Pakistan Struggles with Polio Outbreak: Virus Found in Sewage Across 18 Districts Amid Rising Cases

Pakistan is facing a significant challenge in its fight against polio after the virus was detected in sewage samples across 18 districts nationwide. This development comes as the country continues to report new cases of polio, with six confirmed so far in 2025. Meanwhile, Pakistan has also confirmed its second case of mpox (previously known as monkeypox) this year, highlighting the dual health challenges the nation is grappling with.

Polio Outbreak: A Persistent Threat

Polio remains a major health concern globally, with Pakistan being one of the few countries where the disease is still endemic. The detection of wild poliovirus type 1 (WPV1) in sewage samples from districts spanning all four provinces—Sindh, Punjab, Khyber Pakhtunkhwa, and Balochistan—indicates that the virus is still actively circulating and poses a significant risk to unvaccinated children. The areas affected include major cities like Karachi and Lahore, as well as rural districts such as those in South Waziristan and Chaman.

Key Affected Areas:

• Sindh: The districts with positive samples include Karachi East, South, Central, and West, as well as Badin, Dadu, Hyderabad, Jacobabad, Kambar, Shaheed Benazirabad, Sujawal, and Sukkur.
• Punjab: Lahore and Dera Ghazi Khan are among the districts with detected poliovirus.
• Khyber Pakhtunkhwa: South Waziristan, both upper and lower regions, are affected.
• Balochistan: Chaman is confirmed to have the virus.
• Islamabad Capital Territory: The capital city itself has also recorded positive samples.

Rising Cases and Vaccination Efforts

Pakistan has reported a total of six polio cases in the first quarter of 2025, a continuation of the trend from 2024 when the country recorded 74 cases. The National Polio Eradication Programme has stepped up its efforts to combat the disease by expanding environmental surveillance and implementing rigorous vaccination campaigns.

Vaccination Strategy:

• Expanded Surveillance: The country has increased its surveillance sites from 65 in 2021 to 127 in 2025, ensuring more effective monitoring of poliovirus circulation.
• Nationwide Vaccination Drives: Regular campaigns, such as the upcoming one scheduled for April 21-27, aim to vaccinate over 45 million children under the age of five.
• Emphasis on Oral Polio Vaccine (OPV): Multiple doses of the OPV are crucial for developing strong immunity among young children.

Mpox: A New Health Concern

In addition to the ongoing battle against polio, Pakistan has also faced cases of mpox, a viral illness characterized by skin lesions and other symptoms. After the first case in January, a second mpox case was confirmed in March 2025, involving a 29-year-old man in Karachi. While there have been no reports of local transmission, authorities have heightened vigilance to prevent any potential spread.

Mpox Details:

• First Case: Reported in January in Peshawar.
• Second Case: Confirmed in Karachi, highlighting the need for continued surveillance.
• Global Context: The World Health Organization declared mpox a Public Health Emergency of International Concern in August 2024.

Public Health Strategies and Challenges

Combating these health crises in Pakistan involves both immediate action and long-term strategies aimed at strengthening public health infrastructure and enhancing awareness about the importance of vaccination.

Public Health Challenges:

• Accessibility: Ensuring that all children, especially in remote areas, receive vaccination doses remains a challenge.
• Compliance: Encouraging families to follow through with vaccination schedules is critical.
• Misinformation: Addressing false rumors about vaccines is essential to maintain trust in public health initiatives.

Collaborative Efforts:

• International Support: Partner organizations and donor countries play a crucial role in funding and supporting eradication efforts.
• Community Engagement: Involving local communities in awareness campaigns helps increase vaccination rates and compliance.

Conclusion

The detection of poliovirus in sewage across 18 districts in Pakistan underscores the urgency of intensifying vaccination efforts to protect children from this debilitating disease. Coupled with the emergence of mpox cases, the country must prioritize public health awareness, surveillance, and collaboration with international partners to address these dual health challenges effectively. With a focused approach to vaccination and public health education, Pakistan can make strides towards a healthier future for its children.

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