The girl, from the Jhol area in Sanghar, was bitten by a stray dog about a month and a half ago.

She did not receive the rabies vaccine after the bite.

Authorities say that more than 3,000 cases of dog bites have been reported in Karachi this month alone.

AI is helping find participants and sites for clinical trials and drafting documents for regulators, shaving weeks off these labour-intensive processes, seven large drugmakers and six smaller biotech companies said at the recent JP Morgan Healthcare Conference.

It can take a decade and $2 billion to bring a new drug to market, pharmaceutical companies say. Many, including Eli Lilly, which has partnered with leading chipmaker Nvidia, are betting AI can also improve the success rate of new drugs.

Drug companies have announced a slew of deals for tools to unleash the promise of AI, seen as the biggest technological upheaval since the internet, much as other industries are doing.

Agentic AI - or AI that is autonomous, requiring little human intervention - could increase clinical development productivity by about 35% to 45% over the next five years, consultancy McKinsey predicted last year.

Israel-based Teva Pharmaceutical Industries said it is utilising AI in multiple ways so it can focus on the big picture goal of successfully bringing new drugs to market.

“Everything else that’s around that needs to be as efficient and as small as possible,” Teva CEO Richard Francis said. “This is where I think AI digitisation, modernisation, process improvement, all the unsexy stuff that we get actually quite excited about, makes a difference.”

Executives from global pharmaceutical companies AstraZeneca, Roche and Pfizer, as well as smaller biotechs like Spyre and Nuvalent, described tracking thousands of pages of documents for regulators, including clinical, safety and manufacturing records.

The documents must be compiled, cross-checked and kept consistent across geographies, often requiring the costly use of outside contractors, AstraZeneca Chief Financial Officer Aradhana Sarin explained.

Jorge Conde, a general partner at venture capital firm Andreessen Horowitz, is investing in fixes to what he calls drug development’s “messy middle,” including putting $4.3 million into startup Alleviate Health.

He described trial enrollment as a “leaky funnel” in which participants drop out along the way, and sees Alleviate using AI technology to help with patient outreach, education, screening and scheduling.

TD Cowen analyst Brendan Smith said the use of AI, including large language models like Microsoft Copilot, for administrative tasks has become fairly common in the pharmaceutical industry.

But it may take another one to three years before investors can measure how AI has begun speeding up drug development, he said. Quantifying savings is difficult, Smith said, as it depends on how and where the tools are deployed.

Novartis

Swiss drugmaker Novartis turned to AI in 2023 when it was starting a 14,000-person, late-stage cardiovascular outcomes trial for its cholesterol drug Leqvio, Chief Medical Officer Shreeram Aradhye said.

The typical four- to six-week site selection process became a two-hour meeting, as AI helped identify higher-performing sites and allowed Novartis to close participant enrollment with only 13 patients above its trial target, Aradhye said.

“AI becomes augmenting intelligence, not artificial intelligence,” he added.

A Novartis spokesperson said the time savings afforded by AI can add up to months over a drug-development program.

Gsk Genmap, ITM Plan For Savings

British drugmaker GSK said it’s using a mix of digital and AI tools to reduce manual data collection and aggregation and trial enrollment, and aims to speed up all clinical trials by 15% this way.

That helped save about 8 million pounds ($10.87 million) in costs for late-stage studies of asthma drug Exdensur last year, according to a GSK spokesperson. The drug won U.S. approval last month.

Danish antibody developer Genmab said it plans to deploy Anthropic’s Claude chatbot-powered agentic AI to support clinical development priorities.

Hisham Hamadeh, Genmab’s head of AI, said the goal is to automate post-trial work, including analysis of data and its transformation into graphs, tables, figures and clinical study reports.

German radiopharmaceuticals firm ITM told Reuters it has figured out how to use AI to convert long trial reports into US FDA template formats, potentially saving weeks of effort requiring several staff, but has yet to deploy it.

Amgen research chief Jay Bradner said AI is delivering on multiple fronts in the drug development and regulatory document preparation process.

“What everybody’s waiting for is the AI drug. When do I get the AI drug?“ he said. “I actually think those molecules are in pipelines right now.”

The lab confirmed a polio case from Sindh’s Larkana district. This is the second polio case reported from Sindh this year, bringing the total number of cases to two in Sindh and one in Khyber Pakhtunkhwa.

Last year, a total of 74 cases were reported. Of such, 27 were from Balochistan, 22 from KP, 23 from Sindh, and one each from Punjab and Islamabad.

Polio is a paralysing disease that has no cure. Multiple doses of the oral polio vaccine and completion of the routine vaccination schedule for all children under the age of five are essential to provide children with high immunity against this terrible disease.

The first nationwide polio campaign of 2025 has been concluded, with “99% of the targets achieved across the country.” The campaign was conducted from February 3 to 9, 2025. More than 45 million children were administered the polio vaccine in the vaccination drive.

A second round of the “Big Catch-Up activity” is underway in the country, to vaccinate children up to 5 years with EPI antigens.

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The Pakistan Polio Program launched a Fractional IPV-OPV Polio campaign in Quetta Division and Karachi on February 20 and February 22 respectively.

Around one million children are being targeted for vaccination in the campaign.

Moreover, a vaccination activity targeting 104 UCs bordering Afghanistan or having Afghan refugee camps/populations is scheduled from February 24 to 28. A total of 0.66 million children would be administered with vaccine drops.

The lab confirmed one polio case from Sindh’s Badin district. The first case of the year was reported in Khyber Pakhtunkhwa’s Dera Ismail Khan.

In 2024, a total of 74 cases were reported. Of such, 27 were from Balochistan, 22 from KP, 23 from Sindh, and one each from Punjab and Islamabad.

Polio is a paralyzing disease that has no cure. Multiple doses of the oral polio vaccine and completion of the routine vaccination schedule for all children under the age of five are essential to provide children with high immunity against this terrible disease.

The Pakistan Polio Programme conducts multiple mass vaccination drives in a year while the Expanded Program on Immunization provides vaccinations against 12 childhood diseases free of charge at health facilities.

The first nationwide polio campaign of 2025 has been concluded, “with 99% of the targets achieved across the country.”

The campaign was conducted from February 3 to 9, 2025. During this campaign, more than 45 million children were administered the polio vaccine.

