Background: The epidemiological significance of Hepatitis B virus genotypes has been well established and becoming an essential concern day by day however, much little is known about the mixed infection with more than one Hepatitis B virus genotypes and their clinical relevance.
BackgroundIn early 2009, a novel influenza A(H1N1) virus that emerged in Mexico and United States rapidly disseminated worldwide. The spread of this virus caused considerable morbidity with over 18000 recorded deaths. The new virus was found to be a reassortant containing gene segments from human, avian and swine influenza viruses.Methods/ResultsThe first case of human infection with A(H1N1)pdm09 in Pakistan was detected on 18th June 2009. Since then, 262 laboratory-confirmed cases have been detected during various outbreaks with 29 deaths (as of 31st August 2010). The peak of the epidemic was observed in December with over 51% of total respiratory cases positive for influenza. Representative isolates from Pakistan viruses were sequenced and analyzed antigenically. Sequence analysis of genes coding for surface glycoproteins HA and NA showed high degree of high levels of sequence identity with corresponding genes of regional viruses circulating South East Asia. All tested viruses were sensitive to Oseltamivir in the Neuraminidase Inhibition assays.ConclusionsInfluenza A(H1N1)pdm09 viruses from Pakistan form a homogenous group of viruses. Their HA genes belong to clade 7 and show antigenic profile similar to the vaccine strain A/California/07/2009. These isolates do not show any amino acid changes indicative of high pathogenicity and virulence. It is imperative to continue monitoring of these viruses for identification of potential variants of high virulence or drug resistance.
Background Pakistan is among three countries endemic for wild poliovirus (WPV1) circulation, still struggling for eradication of poliomyelitis. Active clinical and environmental surveillance systems with meticulous laboratory investigations provide insights into poliovirus transmission patterns and genomic diversity to inform decisions for strategic operations required to achieve eradication. Methods We analyzed epidemiological and virological data at molecular level to comprehend the current epidemiological status of WPV1 in Pakistan during 2015-2017. Stool specimens of AFP patients and sewage samples collected from 60 active environmental sites. Viral culturing, intratypic differentiation by real time-PCR and nucleic acid sequencing of VP1 region of poliovirus genome to determine the genetic relatedness among WPV1 strains were applied. The phylogenetic analysis were done using BEAST v2.3.0 [1] . Results Poliovirus isolates were grouped into eleven distinct clusters which had ≥95% nucleotide homology in VP1 coding region. Most burden of poliovirus was shared by three major reservoirs i.e. Karachi, Peshawar and Quetta block (64.2% in 2015; 75.4% in 2016 and 76.7% in 2017). Conclusions Environmental surveillance reveals importations and pockets of unimmunized children which dictate intensive target mop-up campaigns in such areas to contain poliovirus transmission. Decrease in number of orphan isolates reflects effective combination of AFP and ES surveillance working in Pakistan. The genetic data reflects sustained transmission within reservoir areas, further expanded by periodic importations to areas of high immunity reflected by immediate termination of imported viruses. However, it is suggestive that Pakistan is at-risk unless the entire country including Afghanistan attain a polio-free status. Improved immunization coverage with high quality surveillance is vital for global certification.
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