An unprecedented HIV outbreak has hit Pakistan, infecting hundreds of children and adults in the town of Ratodero.

In total, 494 children and 113 adults have been found HIV positive in the district of Larkana in Pakistan's Sindh province.

Rising HIV Cases Among Pakistan's Youth

Back in February, a number of children in Ratodero were brought to the attention of doctors due to their fever that refused to go down. At the time, they were diagnosed and treated in a clinic run by pediatrician Dr. Muzaffar Ghanghar. However, the treatments were ineffective.

By April, Dr. Imran Arbani, who was from another medical center in the province, ordered blood tests on the youngsters who were showing no signs of recovery from the fever.

Devastatingly, 15 of the children were found positive with HIV after the tests, according to a report by Larkana deputy commissioner Muhammad Nauman Siddique on Monday, May 20. All of the infected children are between the ages of 2 and 8 years.

More than 10,000 individuals have already been screened by the Pakistani government after the first diagnosis of the virus in the province. So far, 607 cases of HIV have been identified with about 75 percent of these consisting of children.

The question is, why are they sick?

Finding The Source Of The Outbreak

A number of experts believe that negligent medical practices are likely to be the source of the outbreak.

"There are three ways a child may be infected," Dr. Fatima Mir, a doctor at the Aga Khan University Hospital currently volunteering in Ratodero, told BBC. "It's either through a lactating mother who carries the virus, through blood transfusion, or through an infected surgical instrument or a syringe."

In Mir's experience, most of the mothers are not HIV-positive and most of the sick children had undergone blood transfusions, which leaves the use of infected medical instruments as the likely explanation for the children's illness.

Additionally, Ghangharo, who was the original doctor who treated the sick children involved in the current outbreak, tested positive for HIV.

Masood Bangash, a district police officer, told NPR that Ghangharo's positive diagnosis for the virus led people to suspect that the doctor was the source of the children's HIV. He is currently being held in jail after being arrested on April 30 for "first information report."

Dr. Minhaj Kidwai, the CEO of the Sindh Health Care Commission, believes that unsafe medical practices are the source of the outbreak, but since there has been hundreds of cases, it's unlikely to be blamed entirely on a single individual.

Unqualified doctors or "quacks" are common in Pakistan, many of whom practice unsafe injections and blood transfusions. Roughly 500 facilities in the Sindh province have been identified for unsafe practices, while 147 have been shut down pending investigation, and 600 have received government warnings.

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