Nearly 900 children under 12 are among 1112 cases of HIV infection now confirmed in an outbreak linked to a paediatrician in Ratodero, Pakistan, who reused syringes and IV drips.

Authorities fear that the true number of people infected could be much higher, as only 36 000 of the town’s population of roughly 225 000 have been tested to date.

The cluster of HIV cases was first discovered in May, when children around the city started coming down with a fever. A local journalist, Gulbahar Shaikh, revealed the cause to be HIV, sparking a rush to get tested.

Investigators interviewed the families of children who had tested positive and discovered that many had visited a paediatrician named Muzaffar Ghanghro. Ghanghro was one of the cheapest doctors in the city, but would repeatedly re-use syringes and needles, telling patients that they could have new equipment only if they could afford to pay for them!

https://doi.org/10.1136/bmj.l6284