A high resolution case study of a patient with recurrent Plasmodium vivax infections shows that relapses were caused by meiotic siblings.

摘要: Plasmodium vivax infects a hundred million people annually and endangers 40% of the world's population. Unlike falciparum, P. parasites can persist as dormant stage in liver, known hypnozoite, these forms cause malaria relapses months or years after initial mosquito bite. Here we analyze whole genome sequencing data from blood patient who experienced consecutive over 33 non-endemic country. By analyzing patterns identity, read coverage, presence absence minor alleles polyclonal subsequent monoclonal infections, show that three infections are likely meiotic siblings. We infer siblings descended single tetrad-like form developed infecting midgut shortly fertilization. In this natural cross find recombination rate for to be 10 kb per centimorgan further observe areas disequilibrium surrounding major drug resistance genes. Our provide new strategies studying multiclonal which common all types infectious diseases, distinguishing reinfections endemic regions. This work provides theoretical foundation studies aim determine if existing drugs radical cure malaria.