Abstract
Rubella virus causes mild disease in children but for women in the early stages of pregnancy, it can cause spontaneous abortion, congenital rubella syndrome (CRS) and associated birth defects. Despite the availability of an effective vaccine, rubella virus continues to circulate endemically in several regions of the world. This is particularly true in East and Southeast (E/SE) Asia, where control efforts vary widely among countries that are well connected through travel and immigration. It is therefore important to understand how the regional persistence of rubella is affected both by dynamics occurring across countries and susceptibility within countries. Here, we use genetic and epidemiological data from countries in E/SE Asia to explore the phylogeography of rubella virus in this region. Our results underline that metapopulation dynamics are key for rubella persistence and highlight the source-sink population structure of the region. We identify countries that contribute to the regional metapopulation network and link epidemic dynamics to susceptibility profiles within each country. Our results indicate that human movement plays an important role in driving epidemic dynamics in E/SE Asia.
Highlights
Rubella virus generally causes a mild childhood infection but can lead to severe birth defects when contracted by women in the early stages of pregnancy
The most recent common ancestor (MRCA) of all lineages currently circulating in Asia can be traced back to a common ancestor that existed in China in the late 1990s (mean: 1999.02; highest posterior density interval (HPDI): 1997.77–2000.08) (Fig. 1a )
To understand whether metapopulation dynamics contribute to the persistence of rubella across neighboring countries that vary in their level of vaccination coverage, we combined both phylogenetic and epidemiological lines of evidence
Summary
Rubella virus generally causes a mild childhood infection but can lead to severe birth defects when contracted by women in the early stages of pregnancy. Just a single study has addressed global diffusion of rubella (Cloete, 2014); findings indicated that infection tends to flow out from regions of low vaccination coverage, education index and income rather than necessarily between regions in close geographic proximity. While this result is expected at broad global scales, it is not clear that these patterns will hold at finer spatial resolutions, in regions of Asia where geographically adjacent countries that are strongly connected through travel and immigration have highly variable levels of vaccination coverage
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
