Emergence of #Chikungunya Virus, #Pakistan, 2016–2017 (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 26, Number 2—February 2020 / Dispatch

Emergence of Chikungunya Virus, Pakistan, 2016–2017

Nazish Badar, Muhammad Salman, Jamil Ansari, Uzma Aamir, Muhammad Masroor Alam, Yasir Arshad, Nighat Mushtaq, Aamer Ikram, and Javaria Qazi

Author affiliations: National Institute of Health, Islamabad, Pakistan (N. Badar, M. Salman, J. Ansari, U. Aamir, M.M. Alam, Y. Arshad, N. Mushtaq, A. Ikram); Quaid-I-Azam University, Islamabad (N. Badar, J. Qazi)



During December 2016–May 2017, an outbreak of chikungunya virus infection occurred across Pakistan. The East/Central/South African genotype was predominant. This study provides baseline data on the virus strain and emphasizes the need for active surveillance and implementation of preventive interventions to contain future outbreaks.

Keywords: Chikungunya fever; Pakistan.


#HIV #infection predominantly affecting #children in #Sindh, #Pakistan, 2019: a cross-sectional study of an #outbreak (Lancet Infect Dis., abstract)

[Source: Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]

HIV infection predominantly affecting children in Sindh, Pakistan, 2019: a cross-sectional study of an outbreak

Fatima Mir, MSCR, Faisal Mahmood, MBBS, Prof Amna Rehana Siddiqui, PhD, Prof Shehla Baqi, MBBS, Syed Hani Abidi, PhD, Abdul Momin Kazi, MPH, Apsara Ali Nathwani, MSc, Amerta Ladhani, MSc, Farah Naz Qamar, MSCR, Sajid Bashir Soofi, MBBS, Sikander Ali Memon, MBBS, Jamila Soomro, MPH, Saqib Ali Shaikh, MSc, Victoria Simms, PhD, Palwasha Khan, PhD, Prof Rashida Abbas Ferrand, PhD

Published: December 19, 2019 / DOI: https://doi.org/10.1016/S1473-3099(19)30743-1




In April 2019, an HIV screening camp for all ages was established in response to a report of an unusually large number of paediatric HIV diagnoses in Larkana, Pakistan. We aimed to understand the clinical profile of the children who registered for HIV care.


In this cross-sectional study, we review the outbreak response from the government, academia, and UN agencies in Larkana, Sindh, Pakistan. We report age-stratified and sex-stratified HIV prevalence estimated among individuals screened. For children who registered for HIV care, clinical history of previous injections and blood transfusions, HIV disease stage, hepatitis B and hepatitis C status, and CD4 count was abstracted from clinical records from Sindh AIDS Control Program HIV Clinic (Shaikh Zayed Childrens Hospital, Larkana, Pakistan) and analysed using percentages, χ 2 tests, and weight-for-age Z scores. We also analysed data for parents who were tested for HIV.


Between April 24, and July 15, 2019, 31 239 individuals underwent HIV testing, of whom 930 (3%) tested positive for HIV. Of these, 763 (82%) were younger than 16 years and 604 (79%) of these were aged 5 years and below. Estimated HIV prevalence was 3% overall; 7% (283 of 3803) in children aged 0–2 years, 6% (321 of 5412) in children aged 3–5 years, and 1% (148 of 11 251) in adults aged 16–49 years. Of the 591 children who registered for HIV care, 478 (81%) were 5 years or younger, 379 (64%) were boys, and 315 (53%) of 590 had a weight-for-age Z score of −3·2. Prevalence of hepatitis B surface antigen was 8% (48 of 574) and hepatitis C antibody positivity was 3% (15 of 574). Of children whose mothers tested for HIV, only 39 (11%) of 371 had HIV-positive mothers. Most children (404 [89%] of 453) reported multiple previous injections and 40 (9%) of 453 reported blood transfusions.


This HIV outbreak is unprecedented among children in Pakistan: a 54% increase in paediatric HIV diagnoses over the past 13 years. The outbreak was heavily skewed towards young children younger than 5 years, with a predominance of boys. Epidemiological and molecular studies are needed to understand the full extent of the outbreak and its drivers to guide HIV control strategies.



