9 Mpox deaths, 25 cases reported across Sindh province, Pakistan. Dunya News, April 15 2026. The

Grounds assessments

activeAt least one additional EU/G7 country beyond Spain will report a documented Clade Ib mpox sustained transmission cluster (≥5 epidemiologically linked cases over ≥3 weeks) by September 30 2026, driven by the WHO DON587-confirmed multi-mode global Clade Ib spread and cross-border network linkage with Spain's ongoing outbreak.50%activeIndia will confirm sustained domestic Clade Ib community transmission (≥3 epidemiologically linked locally-acquired cases without direct foreign travel history) within 90 days, based on: Kerala confirmed Clade Ib Jan 2026 with scientists warning of sustained spread; India surveillance gaps noted by Down To Earth; Pakistan Sindh multi-district Clade Ib on India's western border (25 cases, 9 deaths).50%activeA locally-acquired Clade I mpox transmission chain (≥2 epidemiologically linked cases without African travel history) will be confirmed in North America within 90 days of the San Francisco Clade I detection (Apr 19 2026).40%activePakistan (Khairpur/Sindh) mpox cases will be genomically confirmed as Clade Ib by WHO DON or Pakistan MoH by June 2026, representing the third non-African Clade Ib community transmission geography after Spain (Dec 2025) and Singapore (Apr 2026), based on infant mortality in Khairpur district (7 infants dead/positive, Apr 2026) and demographic severity patterns consistent with Clade Ib rather than Clade IIb.40%activeAt least one confirmed mpox Clade Ib case with travel linkage to Singapore will be detected in Japan, South Korea, or Australia by October 2026, given Singapore's confirmed local Clade Ib transmission (2 cases, CDA Apr 4 2026) and Singapore's role as the primary aviation hub for East Asia–Pacific travel.50%resolvedMpox clade Ib will be confirmed in at least 2 East African countries outside the DRC by April 2026.90%activeCalifornia will confirm at least 2 additional Clade I mpox cases (beyond the San Francisco Apr 16 index) within 60 days of Apr 20 2026, with at least one in Los Angeles County or adjacent counties — indicating multi-focus Clade I circulation rather than isolated importation.60%activeWHO will issue a Disease Outbreak News (DON) specifically addressing Clade Ib community transmission outside Africa (Spain Dec 2025, Singapore Apr 2026, Pakistan unconfirmed Apr 2026) as a distinct non-African Clade Ib spread pattern by June 30, 2026, given that the existing global PHEIC DONs have not yet characterized the non-African Ib pattern as a separate epidemiological entity.50%activePakistan Khairpur Sindh Clade Ib cluster (Apr 2026) will trigger WHO or Pakistan MoH-coordinated enhanced surveillance in Afghanistan and/or Iran within 90 days, resulting in at least one MPXV case detected in either country by July 14 2026, based on cross-border population movement patterns in the Balochistan/Sindh/Afghanistan corridor and the unprecedented pediatric severity profile indicating likely Clade Ib circulation at a regional rather than isolated scale.40%activeAt least one confirmed mpox case (clade unspecified) will be detected in India within 90 days of the Pakistan Khairpur Sindh infant deaths cluster (by July 14 2026), given Pakistan-India cross-border movement in the Punjab/Rajasthan/Gujarat corridor and the unprecedented pediatric severity profile suggesting Clade Ib circulation in an adjacent geography.40%activeA novel recombinant mpox lineage arising from tri-clade co-circulation (Clade Ia, Ib, and Clade IIb) in the Republic of the Congo will be genomically documented by April 2027, based on the first reported co-circulation of all three major mpox clades in a single geography.30%

Evidence content

9 Mpox deaths, 25 cases reported across Sindh province, Pakistan. Dunya News, April 15 2026. The — research event update (updated 2026-04-16T00:09)

9 Mpox deaths, 25 cases reported across Sindh province, Pakistan. Dunya News, April 15 2026. The

Field	Value
date	2026-04-16
event_type	news
headline	9 Mpox deaths, 25 cases reported across Sindh province, Pakistan. Dunya News, April 15 2026. The
research_domain	generic
scope	mpox
source_meta	{"publisher":"Dunya News","published_at":"2026-04-15","tier":"T2","geographic_focus":"Pakistan, Sindh province","signal_type":"case_count_escalation"}
source_url	https://dunyanews.tv/en/Pakistan/mpox-sindh-deaths-cases
summary	9 Mpox deaths, 25 cases reported across Sindh province, Pakistan. Dunya News, April 15 2026. The mpox outbreak in Pakistan's Sindh province has escalated beyond the initial Khairpur cluster, with 9 total deaths and 25 confirmed cases reported across the province as of April 15, 2026. This represents a material expansion from the initial reports of approximately 7 infant cases in Khairpur district reported early April 2026. The geographic spread from Khairpur district to broader Sindh implies community circulation rather than a contained nosocomial or neonatal unit outbreak. No genomic clade confirmation has been issued by Pakistan MoH or WHO as of this report. Earlier on April 5, 2026, the Pakistan Ministry of Health stated that the seven newborn deaths in Khairpur were "not directly cause

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