In every campaign, the program ensures that children under five years receive polio drops, to protect them from the crippling effects of the polio virus.

US Surgeon General Vivek Murthy said alcohol consumption increases the risk of at least seven types of cancer, including breast, colon and liver cancer, but most US consumers remain unaware of this.

Murthy also called for the guidelines on alcohol consumption limits to be reassessed so that people can weigh the cancer risk when deciding whether or how much to drink. US dietary guidelines currently recommend two or fewer drinks per day for men and one drink or less per day for women.

“Alcohol consumption is the third leading preventable cause of cancer in the United States, after tobacco and obesity,” Murthy’s office said in a statement accompanying the new report, adding the type of alcohol consumed does not matter.

His advisory sent shares in alcohol companies including Diageo, Pernod Ricard, Anheuser-Busch InBev, and Heineken down, in some cases over 3%.

Alcohol producers and industry associations, did not immediately share comments.

It is unclear when or if the Surgeon General’s suggestions will be adopted. US President Joe Biden’s administration is entering its final two weeks. Murthy could be succeeded by Janette Nesheiwat, a director of a New York chain of urgent care clinics and president-elect Donald Trump’s pick for the role.

Trump, whose brother died from alcoholism and who does not drink himself, has long warned about the risks of drinking. Robert F Kennedy Jr., Trump’s nominee for Secretary of Health and Human Services, has been open about his past struggles with heroin and alcohol, and says that he attends Alcoholics Anonymous meetings.

The decision to update the label will ultimately be made by Congress.

Small print

Murthy’s advisory harks back to early US Surgeon General action on tobacco, starting with a 1964 report that concluded smoking could cause cancer. The report kicked off decades of increasingly strict regulations, starting with US laws on warning labels one year later and still ongoing today.

Alcoholic drinks in the US already carry warnings on their packaging, including that drinking alcohol while pregnant can cause birth defects and that it can impair judgment when operating machinery. These appear in small print on the back of the packaging. This label has not changed since its inception in 1988.

Murthy’s recommendations call for an update to these existing labels, rather than new cigarette-style warnings that are today displayed prominently on the front of every packet.

Analysts however pointed out that cigarette warning labels did little to curb smoking and ingrained habits are hard to change.

“Warning labels won’t be an immediate deathblow to alcohol makers, but it will compound the long-term threats to the industry,” said Blake Droesch, analyst with eMarketer.

In the US, among the largest markets for many western producers, alcohol sales have been falling following a post-pandemic boom. Revenues are now further threatened by looming tariffs.

Longer term, companies face growing competition from alternatives like cannabis and the threat of lower volumes as some consumers, especially younger ones, drink less than previous generations in some markets.

Beer makers especially have, however, enjoyed benefits from a shift towards healthier lifestyles, with low- or no-alcohol products enjoying rapid growth. Heineken’s 0.0 version, for example, grew double digits in 16 markets last year.

‘Save lives’

Public health bodies like the World Health Organization (WHO) are also increasingly turning their attention towards alcohol after making progress on stronger tobacco controls.

The WHO says there is no safe level of drinking and that even a small amount of alcohol can harm health - a position that has prompted tense debate around the impact of moderate drinking and its role in society.

The current US dietary guidelines run until 2025, and companies including Diageo and Heineken have lobbied officials ahead of the change, lobbying records show, amid concerns the U.S. could adopt the WHO’s language around safe consumption.

Other countries’ guidelines already include such language, while nations like Ireland have already moved to introduce warning labels.

Industry associations like the Distilled Spirits Council of the United States (DISCUS), which represents top spirits makers, point to research showing that moderate alcohol consumption can have some health benefits, though it adds no one should choose to drink for this reason and even moderate drinking may pose risks for some.

Some scientists accused the industry of misleading people about the risks of developing cancer from drinking in a 2017 study. DISCUS said the researchers had anti-alcohol biases and their study was selective.

Bruce Scott, president of the American Medical Association, welcomed the Surgeon General’s effort to make the link between alcohol and increased cancer risk clear. He said, coupled with a push to update warning labels, it could “bolster awareness, improve health and save lives.”

The Surgeon General’s advisory said alcohol is responsible for 100,000 US cancer cases and 20,000 cancer deaths each year, more than the 13,500 alcohol-associated traffic crash deaths.

One of the cases was reported from Khyber Pakhtunkhwa’s Tank while the other originated from Sindh’s Kashmore.

Pakistan and neighbouring Afghanistan are the only countries where polio remains endemic and the vaccination teams frequently come under attack by militants targeting security forces.

Earlier this month, the government launched its last campaign of this year, bringing the vaccine to children at their doorsteps while the Expanded Programme on Immunization provides vaccinations against 12 childhood diseases free of charge at health facilities.

The December sub-national Polio vaccination campaign in Balochistan province is scheduled to begin on December 30, during which all 36 districts of the province will be targeted for vaccination.

In Balochistan, the number of children affected by polio has reached 27. Sindh and Khyber Pakhtunkhwa each have 19 reported cases of polio. Moreover, one case has been confirmed in both Islamabad and Punjab.

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Polio can easily be prevented by the oral administration of a few drops of vaccine, but in parts of rural Pakistan health workers risk their lives to save others.

Scores of polio vaccination workers and their escorts have been killed over the years.

In September, dozens of Pakistani policemen who accompany medical teams on door-to-door campaigns went on strike after a string of militant attacks.

The lab confirmed the case from Balochistan’s Killa Abdullah. This is the seventh polio case from Killa Abdullah this year.

Pakistan is responding to the resurgence of WPV1 this year with 65 cases reported so far. Of these, 27 are from Balochistan, 18 from Khyber Pakhtunkhwa, 18 from Sindh, and one each from Punjab and Islamabad.

Polio is a paralysing disease that has no cure. Multiple doses of the oral polio vaccine and completion of the routine vaccination schedule for all children under the age of five are essential to provide children with high immunity against this terrible disease.

Earlier this month, the government launched its last campaign of this year, bringing the vaccine to children at their doorsteps while the Expanded Programme on Immunization provides vaccinations against 12 childhood diseases free of charge at health facilities.

The December sub-national Polio vaccination campaign in Balochistan province is scheduled to begin on December 30, during which all 36 districts of the province will be targeted for vaccination.