Keywords: HIV/AIDS; Pediatrics; Pakistan.


#Seroprevalence and #risk factors of #avian #influenza #H9 virus among #poultry #professionals in #Rawalpindi, #Pakistan (J Infect Public Health, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Infect Public Health. 2019 Jul – Aug;12(4):482-485. doi: 10.1016/j.jiph.2018.11.009. Epub 2018 Dec 18.

Seroprevalence and risk factors of avian influenza H9 virus among poultry professionals in Rawalpindi, Pakistan.

Tahir MF1, Abbas MA2, Ghafoor T3, Dil S4, Shahid MA5, Bullo MMH6, Ain QU7, Ranjha MA8, Khan MA9, Naseem MT10.

Author information: 1 Poultry Research Institute, Rawalpindi, Punjab, Pakistan; Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan. Electronic address: drmftahir@gmail.com. 2 National Agricultural Research Centre, Islamabad, Pakistan. 3 Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan. 4 Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan; Livestock and Dairy Development Department, Punjab, Pakistan. 5 Department of Pathobiology, Faculty of Veterinary Science, Bahauddin Zakariya University, Multan, Pakistan. 6 Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan; Federal General Hospital, Islamabad, Pakistan. 7 Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan; Veterinary Research Institute, Quetta, Balochistan, Pakistan. 8 National Institute of Health, Islamabad, Pakistan. 9 Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan; National Institute of Health, Islamabad, Pakistan. 10 Poultry Research Institute, Rawalpindi, Punjab, Pakistan.




Avian influenza H9 is endemic in commercial and backyard poultry in Pakistan and is a serious occupational health hazard to industry workers. This study aimed to determine the seroprevalence of avian influenza H9 infection in people working with poultry in Rawalpindi, Pakistan and assess the measures they took to protect themselves from infection.


A cross-sectional study was conducted from December 2016 to May 2017 of 419 people working with poultry in Rawalpindi Division, including farm workers, vaccinators, field veterinarians, butchers and staff working in diagnostic laboratories. Potential participants were randomly approached and gave written consent to participate. Data were collected using a standardized questionnaire and serum samples were processed to detect H9 antibodies using the haemagglutination inhibition test.


Of the 419 participants, 406 (96.9%) were male. The mean age of the participants was 36.4 (SD 10.86) years. A total of 332 participants agreed to a blood test, 167 of whom were positive for A(H9) antibodies, giving an overall seroprevalence of 50.3%. Laboratory staff had the highest seroprevalence (100%) and veterinarians the lowest (38.5%). Vaccinators, butchers and farm workers had a seroprevalence of 83.3%, 52.4% and 45.5% respectively. Personals who used facemasks had significantly lower (P<0.002) seroprevalence (29.6%) than those who never used them (90.6%). Similarly, those who always used gloves and washed their hands with soap had a seroprevalence of 32.8% compared with 89.0% in those who never took these precautions. Of the participants who handled antigens, 92.3% were seropositive.


Laboratory staff and vaccinators are exposed to viral cultures and influenza vaccines respectively which may explain their high seroprevalence.

Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

KEYWORDS: Avian influenza; Pakistan; Poultry; Seroprevalence

PMID: 30578143 DOI: 10.1016/j.jiph.2018.11.009 [Indexed for MEDLINE] Free full text

Keywords: Avian Influenza; H9N2; Human; Serology; Seroprevalence; Pakistan.


