Karachi Reports First Polio Case in Over 18 Months, National Tally Hits 7

A six-month-old boy from Union Council Jamali Colony in Karachi's East district has tested positive for wild poliovirus type 1, the city's first confirmed case in over a year and a half and Pakistan's seventh of 2026.

The National Emergency Operations Centre for Polio Eradication (NEOC) said the Regional Reference Laboratory for Polio Eradication at the National Institutes of Health in Islamabad confirmed the case on October 19, after the child was picked up through the routine polio surveillance network. NEOC said the boy was malnourished and had been infected by virus already circulating in the city. An official with the polio programme said it is the first case from Karachi since December 2024. A comprehensive case investigation has been launched, and the Pakistan Polio Eradication Initiative said it is assessing the best science-based response to prevent further transmission.

Where 2026's seven cases have come from

Five of this year's seven confirmed cases are from Khyber Pakhtunkhwa. Four of those sit in Bannu division, where militant threats have repeatedly disrupted vaccination teams, and a fifth, a seven-year-old boy confirmed October 5, came from Khyber district's Jamrud tehsil, outside the Bannu cluster. The remaining two cases are from Sindh, with Karachi's new case joining one earlier in the year. Karachi has had intense virus circulation in its environmental surveillance for roughly two years, though officials say door-to-door vaccination drives and improved routine immunisation have cut transmission; only one of the city's environmental sampling sites tested positive in September.

Why a malnourished child matters to the response

NEOC's description of the boy as malnourished points to a risk factor the polio programme has flagged before: children with weaker immune systems from poor nutrition are more vulnerable to paralysis once infected, and malnutrition can also mean a child missed earlier rounds of vaccination. That makes the case a marker not just of viral transmission in Karachi but of gaps in the basic health coverage reaching some of the city's poorest neighbourhoods, a pattern distinct from the security-driven access problems behind Bannu's cluster.

The campaign ahead

Pakistan has run four nationwide vaccination campaigns in 2026, reaching more than 45 million children, alongside targeted oral and injectable vaccination in high-risk districts. The next round, a subnational campaign scheduled for November 2 to 8, will target nearly 24 million children across 97 districts, including every district in Karachi, and is synchronised with a parallel campaign in Afghanistan, the other country where the virus remains endemic. Pakistan recorded 31 cases in 2025; this year's tally of seven is on pace to be lower, part of a longer decline the country's programme points to from an estimated 20,000 cases in the early 1990s, even as each new case outside an already-flagged district adds pressure on where the next round of vaccination needs to focus.

What to watch

The case investigation in Jamali Colony will determine whether this is an isolated detection or a sign of wider undetected transmission in Karachi, a question the November subnational campaign is designed to help answer once door-to-door teams move through the city's districts again.

Build Better Pakistan's Health Desk is tracking Pakistan's 2026 polio cases and will report on the Karachi investigation and the November vaccination round as they progress.