Arshad Yasir, Mehmood Nayab, Alam Muhammad Masroor, Khurshid Adnan, Akhtar Ribqa, Mujtaba Ghulam, Rehman Lubna, Mushtaq Nighat, Sarfraz Bisma, Hakim Rabia, Umair Massab, Rana Muhammad Suleman, Salman Muhammad, Sharif Salmaan, Sattar Sadia, Javed Sundus, Ahmed Muzzamil, Khan Zainul Abedin, Soghaier Mohammed Ahmed, Bostan Nazish
Department of Virology, National Institute of Health, Islamabad, Pakistan.
Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan.
J Infect Dis. 2025 Feb 20;231(2):471-479. doi: 10.1093/infdis/jiae439.
Pakistan is 1 of the 2 countries endemic for wild poliovirus type 1 (WPV1). Active clinical and environmental wastewater surveillance along with laboratory investigation is an integral and primary component of polio eradication strategies. The current study is mainly focused on virological data to understand the current epidemiology of WPV1 in Pakistan during 2019-2022.
In total, 141 037 stool specimens from patients reported with acute flaccid paralysis and 3171 wastewater samples were tested for detection of poliovirus using cell culture and polymerase chain reaction (PCR). Phylogenetic analysis of WPV1 was performed using MEGA and Nextstrain.
Poliovirus isolates were classified into 15 distinct genetic clusters with multiple transmission lineages. Spatiotemporal trends indicated a significant decline in the incidence of poliomyelitis, reported in 58 districts in 2019 and just 3 in 2022. The historical reservoirs in Peshawar, Quetta, and Karachi successfully eliminated the indigenous transmission chains of wild poliovirus that had been active there for years.
Our findings reinforce the evolving epidemiology of poliovirus in Pakistan, which is now confined to south-KP. All historically known reservoirs in Peshawar, Karachi, and Quetta block are now free of poliovirus. Intensified clinical and environmental surveillance should be maintained to eliminate the very few remaining transmission lineages and certify poliovirus eradication by 2026.
巴基斯坦是1型野生脊髓灰质炎病毒（WPV1）的两个流行国家之一。积极开展临床和环境废水监测以及实验室调查是脊髓灰质炎根除策略不可或缺的主要组成部分。本研究主要聚焦于病毒学数据，以了解2019 - 2022年期间巴基斯坦WPV1的当前流行病学情况。
总共对141037份急性弛缓性麻痹患者报告的粪便标本和3171份废水样本进行检测，采用细胞培养和聚合酶链反应（PCR）检测脊髓灰质炎病毒。使用MEGA和Nextstrain对WPV1进行系统发育分析。
脊髓灰质炎病毒分离株被分为15个不同的遗传簇，具有多个传播谱系。时空趋势表明脊髓灰质炎发病率显著下降，2019年在58个地区有报告，而2022年仅在3个地区有报告。白沙瓦、奎达和卡拉奇的历史疫源地成功消除了多年来在当地活跃的野生脊髓灰质炎病毒的本土传播链。
我们的研究结果强化了巴基斯坦脊髓灰质炎病毒不断演变的流行病学情况，目前该病仅限于开伯尔-普赫图赫瓦省南部。白沙瓦、卡拉奇和奎达街区所有历史上已知的疫源地现在都已无脊髓灰质炎病毒。应加强临床和环境监测，以消除仅存的少数传播谱系，并在2026年前认证脊髓灰质炎病毒已被根除。
