Pakistan Reports 74th Polio Case — Closing a Record Year

Pakistan's National Emergency Operations Centre confirmed the country's 74th wild poliovirus case, closing out the outbreak year at its final total.

Seventy-four, against six the year before

2023 recorded six wild poliovirus cases. 2024 recorded 74 — a twelvefold increase. The provincial split was 27 in Balochistan, 23 in Sindh, 22 in Khyber Pakhtunkhwa, and one each in Punjab and Islamabad.

The distribution mattered as much as the total. Cases in Punjab and Islamabad, areas that had been effectively clear for years, showed that virus was travelling along routes the programme had believed were closed. And the even spread across three provinces pointed to a general fall in population immunity rather than one district failing.

How a year like this happens

Pakistan's case record has swung sharply before — 8 cases in 2017, 147 in 2019, a single case in 2021 — and the mechanism has been consistent. A pool of consistently missed children accumulates over several years. Case counts stay low because population immunity is still high enough to suppress visible paralysis. Then campaign quality slips across several consecutive rounds, or access closes in a key district, and the virus expands into that accumulated pool very quickly.

Environmental surveillance had been signalling the risk beforehand: sewage samples were testing positive across a widening set of sites while case counts were still low. See polio surveillance in Pakistan.

What changed afterwards

The programme's response through late 2024 and 2025 combined intensified national and sub-national campaign rounds, expanded vaccination at permanent transit points, integrated health camps in communities with high refusal rates, and escalation of access constraints to political level.

2025 closed at 31 cases — less than half the 2024 total. By September 2026, four cases had been reported for the year, three of them from the Bannu division in southern Khyber Pakhtunkhwa.

What it did not change

The underlying constraint is unchanged: where campaigns cannot run for consecutive rounds, immunity gaps open regardless of how well the rest of the country performs. Southern Khyber Pakhtunkhwa remains the decisive area.

For parents

Two drops for every child under five in every round, every time. Complete the routine immunisation schedule. Call 1166 if no team reaches your household.

Related: cases by province · eradication within reach