“We will win this war [against polio] despite the difficulties faced in the past, polio cases increased and approximately 60 cases in Pakistan have come forward which is a great challenge and matter of great concern,” PM Shehbaz said at the launch ceremony of the anti-polio drive in Islamabad.

Pakistan is one of the last two countries in the world, alongside Afghanistan, where polio remains endemic, with the disease mostly affecting children under five, and sometimes causing lifelong paralysis.

The seven-day drive, which begins on Monday, aims to vaccinate more than 44 million children in 143 specified districts of the country.

This concluding drive of 2024 would involve 85,000 mobile teams, working “tirelessly” to reach every child across urban and rural areas of the province.

The last anti-polio campaign of the year 2024 is being launched from December 16 to 22.

The prime minister administered polio drops to children at the ceremony.

He urged parents across the country to help the government in the campaign and by giving polio drops to their children to safeguard their future.

“I would like to acknowledge with a deep sense of gratitude the efforts of our international partners, Bill Gates Foundation, World Health Organisation and the Government of Saudi Arabia,” the prime minister added.

Pakistan’s tally of polio cases nationwide has risen to 63.

Vaccine is safe and free of cost: PM’s focal person

“We are determined to make the vaccine accessible to all children up to the age of five years,” Prime Minister’s Focal Person for Polio Eradication Ayesha Raza Farooq said in a video message.

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“As a mother, I appeal to you to open your doors to polio workers and give all your children up to the age of five the mandatory polio drops.”

She reiterated that the polio vaccine is safe, and effective and is provided free of cost. The premier’s focal person said that routine vaccination was necessary to protect against the crippling disease and other deadly diseases.

Ayesha paid tributes to the brave frontline polio workers serving in difficult circumstances. “Our frontline workers are the real heroes in the ongoing struggle against polio.”

For years, families of deceased patients in Islamabad faced the distressing situation of hospitals refusing to release the body until all medical bills were paid.

Many families, already burdened by medical costs and grief, were forced to settle bills upfront before receiving the body. The issue was particularly common in private hospitals, which often charged high advance fees.

Many citizens said when patients passed unexpectedly or after prolonged illnesses, families struggled to gather the funds, risking delays in burying their loved ones.

They said the directives from IHRA’s newly appointed board have brought “immense relief” to the people, with many taking to social media and public forums to voice their gratitude.

Haider Ali, an Islamabad resident, shared his experience, “This decision is a blessing for families going through the toughest time of their lives.”

He said: “I recently lost my father to a sudden heart attack, and I was forced to run from pillar to post to pay bills before we could bury him. It was traumatic. I am so relieved to see this change.”

Advocate Imran Ali described the decision as “long overdue”. He hoped that the new rule would help prevent exploitation. “Hospitals shouldn’t use death as a business transaction.”

Xpert MTB/RIF Ultra, produced by US-based molecular diagnostics company Cepheid, “is the first test for TB diagnosis and antibiotic susceptibility testing that meets WHO’s prequalification standards”, the UN health agency said.

WHO prequalification aims to ensure that key health products meet global standards for quality, safety and efficacy.

The WHO already recommended the test, but prequalification means that UN agencies such as UNICEF, or others like the Gavi vaccine alliance, have a simpler pathway to procure and distribute a product in countries with limited resources.

“This first prequalification of a diagnostic test for tuberculosis marks a critical milestone in WHO’s efforts to support countries in scaling up and accelerating access to high-quality TB assays that meet both WHO recommendations and its stringent quality, safety and performance standards,” said Yukiko Nakatani, a WHO assistant director-general.

“It underscores the importance of such groundbreaking diagnostic tools in addressing one of the world’s deadliest infectious diseases,”

A preventable and curable disease, TB is caused by bacteria and most often affects the lungs. It is spread through the air when people with lung TB cough, sneeze or spit.

In October, the WHO said a record 8.2 million new tuberculosis cases were diagnosed worldwide in 2023 – the highest number since it began global TB monitoring in 1995.

And with 1.25 million related deaths, TB probably returned to being the world’s leading cause of death from a single infectious agent, following three years in which it was replaced by Covid-19, the WHO added.

The test detects the genetic material of the bacterium that causes TB in spit samples, and provides an accurate result within hours.

The WHO says the accurate and early detection of TB, especially drug-resistant strains, is a critical global health priority.

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“High-quality diagnostic tests are the cornerstone of effective TB care and prevention,” said Rogerio Gaspar, the WHO’s regulation and prequalification director.

The disease disproportionately affects 30 high-burden countries.

Five countries – India, Indonesia, China, Philippines and Pakistan – account for more than half of the global TB burden, with more than a quarter of the cases found in India alone.

With the report of fresh cases, the number of total cases in the country this year reached 55.

On Saturday, the lab confirmed the case from DI Khan and Zhob districts, where female children are affected, and Jaffarabad district where a male child is affected.

DI Khan, one of the seven polio-endemic districts of southern KP, has reported six polio cases while this is the third case this year from Zhob and the second from Jaffarabad.

Pakistan is responding to an intense resurgence of WPV1 this year with 55 cases reported so far. Of these, 26 are from Balochistan, 14 from Khyber Pakhtunkhwa, 13 from Sindh, and one each from Punjab and Islamabad.

Polio, a paralysing disease, has no cure. Multiple doses of the oral polio vaccine and completion of the routine vaccination schedule for all children under the age of five is essential to provide children high immunity against this terrible disease.

One in 10 women worldwide suffer from endometriosis a chronic disease in which tissue similar to the lining of the uterus grows outside the womb.

Up to a quarter of women are thought to have non-cancerous growths in their uterus called uterine fibroids.

Despite so many having these conditions, both are considered under-researched — with some blaming a historically male-focused medical establishment for overlooking health problems that affect women.

Previous research has linked both conditions to a higher risk of some potentially deadly diseases, such as heart disease and some types of cancer.

The new study in the BMJ journal analysed data from more than 110,000 women in the United States whose health has been monitored every two years since 1989.

This kind of observational research cannot directly prove cause and effect. From the data, the researchers found that patients with one or both conditions had a slightly higher risk of dying before 70.

