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. 2022 Sep 10;1(4):pgac187. doi: 10.1093/pnasnexus/pgac187

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© The Author(s) 2022. Published by Oxford University Press on behalf of National Academy of Sciences.

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

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Fig. 1. — Superinfection and cotransmission. (A) Under standard assumptions of superinfection, individuals in high-transmission settings are exposed to multiple infectious bites and have multiple opportunities for outcrossing. This results in parasite populations characterized by high proportion of polygenomic infections, high COIs, and few clones. Individuals in low-transmission settings are exposed to fewer infectious bites, resulting in fewer polygenomic infections and low COIs. Low transmission also limits outcrossing and promotes the transmission of clonal parasite strains. (B) Cotransmission weakens the relationships proposed in panel (A) because polygenomic infections can also result from a single bite. Cotransmission is initiated when a mosquito ingests multiple parasite strains from an initial polygenomic infection. The number of strains present in the initial mosquito blood feed depends on the COI and strain proportions in the initial host. These parasites undergo sexual outcrossing to produce genetically related sporozoites that are transmitted into a new host. Cotransmissions do not reflect multiple exposures and instead represent a single exposure event.