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ISLAMABAD: Pakistan on Wednesday decided to enforce \u201cstrict and enhanced health surveillance\u201d at all entry points in the country with immediate effect in order to prevent the cross-border transmission of Nipah virus.<\/p>\n
Nipah, carried by fruit bats and animals such as pigs, can trigger a deadly brain-swelling fever in humans and can also spread directly from person to person through close contact. Several vaccines are in development but remain in testing.<\/p>\n
It is classified as a priority pathogen by the World Health Organisation (WHO) because of its ability to spark fast\u2011moving outbreaks, its fatality rate of 40 per cent to 75pc, and the fact that there is no approved vaccine or cure.<\/p>\n
The measures taken by authorities in Pakistan coincide with those taken multiple other countries \u2014 Singapore, Hong Kong, Thailand and Malaysia \u2014 after India confirmed<\/a> the detection of two cases in December last year.<\/p>\n In this connection, the Border Health Services-Pakistan (BHS-P) \u2014 an ancillary department of the Ministry of National Health Services, Regulations and Coordination \u2014 issued an advisory which referred to a regional alert reported by international and regional public health surveillance mechanisms, including the WHO South East Asia Region Epidemiological Bulletin<\/a>.<\/p>\n Citing the alert, the advisory said in view of the \u201csuspected cases of Nipah virus infection in West Bengal, India, and considering the high case fatality rate, zoonotic nature, and potential for human-to-human transmission, it has become imperative to further strengthen preventive and surveillance measures at Pakistan\u2019s borders\u201d.<\/p>\n \u201cIn order to prevent the cross-border transmission of Nipah virus in Pakistan and to ensure early detection and prompt response, the competent authority has decided to enforce strict and enhanced health surveillance at all points of entry with immediate effect.<\/p>\n \u201cThese instructions shall be applicable to all points of entry, including international airports, seaports, and ground\/ land border crossings, without any exception,\u201d the advisory said.<\/p>\n Outlining the instructions, the advisory said all in-charges at entry points should ensure 100pc screening of all arriving passengers, transit passengers, crew members, drivers, helpers, and support staff.<\/p>\n \u201cNo individual shall be allowed entry into Pakistan without health clearance by BHS-P,\u201d it said.<\/p>\n Under the new measures, mandatory verification of the country of origin and complete travel and transit history for the preceding 21 days shall be carried out for each and every traveller, irrespective of their nationality or travel status.<\/p>\n \u201cAll in-charges at points of entry shall exercise special vigilance for travellers originating from, or transiting through, Nipah-affected or high-risk regions. Any false declaration, concealment, or misreporting of travel history shall be immediately documented and reported to the competent authorities for further necessary action,\u201d the advisory stated.<\/p>\n Moreover, travellers are also required to undergo thermal screening and clinical assessment at entry points.<\/p>\n \u201cScreening staff shall remain alert for early signs and symptoms of Nipah virus infection, including fever, headache, respiratory symptoms and neurological signs such as confusion, drowsiness or altered consciousness.<\/p>\n \u201cAny individual consistent with suspected Nipah virus case definition shall be immediately isolated at the point of entry, restricted from onward movement, and managed strictly in accordance with infection prevention and control (IPC) protocols,\u201d it was instructed in the advisory.<\/p>\n Such suspected cases should be promptly referred to the designated isolation facility or a tertiary care hospital in coordination with provincial and district health authorities, the advisory said, adding that the \u201cconveyance concerned (aircraft, vessel, vehicle) and surrounding area shall be immediately disinfected as per approved standard operating procedures\u201d.<\/p>\n In-charges at entry points have been further directed to ensure strict compliance with IPC measures, including the mandatory use of personal protective equipment (PPE), hand hygiene, and environmental sanitation.<\/p>\n Any lapse in surveillance or IPC practices should be treated as serious negligence, the advisory said.<\/p>\n Moreover, \u201cdaily case\/ nil reports from all points of entry shall be recorded in the BHS-P system already in vogue and shared with National Command and Operation Centre and the National International Health Regulation Focal Point\u201d.<\/p>\n Any delay, weak surveillance, under-reporting, or non-compliance with these instructions should not be tolerated, the advisory stated.<\/p>\n \u201cAll in-charges at points of entry are directed to ensure strict compliance with the above instructions in letter and spirit. These measures shall remain in force until further orders are issued by the competent authority,\u201d it added.