This was because the patients were more likely to get the other health problems suggested by previous research, the study indicated.

For uterine fibroids, the increase in early death was linked to a higher risk of gynaecological cancers, the study said.

These cancers were also a main cause of death among patients with endometriosis, though there were other factors including heart and respiratory diseases.

People with endometriosis had between a nine and 30 per cent higher risk of dying before 70 compared to people who did not have these linked health problems, the study said.

“These findings highlight the importance” of doctors looking out for these health problems in patients with endometriosis and uterine fibroids, the authors of the study said.

While historically overlooked, health conditions that only affect women are receiving more attention from researchers and policymakers.

This has particularly been the case for endometriosis which can cause serious pain during periods and infertility — and for which there is no known cure.

Under the updated health management system, registered diabetic patients will be able to obtain insulin using their National Identity Cards (NIC).

To receive insulin, patients must visit their designated clinic with their original NIC, provide their mobile number, and present their diagnostic test results along with a doctor’s prescription.

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The new guidelines stipulate that patients will be issued one insulin dose at a time.

Additionally, patients with disabilities will be allowed to collect their insulin through their blood relatives. These measures aim to streamline the process and ensure that insulin reaches those who need it most efficiently.

Their research, conducted at esteemed institutions such as Harvard University and Massachusetts General Hospital, has enhanced our understanding of how organisms develop and function.

The Nobel Assembly highlighted that this discovery is “proving to be fundamentally important” in the field of biology.

Ambros conducted his groundbreaking research at Harvard University and currently serves as a professor of natural science at the University of Massachusetts Medical School. Ruvkun carried out his work at Massachusetts General Hospital and Harvard Medical School, where he holds a professorship in genetics, as noted by Thomas Perlmann, Secretary-General of the Nobel Committee.

Last year, the Nobel Prize in Physiology or Medicine was awarded to Hungarian-American Katalin Karikó and American Drew Weissman for their work that led to the development of mRNA vaccines against COVID-19, which were vital in mitigating the pandemic. The prize includes a cash award of 11 million Swedish kronor (approximately $1 million) from a legacy established by Swedish inventor Alfred Nobel.

This announcement marks the beginning of this year’s Nobel Prize season, with upcoming awards in physics on Tuesday, chemistry on Wednesday, and literature on Thursday. The Nobel Peace Prize will be announced on Friday, followed by the Nobel Memorial Prize in Economic Sciences on October 14.

The laureates are set to receive their awards at ceremonies on December 10, the anniversary of Nobel’s death.

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The vaccine in question, labeled “Shore-Rab,” is reportedly manufactured by an Indian company but is not registered with DRAP. The specific batch identified is marked as “RO10821.”

DRAP has warned that using this unregistered vaccine poses a significant health risk, especially for individuals who have been bitten by dogs.

The alert has been disseminated to the DRAP field force, provincial drug authorities, healthcare professionals, and pharmacies.

Concerns over the quality and safety of this fake vaccine could potentially lead to a rise in rabies cases.

DRAP has called for a comprehensive investigation into the vaccine’s supply chain and urged pharmacies and distributors to check their inventory immediately.

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Medical professionals are advised against administering the suspected “Shore-Rab” vaccine to patients with dog bite injuries.

Pharmacies and distributors have been instructed to report any stock of the counterfeit vaccine to DRAP as soon as possible.

They also typically exhibit higher Body Mass Index (BMI), larger waist sizes, and greater amounts of hidden body fat, including visceral and liver fat, which can lead to metabolic health issues.

These findings, which have not yet been published, will be presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) in Madrid, Spain. The study, led by Dr. Jeroen van der Velde from Leiden University Medical Centre in the Netherlands, examines the relationship between sleep timing, body fat distribution, and diabetes risk.

While earlier research indicated that late sleepers often engage in unhealthy behaviors, such as smoking or poor dietary choices, this study suggests that lifestyle factors alone do not completely account for the heightened risk of type 2 diabetes among night owls.

The study examined data from over 5,000 participants as part of the Netherlands Epidemiology of Obesity study. With an average age of 56, these individuals shared information about their sleep patterns, which were used to classify them into three chronotype groups based on their natural sleep-wake preferences:

• Early Chronotypes: Individuals who prefer to wake up and go to bed early. Intermediate Chronotypes: Those with a balanced sleep schedule, neither early nor late.
• Late Chronotypes: People who stay up late and wake up later. These groups illustrate variations in individual internal body clocks and daily rhythms.

The findings revealed that late chronotypes had a 46% higher risk of developing type 2 diabetes compared to those in the intermediate group, even after accounting for factors like age, physical activity, and sleep quality. They also exhibited higher BMI, larger waist sizes, and increased amounts of visceral and liver fat.

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Dr. van der Velde suggests that lifestyle changes, such as avoiding late-night eating and considering time-restricted eating, may help improve metabolic health for night owls.

“We believe that other mechanisms are also at play,” says Dr van der Velde. “A likely explanation is that the circadian rhythm or body clock in late chronotypes is out of sync with the work and social schedules followed by society. This can lead to circadian misalignment, which we know can lead to metabolic disturbances and ultimately type 2 diabetes.”

In preparation for this campaign, various district administrations in Sindh have initiated week-long polio vaccination drives, targeting approximately 9.4 million children in 30 districts across the province.

So far this year, Pakistan has reported 17 polio cases, with three of them originating from Sindh. The situation is further complicated by the detection of positive environmental samples in the province, indicating ongoing virus circulation.

Pakistan, alongside Afghanistan, remains one of the last two countries where polio is still endemic. Despite global efforts to eliminate the virus, challenges such as security concerns, vaccine hesitancy, and misinformation continue to hinder progress.

PM Shehbaz vows to make Pakistan polio-free

Prime Minister Shehbaz Sharif reaffirmed on Sunday his commitment to making Pakistan polio-free, stating that with collective efforts, the disease would be completely eradicated and prevented from re-emerging in the future, ensuring a healthier future for the nation’s children.

While speaking at the ceremony, the prime minister stressed that a unified approach and collaborative efforts are “crucial to successfully tackling” the polio challenge and achieving a polio-free Pakistan.

The prime minister extended a warm welcome to the attendants and expressed his appreciation for the outstanding collaboration and tireless efforts of federal and provincial government staff, foot soldiers, and security officers, who have worked together seamlessly to drive the polio eradication campaign forward.

