Questions are being raised about the screening procedures and performance of Pakistan’s Border Health Services (BHS) staff after a monkeypox patient evaded detection at Islamabad airport and was only later identified in Peshawar, reports said,

According to Ministry of Health officials, the passenger arrived at Islamabad airport on September 7 from a Gulf country. Due to the negligence of BHS staff at the airport, the individual was able to travel to Peshawar, sources told Geo News.

This incident has increased worries as the country’s mpox cases have now reached six, with this being the fifth case since the World Health Organisation (WHO) declared the outbreak a public health emergency.

The patient, from Lower Dir in Khyber Pakhtunkhwa, was later found to be infected with the virus.

Mpox, related to the now-extinct smallpox virus, spreads through close contact and contaminated materials like clothing, bedding, and needles.

Early symptoms include fever, chills, muscle pain, gland swelling, exhaustion, headache, and muscle weakness, often followed by a rash with raised lesions that scab over and heal over weeks.

The failure to detect this case is particularly troubling as the government had recently issued strict guidelines for screening, isolation, and other preventive measures at international airports due to the global outbreak.

BHS was designated as the lead agency for managing mpox operations at airports, including isolating and safely transporting suspected cases and reporting confirmed cases to health authorities. Guidelines also mandated thermal scanning and visual inspections by BHS personnel to identify passengers with symptoms.

However, despite showing visible signs, the infected passenger was neither questioned nor examined by the BHS staff.

The technical working group on mpox (TWG), which includes officials from key public health organisations, has criticised the poor surveillance at other entry points and airports.

The patient, who stayed at a hotel in Peshawar, sought medical help from a skin specialist and was diagnosed with mpox after testing at Khyber Medical University.