<\/p>\n Separately, the National Institute of Health (NIH) also issued an alert to health departments, healthcare providers, and BHS-P regarding the potential threat of Nipah virus spillover into Pakistan.<\/p>\n The alert said that while Pakistan had not yet reported a human case, a significant situation was emerging in South Asia.<\/p>\n \u201cAs of January 2026, an outbreak has been confirmed in West Bengal, India. [\u2026] Due to its high case fatality rate ranging from 40pc to 75pc and the potential for human-to-human transmission, health authorities are placing the region on high alert,\u201d it added.<\/p>\n According to the advisory, there was currently no specific anti-viral treatment or licensed vaccine available for the virus.<\/p>\n Management remains primarily supportive and focuses on symptomatic treatment, including management of fever, respiratory distress, and neurological complications,\u201d it said.<\/p>\n \u201cSeverely ill patients often require hospitalisation and may need intensive care support, including mechanical ventilation. The clinical effectiveness of ribavirin (broad-spectrum antiviral medication) remains inconclusive and it is not routinely recommended,\u201d it said.<\/p>\n It urged travellers to avoid contact with symptomatic individuals or contaminated materials.<\/p>\n \u201cTravellers returning from affected areas within 21 days who develop symptoms should self-isolate, seek medical attention, and inform the provider of their travel history and exposure,\u201d it said.<\/p>\n It further directed the provincial health department to designate at least one tertiary-care hospital or infectious disease unit for the isolation and clinical management of cases.<\/p>\n It also urged provincial public laboratories to review and strengthen their capability for safe sample handling and transportation. Further, it directed that rapid response teams be placed on standby for case investigation, contact tracing, and coordinated field response for any cluster of acute encephalitis (brain inflammation).<\/p>\n It further said that provinces with international airports or land border points needed to main realtime communication with BHS-P for any alerts or travellers requiring follow-up.<\/p>\n Talking to Dawn<\/em>, Microbiologist Prof Dr Javaid Usman said that the virus was named after a place in Malaysia.<\/p>\n \u201cThe virus is spread through the droppings of fruit bats and pigs,\u201d he said. He further said that if cases were reported in Pakistan, it would be through carriers.<\/p>\n \u201cCurrently, a few cases have been reported in the Indian state of Bengal due to which neighbouring countries have announced to screen their masses,\u201d he said.<\/p>\n Replying to a question, he said that the major symptoms of the virus included fever and neurological disorders.<\/p>\n \u201cPeople can have fits. The virus can spread through respiratory droplets, saliva and the blood of a patient who has tested positive. So positive samples are kept in isolation,\u201d Dr Usman said.<\/p>\n Chief of the Centre for Disease Control (CDC) at the National Institutes of Health (NIH), Dr Mumtaz Ali Khan, told Dawn<\/em> that this was the 51st outbreak since 2001.<\/p>\n \u201cAlthough we have issued advisories to alert airport authorities, there are very few chances of identifying patients as the incubation period of the virus is 9 to 14 days,\u201d he said.<\/p>\n Infectious disease expert Dr Rana Safdar told Dawn<\/em> that Nipah virus was listed by the WHO as a priority pathogen due to a high fatality rate (up to 80pc).<\/p>\n \u201cIts progression is therefore being closely monitored. While efforts are underway, to date no effective vaccine or treatment is available so the management of infected cases is largely supportive,\u201d he added.<\/p>\n Dr Safdar said, since its identification in 1998, the outbreaks of Nipah virus had been sporadically occurring in South and Southeast Asia, largely in rural settings. Countries which have previously reported outbreaks include Malaysia, Philippines, Singapore, Bangladesh and India, he said.<\/p>\n \u201cWhile the principle \u2018infectious diseases respect no boundaries\u2019, holds, due to the peculiar transmission dynamics, the risk of spread to surrounding countries thus far remains moderate to low. Given the current outbreak in India\u2019s West Bengal and the associated media hype, there is no reason to panic as the risk of the virus in Pakistan stays minimal,\u201d he said.<\/p>\n \u201cWhile executing preventive measures, it\u2019s important to consider that the usually deployed passenger screening at airports does not help much in preventing virus importation. We otherwise need to remain prepared, anticipating and mapping risk and enhancing vigilance in identified vulnerable zones,\u201d Dr Safdar said.<\/p>\n<\/a>\u2018Risk in Pakistan minimal\u2019<\/h2>\n
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