He voiced his confidence that by working together with provincial chief ministers, chief secretaries, health ministers, and health secretaries, the government will successfully eliminate polio, paving the way for a polio-free future and eradicating this preventable disease in the years to come.

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The prime minister assured that the polio eradication campaign “is in capable hands, being led by expert teams, and expressed optimism that the federal government’s joint efforts with the provinces will ultimately lead to the disease’s eradication.”

“Once polio is eliminated, the government will ensure it never returns, providing a safer future for generations to come,” he said.

In addition, he added that a suspected case has been reported and the individual has been transferred to a hospital for further evaluation.

The Sindh Health Department also reported a suspected case at Karachi airport, heightening concerns about the spread of the virus.

Earlier this month, the World Health Organization (WHO) classified the recent outbreak as a public health emergency of international concern, following the identification of the new Clade 1b variant. The variant has raised alarms due to its potential for rapid transmission through close contact.

Despite such developments, the WHO has reassured the public that the mpox outbreak differs significantly from Covid-19, noting that there is already substantial knowledge regarding the virus and effective control measures.

The first confirmed case in Pakistan was identified as belonging to the Clade 2 variety. The second case was reported last week, also at Peshawar airport. Medical staff at Bacha Khan International Airport detected two travelers exhibiting symptoms of the virus on Thursday.

Both individuals confirmed as mpox cases were passengers on the same flight from Jeddah to Peshawar.

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According to Roghani, the confirmed case involves a 51-year-old man from Orakzai, who is currently stable and receiving treatment at Peshawar’s PSH hospital. This marks the third confirmed mpox case in Khyber Pakhtunkhwa for 2024, with no local transmissions reported to date.

Roghani stated that the Rapid Response Team collected samples from the patient, which were subsequently tested at the Public Health Reference Laboratory, confirming the presence of the mpox virus.

Samples from a second patient, a 47-year-old man from Peshawar, have also been sent for testing, and results are pending.

With input from News Desk

“… Instructions were given to establish emergency isolation and screening wards at Qazi Hussain Ahmed Medical Complex, district headquarters hospital and Mian Rashid Memorial Hospital, the largest teaching hospital in Nowshera,” he said in a post on X on Saturday.

“Isolation and screening wards will be set up at three hospitals Qazi Hussain Ahmad Medical Complex, DHQ Hospital, and Mian Rashid Memorial Hospital in Pabbi.”

This brings the total number of mpox cases in Pakistan to three after the second reported in Peshawar on Friday.

The development comes a week after the World Health Organization (WHO) declared the recent global outbreak of the disease as a public health emergency of international concern. The WHO noted that the new Clade 1b variant of the virus is spreading more easily through routine close contact.

The health agency has emphasised that the mpox outbreak “is not on the same scale as the Covid-19 pandemic,” as much is already known about the virus and the means to control it.

Earlier this week, Pakistan’s health ministry clarified that the country’s first mpox case belonged to the Clade 2 variety, and no Clade 1b infections have been reported so far.

KP Health Minister Qasim stressed the importance of such precautions, urging citizens to stay vigilant and seek medical attention if they experience symptoms related to Monkeypox.

“Apart from this, trained staff will be on 24-hour duty to establish an effective system of screening and surveillance in the isolation wards.”

Dr Malik Mukhtar Ahmad, the prime minister’s coordinator for health, stated that the new case was detected at the Peshawar airport. The patient had recently arrived from a Gulf country.

“A second case of mpox has been reported in Pakistan, which has come from a Gulf country,” Dr Mukhtar was quoted as saying by PTV News. He added that the patient was immediately shifted to a hospital by the health desk at the Peshawar airport.

The development comes a week after the World Health Organization (WHO) declared the recent global outbreak of the disease as a public health emergency of international concern. The WHO noted that the new Clade 1b variant of the virus is spreading more easily through routine close contact.

The health agency has emphasised that the mpox outbreak “is not on the same scale as the Covid-19 pandemic,” as much is already known about the virus and the means to control it.

Earlier this week, Pakistan’s health ministry clarified that the country’s first mpox case belonged to the Clade 2 variety, and no Clade 1b infections have been reported so far.

“An effective system of screening and surveillance system was functional at all airports,” Dr Ahmed said and added that border health staff were working diligently at airports and entry points.

Dr Ahmad said that the government was ensuring serious measures to keep people safe from epidemics.

According to a health ministry spokesperson, the ministry was ensuring continuous monitoring of the situation.

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Pakistan implements massive screening of int’l passengers amid mpox scare

EU public health body lifts mpox risk alert level

The staff of Border Health Services were engaged at airports and entry points for scrutiny of suspected cases and to ensure “serious steps to keep the public safe from epidemics”, Dr Ahmed said.

Dr Naseem Akhtar, the focal person at the Pakistan Institute of Medical Sciences (Pims), had said on Monday that a 47-year-old traveller from the Middle East was referred by the airport authorities to Pims on suspicion of being infected with mpox.

The individual was working as a labourer in the Middle East and was a resident of Azad Jammu and Kashmir, Dr Akhtar had said.

They were identified as a mother, son, and daughter from Bahawalpur. They were on their way to Iraq for pilgrimage via Iran.

Pakistan and Iran share a border of roughly 750km (466 miles) located in Balochistan and Iran’s southeast.

Every year, several pilgrims travel to Iran and Iraq via the Taftan border. Similar health precautions were taken when the coronavirus hit the world.

The Iranian government has issued a letter to its health ministry, stating that all pilgrims arriving from Pakistan must undergo tests before being allowed to proceed.

The letter also requests that all pilgrims be required to present a mpox check-up certificate along with their travel documents.

The mpox diagnosis in a 34-year-old man recently returned from a Gulf country was declared by health officials on Friday, while testing over the exact strain was carried out.

“The virus has been classified as Clade 2b,” the health ministry said in a statement on Monday.

“Currently, the ongoing outbreak in the Democratic Republic of the Congo (DRC) is primarily associated with Clade 1b. Notably, as of now, there have been no reported cases of Clade 1b in Pakistan.”

Mpox infections surged worldwide in May 2022, mostly affecting gay and bisexual men due to the Clade 2b subclade, but cases have largely subsided.

