. “Since January 2022, cases of Monkeypox have been reported to WHO from 110 member states across all 6 WHO regions. As of April 25th 2023, a total of 87,113 laboratory-confirmed cases and 130 deaths, have been reported to WHO,” the NHS, R&C official said.

Giving details of the Mpox cases reported in the country, the NHS official said on April 17, 2023, a very sick person who had been deported from Saudi Arabia for over-staying, landed in Islamabad with high-grade fever, rashes, headache, muscle aches and sore throat. He was advised to visit the Pakistan Institute of Islamabad (PIMS), Islamabad. “On suspicion of being infected with Mpox (Monkeypox), the samples of the said person, who is a resident of Rawalpindi/Islamabad, were sent to the National Institute of Health (NIH), which confirmed that he was infected with Mpox,” the official said, adding that currently he was admitted at an isolation ward of PIMS.

Following the detection of two Mpox cases, airports across the country have been put on high alert and airlines have been advised to report all the suspected cases to the border health services department at the airports. On the other hand, all the provincial health departments have started establishing isolation wards at major health facilities in their provincial capitals to admit suspected and confirmed Mpox cases.

Meanwhile, training of healthcare officials to deal with infectious disease has also started.

Mpox is a viral illness caused by the monkeypox virus, a species of the genus Orthopoxvirus. Two different clades exist — clade I and clade II. The WHO has said that the common symptoms of monkeypox or Mpox are a skin rash or mucosal lesions which can last 2–4 weeks and are accompanied by fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes. It can be transmitted to humans through physical contact with someone who is infectious, with contaminated materials, or with infected animals.

The disease is treated with supportive care. Vaccines and therapeutics developed for smallpox and approved for use in some countries can be used for Mpox in some circumstances.