The Pakistani government on Thursday ordered enhanced screening for travelers arriving from “Nipah-affected or high-risk regions.”

Hong Kong, Indonesia, Malaysia, Singapore, and Vietnam previously implemented such screening in response to an outbreak of the deadly Nipah virus in West Bengal, India.

“In view of suspected cases of Nipah virus infection in West Bengal, India, and considering the high case fatality rate, zoonotic nature, and potential for human-to-human transmission, it has become imperative to further strengthen preventive and surveillance measures at Pakistan’s borders,” the Pakistani Border Health Services agency announced on Thursday.

“These instructions shall be applicable to all points of entry, including international airports, seaports, and ground/ land border crossings, without any exception. No individual shall be allowed entry into Pakistan without health clearance,” the announcement said.

The Pakistani agency said that travelers will be required to provide their travel history for the past three weeks to establish if they have passed through “Nipah-affected” regions — which would appear, for the moment, to be limited to West Bengal. Travelers arriving directly from areas affected by the outbreak will face “special vigilance.”

“Any false declaration, concealment, or misreporting of travel history shall be immediately documented and reported to the competent authorities for further necessary action,” the announcement warned.

Screening for the Nipah virus will include temperature checks and clinical assessments by staff trained to look for common early symptoms of the deadly virus – which are very similar to signs of more common and less dangerous diseases, including “fever, headache, respiratory symptoms and neurological signs such as confusion, drowsiness or altered consciousness.” Any traveler suspected of being infected by Nipah will be quarantine by the Pakistani Border Health Service.

Pakistan’s response seems ostentatiously more stringent than the measures imposed by the other Southeast Asian nations, all of which have considerably more direct arrivals from India. Pakistan and India have strained relations, so there are no direct flights and relatively little cross-border traffic.

Indian officials say there have been only two confirmed infections in the Nipah outbreak so far, both of them health workers, one male and one female. The male patient is reportedly doing well and could be discharged from the hospital soon, while the female patient remained in critical condition on Thursday.

“There is no outbreak, there were just two cases in one district in Bengal and there is no spread. There is no consideration for screening at airports in India because there appears to be no need for it,” an Indian health ministry official said on Thursday.

Indian officials said they saw no need to screen outbound travelers for Nipah, but they did not quarrel with the right of other nations to screen incoming passengers if they felt it was necessary.

Nipah is a dangerous zoonotic disease that can spread from animals to humans through eating contaminated meat, or fruit that has been tainted by contact with infected animals, such as fruit bats. It has mild early symptoms that resemble a common fever, but it causes swelling in the brain and spine in its later stages. The World Health Organization estimates that Nipah has a mortality rate of 40 to 70 percent.

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