The World Health Organization declared the recent outbreak of the disease a public health emergency of international concern after the new variant was identified.

The WHO last week sounded its highest level of alert over the outbreak in Africa after cases in the Democratic Republic of Congo spread to nearby countries. There have been 27,000 cases and more than 1,100 deaths, mainly among children, in DR Congo since the current outbreak began in January 2023.

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Global health officials last week confirmed an infection with the new strain of mpox in Sweden and linked it to a growing outbreak in Africa, the first sign of its spread outside the continent. The WHO did not urge any travel restrictions to curb the spread of mpox.

The disease presents with flu-like symptoms and pus-filled lesions. It is usually mild but can kill, and children, pregnant women and people with weakened immune systems are at higher risk of complications.

He said this while presiding over a meeting on the measures being taken against mpox spread on Saturday. The prime minister stressed the need for ensuring screening measures at all airports, seaports and borders of the country, besides asking the border health services to keep complete surveillance of the situation.

PM Shehbaz also directed the National Command and Operations Center (NCOC) to keep alert and hold daily evaluations of the situation and asked for the provision of all required gadgets and kits to evaluate mpox virus.

The prime minister also called for the strengthening of coordination among the Gilgit Baltistan and Azad and Jammu Kashmir. He asked for the launch of the awareness campaign, besides hinting at getting weekly briefings over the mpox situation.

Officials told the meeting participants that a person in the Mardan district was diagnosed as a “carrier of the virus.” The resident had just returned to Pakistan from abroad where he was employed, they said and added that the affected person was quarantined and his condition was “out of danger.”

No local transmission of mpox was detected in Pakistan, they stated.

Pakistan enhances surveillance, screening for mpox, says nothing to worry

Surveillance and screening were in place at all airports and points of entry in Pakistan to stem the spread of the mpox virus (previously monkeypox), Dr Malik Mukhtar Ahmad Bharath, the prime minister’s coordinator on health said on Saturday.

“The people need not worry as only one case of mpox has been reported in Pakistan,” he said at a press conference in Islamabad. “The government has formulated a comprehensive strategy to protect the people from the virus.”

The World Health Organisation (WHO) declared the recent outbreak of the disease as a public health emergency of international concern after the new variant of the virus was identified.

A new form of the virus has triggered global concern because it seems to spread more easily through routine close contact. A case of the new variant was confirmed on Thursday in Sweden and linked to a growing outbreak in Africa, the first sign of its spread outside the continent. Pakistan also reported its first case of the virus on Friday.

Ahmad said that laboratories were allocated for the diagnosis of mpox in the provinces including the federal capital. Cases have been reported from Africa, he said and added that people coming from the continent, America and the Gulf countries would be monitored.

“The ministry is in full contact with the provinces and a meeting is being conducted on daily basis,” the premier’s coordinator said and appealed to the people to isolate themselves at home if their family has a travel history and mpox symptoms. “In such a situation contact a qualified doctor and follow the doctor’s instructions in case of having any such symptoms.”

He went on to add that the virus has been found in 99,000 people in the world and only 200 patients died and all others recovered. Symptoms may take 10 to 15 days to appear and spending too much time with the patient can spread it, he said and added: “It is better if the patient is quarantined. Fever medicines are used for mpox.”

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Sindh Health Department deploys team at airport

The Sindh Health Department has stationed a team at the airport to screen passengers arriving from abroad.

According to Dr Zafar Mehdi, the Sindh focal person for mpox, screening for international travelers was ongoing in line with advisory guidelines. He confirmed that there have been no reported cases of suspected monkeypox at Karachi airport thus far, with the screening being directly monitored by the Sindh Health Department.

Dr Mehdi stated that doctors and additional staff have also been deployed at the airport following the instructions of the health secretary. More than 150 diagnostic kits, along with two ambulances, have been provided to the team.

In the event a passenger shows symptoms of the disease, they would undergo testing, and if necessary, quarantine procedures would be implemented at NIPA Hospital, which has prepared an isolation ward for patients.

The EU public health body’s head said there will be more imported cases of the new mpox strain in Europe in the coming weeks, though the risk of sustained transmission remains low.

The World Health Organization on Wednesday declared mpox a global public health emergency, its highest form of alert, following an outbreak in the Democratic Republic of Congo that had spread to neighbouring countries.

The global health body is due to host an emergency meeting on Friday to discuss ways to ensure fair global access to tests, treatments and vaccines for the virus, a leading official said.

Mpox, a viral infection that causes pus-filled lesions and flu-like symptoms, is usually mild but can kill. Two strains are now spreading in Congo - the endemic form of the virus, clade I, and a new offshoot called clade Ib.

The ECDC on Friday raised its risk level assessment for mpox to “moderate” from “low” for sporadic cases appearing in the bloc, and asked countries to maintain high levels of awareness among travellers visiting from affected areas.

“Due to the close links between Europe and Africa, we must be prepared for more imported clade I cases,” its director Pamela Rendi Wagner said.

Pakistan also confirmed on Friday a case of the mpox virus in a patient who had returned from a Gulf country, though it was not clear whether it was of the new variant or of the clade that has been spreading globally since 2022.

Mpox transmits through close physical contact, including sexual contact, but unlike previous global pandemics such as Covid-19 there is no evidence it spreads easily through the air.

WHO official Margaret Harris said on a media call on Friday that she expects more cases outside Africa to emerge soon, also as a result of heightened monitoring.

However, the WHO has advised against any travel restrictions to stop the spread of the virus. China said earlier on Friday it plans to monitor people and goods entering the country for mpox for the next six months.

Diagnostics

Far more diagnostic kits, treatments and vaccines need to be shipped to Africa to respond adequately to the outbreak of the new strain of the mpox virus there, an official of the Red Cross and Red Crescent humanitarian network said on Friday.

The head of global vaccine group Gavi told Reuters it has up to $500 million to spend on getting shots to countries affected by the escalating outbreak in Africa.

Shares in pharmaceutical companies producing and developing mpox vaccines rose on Friday.

Danish biotech firm Bavarian Nordic’s shares soared 20% after it said it had submitted data to the EU’s drug regulator for approval to extend the use of its mpox and smallpox vaccine to adolescents aged 12 to 17 years.

