Reconstructing patterns of virus spread and evolution for prevention of childhood infections
BACKGROUND: In 2013, 6.3 million children died before the age of 5. Most of these childhood deaths (51.8 %) were due to infectious causes that could be largely preventable.
GAP: Our ability to prevent childhood infections, however, is limited because transmission of infectious diseases is rarely observed. Where are most children infected, who is at greatest risk, and how can we most effectively intervene to prevent disease spread?
HYPOTHESIS: The global use of oral polio vaccine (OPV), a live virus that spreads from vaccinated children to their contacts, constitutes a natural, epidemiological experiment. By tracking the spread of OPV following vaccination campaigns, we have the rare opportunity to observe viruses move through populations.
METHODS: We will deep sequence OPV viruses collected over four months following vaccination campaigns in three Mexican communities. With OPV genomes, we will reconstruct chains of OPV transmission (who-infected-who), allowing us to estimate where the majority of transmission occurs and where interventions could prevent transmission.
IMPACT: We will use the unique, natural experiment of OPV spread as a model of transmission of other pediatric pathogens. We will develop methods to use virus and bacterial genomes to better understand pathogen transmission and directly inform public health interventions.