Jorgensen David, Pons-Salort Margarita, Salman Muhammad, Khurshid Adnan, Arshad Yasir, Mahmood Nayab, da Silva Candido Darlan, Kroiss Steve, Lyons Hil, Grassly Nicholas C, Alam Muhammad Masroor
MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.
National Institute of Health, Islamabad, Pakistan.
Nat Commun. 2025 Jun 4;16(1):5170. doi: 10.1038/s41467-025-60432-x.
Despite concerted global vaccination efforts, wild poliovirus remains endemic in two countries in 2024, Pakistan and Afghanistan. This study uses phylogeographic analysis of poliovirus genetic and epidemiological data from clinical and wastewater surveillance to identify the causes of poliovirus persistence and routes of spread over the last decade (2012 to 2023). Poliovirus genetic diversity declined after 2020, with one of two major genetic clusters dying out, and recent detections are now closely related genetically. High-risk and hard-to-access regions have sustained polio transmission over the past decade, even when interrupted elsewhere. Karachi, one of the most densely populated cities globally, has acted as a hub for the amplification and spread of poliovirus to other regions, many of which we show to be dead-end for onwards transmission despite frequent virus detection. Phylogenetic analysis has long been central to the polio surveillance network, and advancing the approaches used can provide critical epidemiological insights to accelerate eradication efforts.
尽管全球齐心协力开展疫苗接种工作，但野生脊髓灰质炎病毒在2024年仍在巴基斯坦和阿富汗这两个国家流行。本研究利用对来自临床和废水监测的脊髓灰质炎病毒基因及流行病学数据进行系统地理学分析，以确定过去十年（2012年至2023年）脊髓灰质炎病毒持续存在的原因和传播途径。2020年后脊髓灰质炎病毒的基因多样性下降，两个主要基因簇之一灭绝，最近检测到的病毒在基因上现在密切相关。在过去十年中，高风险和难以进入的地区一直存在脊髓灰质炎传播，即使其他地方的传播被打断。卡拉奇是全球人口最密集的城市之一，一直是脊髓灰质炎病毒向其他地区扩增和传播的中心，我们发现，尽管经常检测到病毒，但其中许多地区对于病毒的进一步传播而言是传播终点。长期以来，系统发育分析一直是脊髓灰质炎监测网络的核心，改进所使用的方法可为加速根除工作提供关键的流行病学见解。
