Epidemic of lumpy skin disease in Pakistan

Lumpy skin disease (LSD) is a viral infection of cattle and water buffalo caused by the lumpy skin disease virus (LSDV), a Capripoxvirus within the Poxviridae family. Transmission occurs primarily through arthropod vectors and potentially via direct contact and contaminated feed and water; persistent virus in skin lesions is a major infection source. Diagnosis is by histopathology, virus isolation, or PCR, with differentiation from pseudo‑LSD via PCR. There are no specific antivirals; management is supportive with treatment of secondary infections and prevention via vaccination. With recent regional outbreaks (e.g., Malaysia, Thailand) and livestock movement, Pakistan has seen rapid spread: historically free of LSDV, it reported more than 20,000 affected animals in Sindh initially, with Karachi most impacted. Nationwide, 190,000 cases and over 7,500 deaths have been reported, with more than 141,000 recoveries. Amid the ongoing COVID‑19 pressures on healthcare, additional crises like LSD pose economic and health system risks. This article outlines LSD virology, diagnosis, symptoms, treatment, and the economic and health impacts in Pakistan, along with government preventive measures and proposals to control further spread.

- Pakistan has experienced a rapid LSD spread: approximately 190,000 cases nationwide, with more than 7,500 deaths and over 141,000 recoveries. - Provincial distribution reported: Khyber Pakhtunkhwa 74,590 cases; Sindh 53,668; Punjab 35,000; Balochistan 22,225; Azad Jammu and Kashmir 6,351. In Sindh, about 54 deaths and 4,751 recoveries were reported early during the outbreak. - Economic impacts include reduced milk production, infertility, weight loss, abortion, skin damage, traction loss, and mortality, threatening a major livestock sector that contributes Rs.1466 billion to Pakistan’s GDP and supports about 8 million households. - Historical cost indicators: Israel reportedly spent USD 750,000 to control an initial LSD outbreak; in Ethiopia, median financial loss per dead animal was USD 375 and milk loss per affected cow USD 141. - Control measures implemented in Pakistan include formation of a national task force, importation of 500,000 vaccine doses (with interim use of goatpox vaccine), bans/restrictions on livestock markets and movements, vector control, farm biosecurity, disinfection, and awareness campaigns. In Sindh, 30,000 vaccine doses were administered in Karachi in March 2022. - Vaccination is the most effective control; the available live attenuated vaccine is estimated to be about 75% effective.

The letter contextualizes Pakistan’s LSD outbreak within the global expansion of the disease from Africa to the Middle East, Eastern Europe, and Asia since 2019. It emphasizes that Pakistan’s large cattle and buffalo population and dependence on livestock for GDP and household income intensify the consequences of LSD. The reported provincial case counts, deaths, and recoveries illustrate widespread transmission. Compounding challenges include COVID‑19–related strain on laboratories and veterinary services, medicine shortages, and potential trade restrictions. The authors argue for comprehensive control: mass vaccination, strict movement controls and certification, rigorous vector control (reducing breeding sites and using repellents), intensified surveillance (active and passive clinical monitoring with lab testing of blood, nasal swabs, and skin biopsies), strict biosecurity and disinfection, and broad awareness campaigns for veterinarians, farmers, transporters, and related personnel. These measures directly address the outbreak dynamics by reducing transmission, improving early detection, and mitigating economic losses through faster control.

LSD poses a serious threat to Pakistan’s livestock economy amid concurrent public health challenges. The most effective intervention is widespread, uniform vaccination with the live attenuated vaccine, complemented by movement controls, vector management, surveillance, and strict farm biosecurity and disinfection. While LSD is lethal for cattle, it is not a zoonosis. Coordinated national efforts—task force guidance, sufficient vaccine supply, awareness and training, and enforcement of control measures—are essential to limit spread and reduce economic losses. Future efforts should focus on ensuring vaccine coverage across regions, strengthening veterinary diagnostic capacity, and sustaining surveillance and vector control to prevent recurrent outbreaks.