#MERS #Coronavirus #Seropositivity in #Camel #Handlers and Their #Families, #Pakistan (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 12—December 2019 / Dispatch

Middle East Respiratory Syndrome Coronavirus Seropositivity in Camel Handlers and Their Families, Pakistan

Jian Zheng1, Sohail Hassan1  , Abdulaziz N. Alagaili, Abeer N. Alshukairi, Nabil M.S. Amor, Nadia Mukhtar, Iqra Maleeha Nazeer, Zarfishan Tahir, Nadeem Akhter, Stanley Perlman  , and Tahir Yaqub

Author affiliations: University of Iowa, Iowa City, Iowa, USA (J. Zheng, S. Perlman); University of Veterinary and Animal Sciences, Lahore, Pakistan (S. Hassan, I.M. Nazeer, T. Yaqub); King Saud University, Riyadh, Saudi Arabia (A.N. Alagaili, N.M.S. Amor); King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia (A.N. Alshukairi); Government of Punjab, Lahore (N. Mukhtar, Z. Tahir, N. Akhter); The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China (S. Perlman)



A high percentage of camel handlers in Saudi Arabia are seropositive for Middle East respiratory syndrome coronavirus. We found that 12/100 camel handlers and their family members in Pakistan, a country with extensive camel MERS-CoV infection, were seropositive, indicating that MERS-CoV infection of these populations extends beyond the Arabian Peninsula.

Keywords: MERS-CoV; Serology; Seroprevalence; Human; Camels; Pakistan.


Rapidly expanding #nuclear #arsenals in #Pakistan and #India portend #regional and #global #catastrophe (Sci Adv., abstract)

[Source: Science Advances, full page: (LINK). Abstract, edited.]

Rapidly expanding nuclear arsenals in Pakistan and India portend regional and global catastrophe

Owen B. Toon1,*, Charles G. Bardeen2, Alan Robock3, Lili Xia3, Hans Kristensen4, Matthew McKinzie5, R. J. Peterson6, Cheryl S. Harrison7,8, Nicole S. Lovenduski9 and Richard P. Turco10

1 Laboratory for Atmospheric and Space Physics, Department of Atmospheric and Oceanic Sciences, University of Colorado, Boulder, CO 80303, USA. 2 Atmospheric Chemistry Observations and Modeling Laboratory, National Center for Atmospheric Research, Boulder, CO 80307, USA. 3  Department of Environmental Sciences, Rutgers University, New Brunswick, NJ 08901, USA. 4 Federation of American Scientists, 1112 16th St., N.W. Suite 400, Washington, DC 20036, USA. 5 Natural Resources Defense Council, 40 West 20th St., 11th Floor, New York, NY 10011, USA.6 Department of Physics, University of Colorado, Boulder, CO 80309-0390, USA. 7 School of Earth, Environmental, and Marine Sciences, University of Texas Rio Grande Valley, Port Isabel, TX 78597, USA. 8 Institute of Arctic and Alpine Research, University of Colorado, Boulder, CO 80309-0450, USA. 9 Department of Atmospheric and Oceanic Sciences, Institute of Arctic and Alpine Research, University of Colorado, Boulder, CO 80309-0450, USA. 10 Department of Atmospheric and Oceanic Sciences, University of California, Los Angeles, Los Angeles, CA 90095, USA.

*Corresponding author. Email: toon@lasp.colorado.edu

Science Advances  02 Oct 2019: Vol. 5, no. 10, eaay5478 / DOI: 10.1126/sciadv.aay5478



Pakistan and India may have 400 to 500 nuclear weapons by 2025 with yields from tested 12- to 45-kt values to a few hundred kilotons. If India uses 100 strategic weapons to attack urban centers and Pakistan uses 150, fatalities could reach 50 to 125 million people, and nuclear-ignited fires could release 16 to 36 Tg of black carbon in smoke, depending on yield. The smoke will rise into the upper troposphere, be self-lofted into the stratosphere, and spread globally within weeks. Surface sunlight will decline by 20 to 35%, cooling the global surface by 2° to 5°C and reducing precipitation by 15 to 30%, with larger regional impacts. Recovery takes more than 10 years. Net primary productivity declines 15 to 30% on land and 5 to 15% in oceans threatening mass starvation and additional worldwide collateral fatalities.

Keywords: Environmental disasters; Environmental Pollution; Wars; Radiations; WMD.


Acquisition of cross- #resistance to #Bedaquiline and #Clofazimine following #treatment for #Tuberculosis in #Pakistan (Antimicrob Agents Chemother., abstract)

[Source: Antimicrobial Agents and Chemotherapy, full page: (LINK). Abstract, edited.]

