This article is general information only and is not medical advice. If you have symptoms or have been in close contact with a suspected case, see a doctor promptly.
Khyber Pakhtunkhwa has reported four new confirmed mpox cases, taking the province's 2026 total to 18. None of the four had travelled abroad. All four have been advised to isolate at home, and contact tracing is under way amid concern about possible local transmission. The figure of 18 is for KP only — not a Pakistan-wide total.
Mpox in Khyber Pakhtunkhwa: 4 New Cases, No Travel History — What We Know So Far
Khyber Pakhtunkhwa has reported four new confirmed mpox cases — none had travelled abroad — taking the province's 2026 total to 18. All four are isolating at home, and contact tracing is under way. This page explains what we know so far: the symptoms, how it spreads, and when to see a doctor.
Khyber Pakhtunkhwa has reported four new confirmed cases of mpox, taking the province's total for 2026 to 18, according to the provincial health department. The cluster was first reported on 25 October, and covered again in the health department's update on 27 October. The four patients — one woman and three men — are from Nowshera (two), Peshawar (one) and Mardan (one). Their infections were confirmed by the Public Health Reference Laboratory at Khyber Medical University, after samples sent by Khyber Teaching Hospital tested positive.
This is the province's position for the year so far: the first KP case of 2026 was recorded on 9 January; one person has died, 13 people have recovered, and four cases are currently active. Peshawar has the highest district count, with five cases. All four new patients have been advised to isolate at home.
The figure of 18 is for Khyber Pakhtunkhwa only. It is not a Pakistan-wide total, and no single verified national total exists right now.
Why this cluster is different
None of the four new patients has a reported history of international travel, the health department said. That is what makes this cluster different: until now, KP's cases were mostly linked to travel abroad. The province's first case, in 2023, was a driver working in Saudi Arabia who tested positive after arriving in Pakistan. Read our news update: 4 new mpox cases in KP.
Health workers have raised concern about possible local or community transmission, and contact tracing is under way. The four patients include a married couple, as reported — which points to possible household spread, but it does not prove a route of transmission. The investigation is ongoing, and the question of whether these patients were infected locally or through an untraced contact is not yet settled. It is a concern being investigated, not a proven fact.
Local transmission in KP is not brand new with this cluster. Pakistan's first locally transmitted case was reported in early 2026, in a 20-year-old man from Peshawar with no travel history. Genomic surveillance of 29 confirmed cases in Pakistan found 13 (44.8%) imported, 5 (17.2%) secondary transmission, 6 (20.7%) locally acquired with no link to an imported case, and 5 (17.2%) probably local — meaning more than a third of confirmed cases were locally acquired or probably local.
What mpox is
Mpox is a viral illness caused by the monkeypox virus, a species of the genus Orthopoxvirus. Two different clades exist: clade I and clade II. Clade Ib has been recorded in Pakistan in earlier reporting, but no clade has been reported for this KP cluster, and this article does not attribute one to it.
Laboratory confirmation is done by testing skin lesion material by PCR. Treatment is supportive care. Vaccines and therapeutics developed for smallpox and approved for use in some countries can be used for mpox in some circumstances — this article makes no claim about any specific product, dose or schedule.
Symptoms — what to look for
Common symptoms are a skin rash or mucosal lesions lasting 2–4 weeks, accompanied by fever, headache, muscle aches, back pain, low energy and swollen lymph nodes. The rash often begins on the face and spreads over the body, including the palms and soles. It evolves from flat spots to blisters to scabs. Swollen lymph nodes are a classic feature of the illness. Some people have no symptoms at all.
The incubation period is 3–21 days, and the illness usually lasts 2–4 weeks. Children, pregnant people and people with weak immune systems are at higher risk of complications.
How it spreads — and how to reduce risk
Mpox can be transmitted through physical contact with someone who is infectious — including touch, kissing and sex — through contact with contaminated materials such as sheets, clothes and needles, and through contact with infected animals. As the head of the dermatology department at Khyber Teaching Hospital explained, it can be transmitted through direct contact with a patient's blood, body fluids, skin lesions or mucous membranes, as well as through contaminated objects, including bedding.
A person is infectious until all scabs have fallen off and a new layer of skin has formed.
To reduce risk: avoid physical contact with someone who has mpox, and vaccination can help people at risk. If you have mpox: tell anyone you have been close to recently, stay at home until all scabs fall off and a new layer of skin forms, and cover lesions and wear a well-fitting mask when around other people.
When to seek care
See a doctor promptly if you develop a rash with fever after close contact with a suspected case, or an unexplained rash with swollen lymph nodes. Diagnosis is by PCR test of lesion material — this is why early presentation matters.
The rest of Pakistan — one careful paragraph
Nationally, the picture is older and incomplete. A National Institute of Health report published on 10 April 2026 recorded 60 cases in the country that year so far, with 11 deaths (reported by the BMJ) — that is an April figure, not a current total. Separately, Sindh saw a large outbreak earlier in 2026: from 14 March to 20 April, 249 suspected cases were reported across nine of Sindh's 30 districts, of which 29 were laboratory-confirmed, including eight deaths — a healthcare-associated outbreak in Khairpur district, mostly in children under six months, linked to suboptimal infection prevention and control (WHO Situation Report no. 65). That is a different outbreak from the KP cluster, and this article states no current Sindh total, because the outlets reporting one disagree with each other and neither figure is verified against the Sindh Health Department.
Globally, the World Health Organization declared mpox a public health emergency twice — from July 2022 to May 2023, and from August 2024 to September 2025. The emergency was lifted in September 2025.
What is still unknown
- Whether the four patients were infected locally or through an untraced contact — contact tracing is under way.
- The clade of this cluster — not reported.
- A current, verified national total — none exists right now; the April NIH figure (60 cases) is the latest official national figure found, and it is dated.
Sources
Only articles marked Reviewed ✓ with a date have passed Dr Umer’s medical review.
How this article was reviewed
- Written by: Dr. Muhammad Umer Farooq, MBBS — October 2026
- Medically reviewed by: Dr. Muhammad Umer Farooq, MBBS — October 2026.
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