Sindh’s mpox story has changed — and the shift could prove far more dangerous than the numbers currently suggest.
KARACHI: What began weeks ago as a travel-linked imported mpox case in Karachi has now evolved into something much more unsettling: a second confirmed case inside the city within days, this time with no immediately established foreign travel link in the official statement, raising fears among infectious disease experts that the virus may be moving beyond imported infections and edging toward possible local transmission inside Sindh.
The Sindh Health Department on Wednesday confirmed mpox in a 20-year-old resident of Buffer Zone, Karachi Central, officially making this the second documented Karachi case of 2026.
Related story: Karachi’s first mpox case of 2026 triggers a public health warning Pakistan can’t ignore
According to officials, the patient developed high fever, headache, and a progressive rash on April 2, before a PCR test performed at Dow University of Health Sciences (DUHS) confirmed mpox on April 8. He was immediately shifted to the Sindh Institute of Infectious Diseases Hospital isolation ward, where his condition is currently reported to be stable.
On the instructions of Provincial Director Dr Asif Syed, a special investigation team headed by focal person Dr Shankar has been constituted to reconstruct the patient’s exposure pathway and determine whether this is another imported event, a healthcare-linked exposure, or an early sign of local spread.
The patient’s father, mother, and cousin have already been identified as close contacts and placed under active surveillance. So far, no symptoms have been reported among them.
What makes this second Karachi case even more significant is the timing.
It comes as Sindh is still reeling from the Khairpur infant deaths cluster, where multiple newborns and infants died amid confirmed and suspected mpox infections, forcing emergency neonatal unit closures, rapid response activation, and province-wide scrutiny of sterilization failures and infection prevention gaps.
Related story: Khairpur mpox horror deepens as another child dies amid rising cases
That cluster exposed a deeply troubling possibility: mpox may already have entered sensitive healthcare settings in interior Sindh, particularly neonatal and maternity environments where delayed recognition can be catastrophic.
Now, with Karachi reporting another fresh case, Sindh’s outbreak map is no longer split between “urban importation” and “rural tragedy.”
It is beginning to look like a two-front transmission challenge.
This concern was sharply reinforced by infectious disease specialists at Aga Khan University Hospital (AKUH) during a media roundtable in Karachi.
Dr Faisal Mahmood, Professor of Infectious Diseases and Dr Fatima Mir, Professor of Paediatric Infectious Diseases at Aga Khan University Hospital are speaking at the media roundtable.
Dr Faisal Mahmood, Professor of Infectious Diseases at Aga Khan University Hospital, warned that Pakistan’s mpox epidemiology appears to be changing.
He noted that while 53 confirmed mpox cases in 2025 were largely travel-related, the 2026 pattern now includes signals that suggest possible local transmission, particularly in Karachi, while the Khairpur cluster raises concern that healthcare-linked spread may already be occurring beyond major urban centres.
That assessment dramatically elevates the public health significance of the Buffer Zone case.
This may no longer be a city receiving imported infections.
This may be a city where the virus is beginning to find local pathways of spread.
Adding to the urgency, Dr Fatima Mir, Professor of Paediatric Infectious Diseases at Aga Khan University Hospital, warned that delayed isolation, missed early symptoms, and weak infection prevention and control (IPC) measures can rapidly turn isolated cases into uncontrolled cross-infection chains.
For the public, the warning signs remain critically important:
• high fever
• swollen lymph nodes
• unusual rash, blisters, or lesions
• severe body aches
• unexplained fatigue after close contact exposure
Anyone developing these symptoms — especially after exposure to a confirmed case, hospital environment, or symptomatic household member — should isolate immediately and seek urgent evaluation at the nearest government facility.
Sindh’s health authorities have already moved into an intensified containment mode, reinforcing hospital IPC protocols, isolation pathways, contact tracing, and round-the-clock surveillance coordination.
The bigger story now is no longer about one patient in Buffer Zone.
It is about what two Karachi cases within weeks mean when Khairpur remains under active outbreak investigation.
For hospitals, clinicians, families, and policymakers, the warning is now impossible to ignore:
the containment window is still open, but Sindh may now be racing against the first real signs of local mpox spread in 2026.
Stay informed, stay protected
CLICK HERE TO JOIN Medical News Pakistan on WhatsApp for real-time health alerts, expert insights, and breakthrough medical discoveries.