Acquisition of cross-resistance to Bedaquiline and Clofazimine following treatment for Tuberculosis in Pakistan

Arash Ghodousi, Alamdar Hussain Rizvi, Aurangzaib Quadir Baloch, Abdul Ghafoor, Faisal Masood Khanzada, Mehmood Qadir, Emanuele Borroni, Alberto Trovato, Sabira Tahseen,Daniela Maria Cirillo

DOI: 10.1128/AAC.00915-19



We report on the first six cases of acquired-resistance to bedaquiline in Pakistan. Seventy sequential isolates from 30 drug-resistant tuberculosis patients on bedaquiline-containing regimens were retrospectively tested for bedaquiline resistance by MIC test and by detection of mutations in relevant genes. We documented cases failing therapy developed specific mutations in Rv0678 and increased MICs associated with cross-resistance to clofazimine during treatment. This study underlines the relevance of surveillance programs following the introduction of new drugs.

Copyright © 2019 Ghodousi et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license.

Keywords: Antibiotics; Drugs Resistance; Tuberculosis; Pakistan; Bedaquiline; Clofazimine.


#Prevalence and #Phylogenetics of #H9N2 in Backyard and Commercial #Poultry in #Pakistan (Avian Dis., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Avian Dis. 2018 Dec;62(4):416-424. doi: 10.1637/11690-062117-ResNote.1.

Prevalence and Phylogenetics of H9n2 in Backyard and Commercial Poultry in Pakistan.

Ali M1, Yaqub T2, Mukhtar N3, Imran M4, Ghafoor A5, Shahid MF1, Yaqub S1, Smith GJD6,7, Su YCF6, Naeem M8.

Author information: 1 Department of Microbiology, University of Veterinary and Animal Sciences, Lahore 54600, Pakistan. 2 Department of Microbiology, University of Veterinary and Animal Sciences, Lahore 54600, Pakistan, tahiryaqub@uvas.edu.pk. 3 Primary and Secondary, Health Care Department, Government of Punjab, Lahore 54000, Pakistan. 4 Institute of Biochemistry and Biotechnology, University of Veterinary and Animal Sciences, Lahore 54600, Pakistan. 5 University Diagnostic Laboratory, University of Veterinary and Animal Sciences, Lahore 54600, Pakistan. 6 Duke-NUS Medical School, 8 College Road, 169857 Singapore. 7 Duke Global Health Institute, Duke University, Durham, NC 27710. 8 Institute of Pure and Applied Biology, Bahauddin Zakariya University, Multan 60800, Pakistan.


Abstract in English, Spanish

Surveillance of H9N2 is currently focused on areas central to the commercial poultry industry. This study determined the prevalence of H9N2 virus in commercial and backyard poultry flocks in Punjab Province, Pakistan. Oral and tracheal swabs were collected from commercial and backyard poultry from January 2015 through June 2016. Antisera against H5, H7, H9, and Newcastle disease viruses were used for virus identification. Molecular confirmation was made by reverse transcription PCR. Avian influenza virus subtypes H5 and H7 were not detected. The H9N2 virus was isolated in 5.7% of 905 tested flocks (5-10 birds/flock). Prevalence in commercial and backyard poultry was 6.7% of 687 flocks and 2.7% of 218 flocks, respectively. Hemagglutinin and neuraminidase-gene-based phylogenetic analysis of commercial and backyard poultry isolates showed 100% homology. Within sublineage B2 of Pakistan, identity among most recent isolates (2015) was 100%, compared to 75%-99% identity with previously isolated viruses (2010-12), indicating continued virus evolution. Most of the previously reported and currently studied viruses were isolated near the Pakistan-India border. Phylogenetic analysis showed that Pakistani and Indian isolates were closely related, indicating that avian influenza virus transmission may occur across this border.

KEYWORDS: H9N2; Punjab; commercial poultry; hemagglutinin; neuraminidase; phylogenetic analysis; prevalence

PMID: 31119926 DOI: 10.1637/11690-062117-ResNote.1

Keywords: Avian Influenza; H9N2; Poultry; Pakistan; India.