Shares in New Jersey-based Tonix Pharmaceuticals also leapt after the company said it will advance development of its mpox vaccine candidate.

“We are motivated to advance development for our mpox vaccine with urgency given the global public health emergency,” its CEO Seth Lederman said.

Shares of mpox vaccine developers Emergent BioSolutions and GeoVax Labs also rose.

The Director of Public Health at the provincial Directorate-General of Health Services, Dr Irshad Ali Roghani, stated that the zoonotic infection was detected in a 34-year-old male resident of Lower Dir district on Wednesday. The patient, who had a travel history to the Middle East, has been isolated.

The patient visited Khyber Teaching Hospital in Peshawar for skin-related issues, where he was advised to undergo a monkeypox test. The test conducted at the Public Health Reference Laboratory (PHRL) of Khyber Medical University came back positive.

Dr Irshad said that the specimen has also been sent for genetic sequencing to the National Institute of Health in Islamabad. The health department has strengthened its surveillance network and is actively working to screen people who have been in close contact with the infected individual.

The provincial authorities have taken these precautionary measures to prevent the potential spread of the monkeypox virus and ensure the timely detection and management of any additional cases.

In response to the confirmed monkeypox case, the provincial health authorities have taken several proactive measures. An advisory has been sent to hospital medical superintendents and district health officers, providing guidance on the proper collection, storage, and transportation of samples to the Public Health Reference Laboratory (PHRL).

Hospitals have also been directed to ensure they follow standard operating procedures to accurately diagnose monkeypox cases. Additionally, the hospitals have been informed about the symptoms of the disease, enabling them to identify and test suspected patients appropriately.

The PHRL has further issued detailed guidelines to hospitals about the nature of the monkeypox virus. It has been explained that the disease is transmitted from animals to humans, with an incubation period of 3-17 days. The initial symptoms include fever, headache, muscle aches, back pain, swollen lymph nodes, chills, and exhaustion, followed by the development of a characteristic rash that progresses through various stages.

Transmission of the virus occurs through direct contact with the bodily fluids or lesions of infected patients, as well as indirect contact with contaminated materials. While there is no specific treatment for monkeypox, the focus is on supportive care to alleviate symptoms. Antiviral drugs have been approved for treatment in some countries, but are not routinely prescribed.

The health authorities have emphasized that the infection can be more severe in patients with underlying health conditions or immunodeficiencies. To prevent the spread of the virus, the World Health Organization recommends avoiding close contact with suspected or confirmed cases, practicing good hand hygiene, and using personal protective equipment when caring for patients.

The advisory highlights vaccination as a critical preventive measure, particularly for high-risk groups. While the smallpox vaccine has been approved for monkeypox prevention in some regions, the global availability of vaccines remains limited.

The advisory emphasizes the importance of healthcare workers strictly following infection prevention protocols, including the use of appropriate personal protective equipment and the isolation of patients. Rapid identification and isolation of cases, as well as contact tracing and public education, are deemed essential components of outbreak control.

Regarding laboratory testing, the advisory stresses that physicians should provide maximum clinical information, such as possible contact history, date of onset of symptoms, and details about sample collection. The clinical summary must accompany the sample, which should be packaged in a separate plastic zipper bag and placed in the second layer of the triple package.

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Meanwhile, in Punjab, the government has instructed all public and private hospitals in the province to prepare for and provide medical assistance against monkeypox, hospitals in Lahore have failed to set up counters for this purpose. Patients are complaining that doctors are only advising them to take precautions, wear masks and gloves.

The Punjab government has alerted all public hospitals in the province and instructed them to make arrangements, but while precautionary measures against this are visible in Lahore’s public hospitals, there is little evidence of preparations for monkeypox.

An emergency doctor at Services Hospital, Dr. Bashir Mohiuddin has said that the new monkeypox virus is dangerous and the public should take precautions. However, according to the Punjab Health Department, no suspected or confirmed monkeypox cases have been reported in the province so far.

Pakistan has reported its first mpox (monkeypox) cases of 2024, with three patients testing positive. The three patients had recently returned from the United Arab Emirates (UAE). This news comes as the World Health Organization (WHO) has declared mpox a global public health emergency for the second time in two years, after an outbreak in the Democratic Republic of Congo that has since spread to other nations.

According to the administration of Fatima Jinnah Institute of Chest Diseases, Muhammad Iqbal, a 42-year-old resident of Zarghoon Road Quetta, was admitted to the isolation ward of the institute.

His samples were sent for lab reports, which proved to be positive. Later, the patients succumbed to the Congo virus.

In the current season, the number of patients affected by the Congo virus in Balochistan has reached 18, with the death toll at five.

What is Congo virus

Crimean-Congo hemorrhagic fever (CCHF) is caused by infection with a virus from that is transmitted by ticks. Crimean hemorrhagic fever was the term given to the illness when it was first identified in the Crimea in 1944. The disease’s current name came about as a result of the fact that it was later identified as the illness’s primary cause in the Congo in 1969.

Humans contract the disease by coming into contact with infected ticks or animal blood, infectious blood, or bodily fluids. The hosts of the CCHF virus include a wide range of wild and domestic animals such as cattle, sheep, goats and other livestock.

Hospitals have also documented cases of CCHF spreading because of contaminated medical supplies, reused needles, and insufficient sterilization of medical equipment.

An emergency committee met earlier on Wednesday to advise WHO Director-General Tedros Adhanom Ghebreyesus on whether the disease outbreak constitutes a “public health emergency of international concern,” or PHEIC.

PHEIC status is WHO’s highest level of alert and aims to accelerate research, funding and international public health measures and cooperation to contain a disease.

“It’s clear that a coordinated international response is essential to stop these outbreaks and save lives,” said Tedros.

Mpox can spread through close contact. Usually mild, it is fatal in rare cases. It causes flu-like symptoms and pus-filled lesions on the body.

The outbreak in Congo began with the spread of an endemic strain, known as clade I. But a new variant, clade Ib, appears to spread more easily through routine close contact, including sexual contact.

It has spread from Congo to neighbouring countries, including Burundi, Kenya, Rwanda and Uganda, triggering the action from the WHO.

