Genomic and epidemiological monitoring of yellow fever virus transmission potential.
Faria NR., Kraemer MUG., Hill SC., Goes de Jesus J., Aguiar RS., Iani FCM., Xavier J., Quick J., du Plessis L., Dellicour S., Thézé J., Carvalho RDO., Baele G., Wu C-H., Silveira PP., Arruda MB., Pereira MA., Pereira GC., Lourenço J., Obolski U., Abade L., Vasylyeva TI., Giovanetti M., Yi D., Weiss DJ., Wint GRW., Shearer FM., Funk S., Nikolay B., Fonseca V., Adelino TER., Oliveira MAA., Silva MVF., Sacchetto L., Figueiredo PO., Rezende IM., Mello EM., Said RFC., Santos DA., Ferraz ML., Brito MG., Santana LF., Menezes MT., Brindeiro RM., Tanuri A., Dos Santos FCP., Cunha MS., Nogueira JS., Rocco IM., da Costa AC., Komninakis SCV., Azevedo V., Chieppe AO., Araujo ESM., Mendonça MCL., Dos Santos CC., Dos Santos CD., Mares-Guia AM., Nogueira RMR., Sequeira PC., Abreu RG., Garcia MHO., Abreu AL., Okumoto O., Kroon EG., de Albuquerque CFC., Lewandowski K., Pullan ST., Carroll M., de Oliveira T., Sabino EC., Souza RP., Suchard MA., Lemey P., Trindade GS., Drumond BP., Filippis AMB., Loman NJ., Cauchemez S., Alcantara LCJ., Pybus OG.
The yellow fever virus (YFV) epidemic in Brazil is the largest in decades. The recent discovery of YFV in Brazilian Aedes species mosquitos highlights a need to monitor the risk of reestablishment of urban YFV transmission in the Americas. We use a suite of epidemiological, spatial, and genomic approaches to characterize YFV transmission. We show that the age and sex distribution of human cases is characteristic of sylvatic transmission. Analysis of YFV cases combined with genomes generated locally reveals an early phase of sylvatic YFV transmission and spatial expansion toward previously YFV-free areas, followed by a rise in viral spillover to humans in late 2016. Our results establish a framework for monitoring YFV transmission in real time that will contribute to a global strategy to eliminate future YFV epidemics.