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The Pakistan government has sought international help after more than 700 people, most of them children, tested positive for HIV in the southern town of Ratodero. The outbreak was thought to have been spread through reused syringes used mostly by unqualified practitioners.

“As part of key tasks, a WHO-led team will determine the factors behind the outbreak and suggest control measures,” said Pakistan’s Minister for Health, Zafar Mirza. “[They will] provide technical expertise in the areas of HIV testing, paediatric HIV treatment and family counselling.”

Mirza said the team, who reached Ratodero on May 31 would ensure that there are enough supplies of rapid diagnostic tests and antiretroviral medicines for adults and children. They will also look into the availability of single-use needles and syringes especially as initial investigations into the outbreak have pointed to the use of repackaged syringes.

As of May 31, mas screenings in Ratodero suggested that 728 people would test positive for HIV. Five hundred and ninety-five of them were children, 70% of whom were aged between two years and five years, according to Pakistani National AIDS Control Programme officials.

The incident is believed to be the world’s first HIV outbreak where the majority of those affected are children. Seventy-three women also tested positive for HIV.

Oliver Morgan, director of health emergency information and risk assessment at the Health Emergencies Programme of WHO, is leading the 12-member international investigation team. The team is comprised of health experts from US-based Centre for Disease Control and Prevention, UNICEF, UNAIDS and the Global Outbreak Alert and Response Network.

The delegation will try to trace the origin of infection and identify the exact source before it spreads further. It will also provide paediatric HIV treatment and family counselling.

Provincial and federal health officials say unqualified practitioners, on whom the poverty-racked rural parts of the country depend, are behind the reuse of syringes.

Pakistani National AIDS Control Programme manager Abdul Baseer Khan Achakzai told SciDev.Net: “Initial official investigations conducted by our organisation in collaboration with provincial and federal health departments point towards the reuse of infected syringes in the area and also unscreened blood transfusions. [Other reasons] could be poor infection prevention and unprotected sex.”

According to the Pakistani National AIDS Control Programme, Pakistan already has 1,65,000 people living with HIV, but only around 25,000 are registered with national and provincial HIV programmes.

Long thought to have low HIV prevalence, Pakistan has, in recent years, seen the virus rapidly resurfacing among sex workers and intravenous drug users. According to UNAIDS, Pakistan has among the fastest rates of HIV spread in the Asia Pacific region with 20,000 new infections reported in 2017.

This article first appeared on SciDev.

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