“The detection and rapid spread of a new clade of mpox in eastern DRC, its detection in neighbouring countries that had not previously reported mpox, and the potential for further spread within Africa and beyond is very worrying,” Tedros added.

Tedros said on Wednesday that WHO had released $1.5 million in contingency funds and plans to release more in the coming days. WHO’s response plan would require an initial $15 million, and the agency plans to appeal to donors for funding.

Earlier this week, Africa’s top public health body declared an mpox emergency for the continent after warning that the viral infection was spreading at an alarming rate, with more than 17,000 suspected cases and more than 500 deaths this year, mainly among children in Congo.

Professor Dimie Ogoina, chair of WHO’s mpox emergency committee, said all members unanimously agreed that the current upsurge of cases is an “extraordinary event,” with a record number of cases in Congo.

Vaccines and behaviour change helped stop the spread when a different strain of mpox spread globally, primarily among men who have sex with men, and WHO declared an emergency in 2022.

In Congo, the transmission routes need further study, WHO said. No vaccines are yet available, although efforts are underway to change that and work out who best to target. The agency also appealed to countries with stockpiles to donate shots.

“The competent authority has been pleased to notify the SOPs regarding the off-label intravitreal usage of injection Bevacizumab for hospitals in Punjab,” said a notification by the secretary for Specialised Healthcare and Medical Education Department.

The interim Punjab government slapped a ban on the use of Avastin injection for eye patients for an indefinite period across the province on September 26, 2023 after vision loss among patients due to the injection.

The government launched a portal to collect data on the patients affected by the drug and provide them with treatment facilities.

“Bevacizumab (Avastin) was originally FDA-approved for cancer treatment, its off-label use for eye complications has been supported by numerous studies since 2005,” it said. The off-label indications of intravitreal injection Bevacizumab (Avastin) are diabetic retinopathy, retinal vein occlusion, age-related macular degeneration, eale’s disease, retinotherapy of prematurity, neovascular glaucoma, choroidal neo vascularisatin, corneal graft rejection.

“The common adverse drug reactions (ADRs) include eye redness, dryness, discomfort, and temporary blurred vision. Severe ADRs are rare and include eye pain, infections, detached retina, cataracts, endophthalamitis, etc.

The SOPs include authorised distribution, preparation and dispensing (personnel, workplace/area, method of preparation, microbiological air and surface monitoring), propoer disposal, informed consent, administration, surveillance, measures for ocular infection, reporting adverse events (the drug/therapeutic good, the event), bulk supply or inter-city transportation, record keeping, display of charges, healthcare professionals should not deviate from SOPs, PHC must follow SOPs.

“Transportation will not be provided after Avastin injection dispensing,” it said and the injections for eye use would be administered in the operation theater.

“Avastin injections will come in 20 or 50 dose vials, with all patients getting their dose on the same day. Any remaining doses after initial administration will be discarded within 6 hours,” it said and added that storage of used injections would be prohibited.

The Nordic country has bought vaccines for 10,000 people, each consisting of two injections, as part of a joint EU procurement of up to 40 million doses for 15 nations from manufacturer CSL Seqirus.

The Australian company in a statement to Reuters said Finland would be the first country to roll out the vaccine.

“The vaccine will be offered to those aged 18 or over who are at increased risk of contracting avian influenza due to their work or other circumstances,” the Finnish Institute for Health and Welfare (THL) said in a statement.

The H5N1 strain of bird flu has killed or caused the culling of hundreds of millions of poultry globally in recent years and has increasingly been spreading to mammals, including cows in the United States and, in some cases, also to humans.

Finland has not detected the virus in humans, THL said.

However, the country is eager to roll out vaccinations given transmission risks posed by its fur farms.

“The conditions in Finland are very different in that we have fur farms where the animals can end up in contact with wildlife,” Chief Physician Hanna Nohynek at the Finnish Institute for Health and Welfare (THL) told Reuters.

Widespread outbreaks of bird flu among mink and foxes at Finland’s mostly open-air fur farms led to the culling last year of some 485,000 animals to stop the virus from spreading among the animals as well as to humans.

Vaccinations are likely to start as early as next week in at least some parts of Finland, a THL spokesperson told Reuters.

Finland said it procured vaccines for people it deems to be at risk, such as workers at fur and poultry farms, lab technicians who handle bird flu samples and veterinarians who work as animal control officers in regions where fur farms are located.

People working in sanctuaries caring for wild birds, in livestock farms or in the cleaning of premises, such as animal by-products processing plants, will also be offered vaccines, THL said.

If human infection of avian influenza were to occur, close contacts of a suspected or confirmed case would also be offered the vaccine, it added.

This law criminalizes the unauthorized production, import, export, transport, purchase, sale, possession, and storage of narcotic and psychotropic substances.

Travelers Must Comply with Medication Laws: It is essential for both residents and visitors to be aware of the UAE’s regulations on medications, as non-compliance can lead to serious consequences.

Travelers must carry prescriptions for any medicines they are bringing and verify whether their medications are controlled.

Categories of Controlled Drugs: Controlled drugs in the UAE are categorized under strict regulations, and their import, export, distribution, and use are closely monitored. These include narcotics, psychotropic substances, stimulants, and sedatives/tranquilizers.

Approval Process for Controlled Medications: For controlled medications and semi-controlled substances, prior approval through the Ministry of Health and Prevention (MoHAP) website is mandatory for UAE residents, tourists, and transit passengers.

This process typically requires detailed documentation, including a prescription and a letter from a doctor, as well as a limit on the quantity of medication allowed for personal use during the stay in the UAE.

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Guidelines for Travelers:

1. Controlled Medicines (Narcotics, Psychotropics, Class A and Class B): Travelers require prior approval from MoHAP and must carry specific documents, including a valid medical prescription and an authenticated certificate from the country of departure.

2. Regular Prescription-Only Medicines (POM): Travelers can carry POM medicines for personal use for up to 3 months, provided they have a valid prescription.

3. Non-Registered and Cancelled Medicines: It is prohibited to bring non-registered or cancelled medicines into the UAE.

4. Herbal Medicines: Some herbal medicines may also be restricted, so travelers should follow the same procedures as for regular POM medicines.

Compliance with the UAE’s strict drug policies is essential, as violations can result in severe penalties, including fines and imprisonment.