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Omicron: Why The WHO Designated It A Variant Of Concern



New At-Home Testing Device Detects COVID-19 Variants In Saliva In An Hour

The World Health Organization (WHO) has announced that the B.1.1.529 lineage of Sars-CoV-2, thought to have emerged in southern Africa, is to be designated as a variant of concern (VoC) named omicron. This decision has already precipitated a broad shift in priorities in pandemic management on a global scale.

The WHO has recommended, among other things, increased surveillance, particularly virus genome sequencing; focused research to understand the dangers posed by this variant; and ramping up mitigation measures, such as mandatory mask wearing. Greater restrictions on international travel have already come into force in the UK and many other countries. Indeed, Japan has closed its borders to all foreign visitors.

The speed with which the omicron variant was designated a VoC was dizzying. A little over two weeks passed since the first known infections in Botswana and South Africa. Contrast this with the delta variant that is currently dominant in Europe and many other parts of the world. This variant was first reported in India in October 2020, but despite causing a tremendous surge in cases in the country (as well as spreading to many others), it did not receive the elevated status of VoC until at least six months later.

There was certainly sluggishness in recognising the danger posed by the delta, and lessons have no doubt been learned of the importance of acting quickly to nip dangerous new variants in the bud, or at least to slow their spread to buy the world some time. But this delay also reflected the difficulties in generating robust evidence as to what a new variant is capable of.

There are three types of behaviour (“phenotypes”) that determine the threat posed by a new variant. These are transmissibility (the rate at which it spreads from one person to another), virulence (the seriousness of disease symptoms) and immune evasion (the degree of protection a person receives from the vaccine or natural infection). The underlying genetics and evolutionary interactions among these three phenotypes are complex, and unpicking them requires both detailed real-world clinical and epidemiological data and careful experiments in the laboratory.

So what is it about the omicron variant that has led the WHO, and many experts around the world, to be so concerned with such little data to go on – and are their warnings justified that this variant is the “most worrying we have seen”?

There is no suggestion as yet that omicron causes more serious disease, but then there is almost no data available. Whether anecdotal reports from South Africa suggesting that this variant causes more mild symptoms turn out to be accurate, particularly for elderly or otherwise vulnerable people, remains to be seen. Yet there is clear cause for concern for both transmissibility and immune evasion.

The heightened transmissibility of a new variant can be difficult to pin down, as stochastic (random) effects can result in alarming surges in case rates without requiring any underlying changes in viral genetics. When case rates are relatively low, as they have been recently in South Africa, super-spreading or “founding” events can cause dramatic increases in the prevalence of single lineage by chance.

Even given these caveats, the consensus view is that the omicron variant does probably spread more rapidly than other variants. In the South African province of Gauteng, the emergence of omicron is thought to have pushed the R number (the number of people that one infected person will pass on a virus to, on average) up from around 1.5 to nearly 2, a significant shift if true. Unsurprisingly, it is also being picked up in an increasing number of countries outside of southern Africa, including the UK, Israel, Belgium, Canada, Australia, the Netherlands and Austria.

Jaw dropping

Easily the most jaw-dropping feature of the omicron variant, however, is the fact that it represents a significant and sudden evolutionary leap, as reflected by the unprecedented number of mutations in the genome. How this came about is a matter of continuing speculation but, critically, 32 mutations have affected the spike protein, many of which are known to alter how the virus interacts with the antibodies produced by the vaccines or prior infection.

It is this potential for increased immune escape, combined with a rapid rate of spread, that is causing so much concern. But predicting how a virus is likely to behave from the genome sequence alone is not an exact science. And there is not a straightforward relationship between the number of mutations a variant contains and the dangers that it may pose.

While the omicron variant certainly warrants mitigating measures, close surveillance and a global research effort, it remains too early to say exactly what we are dealing with. A clearer picture should emerge over the coming weeks as the evidence builds.

In the meantime, the world should be thankful for the vigilance and openness of South African and Botswanan scientists and public health officials, and the emergence of this variant should act as a wakeup call to re-double our efforts for equitable and speedy vaccine delivery on a global level.

Ed Feil, Professor of Microbial Evolution at The Milner Centre for Evolution, University of Bath

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Multi-State Listeria Outbreak Causes 1 Death, 1 ‘Fetal Loss’



Multi-State Listeria Outbreak Causes 1 Death, 1 'Fetal Loss'

A Listeria outbreak has caused nearly two dozen illnesses, with most of the patients living in or having traveled to Florida. One person died while a pregnant patient experienced “fetal loss.”

A total of 23 people have been infected with the Listeria monocytogenes outbreak strain as of Wednesday, according to the U.S. Centers for Disease Control and Prevention (CDC). 

The illnesses were reported from 10 states. Twelve of the cases were reported in Florida, while eight of the patients who did not live in Florida also reported traveling to the state in the month before they got sick.

That said, “the significance of this is still under investigation,” the CDC noted.

Twenty-two (96%) of the patients had to be hospitalized, with one death reported from Illinois. Five of the patients also fell ill during their pregnancy. One of them experienced a “fetal loss.”

As the CDC explained, pregnant people and their newborns, older adults and those who have weakened immune systems are most at risk of getting sick with Listeria. In pregnant people, it may result in miscarriage, stillbirth or premature delivery even though the illness itself may only be mild. Their newborns may also experience a “life-threatening infection.”

While other people can be infected with Listeria as well, they “rarely become seriously ill.”

“The true number of sick people in an outbreak is likely higher than the number reported, and the outbreak may not be limited to the states with known illnesses,” the CDC explained. “In addition, recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak.”

Results of whole-genome sequencing suggest that the patients “likely got sick from the same food.” Authorities are still conducting investigations and interviews to determine what the patients may have eaten before they got sick.

“So far, a common food item has not been identified,” the CDC said.

As such, the agency is urging anyone who may have symptoms of Listeria to list the foods they remember eating in the month before they got sick to help “solve the outbreak.”

Symptoms of Listeriosis may be flu-like in pregnant people. In those who aren’t pregnant, the symptoms may include headache, fever, stiff neck, convulsions, loss of balance, confusion and muscle aches. They may also experience food poisoning symptoms such as diarrhea.

According to the CDC, symptoms of “severe illness” typically begin about two weeks after eating the contaminated food. But there are also cases in which the symptoms are reported “as early as the same day or as late as 70 days after.”

“If you are at higher risk for Listeria infection and have symptoms, especially if you recently traveled to Florida, talk to your healthcare provider,” the CDC noted.

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Who Should Get Vaccinated Against Monkeypox?



Omicron And COVID Boosters: Everything You Need To Know

After the Centers for Disease Control and Prevention (CDC) confirmed that the United States already recorded about 300 monkeypox cases, the U.S. government has decided to roll out vaccines to contain the situation as soon as possible. 

The Biden administration has already confirmed that it will roll out 296,000 doses of the only monkeypox vaccine approved by the Food and Drug Administration (FDA). However, it’s unclear who should be getting the Jynneos vaccine doses amid the outbreak. 

Last month, the CDC issued a warning, saying members of the LGBTQ community have a higher risk of contracting the virus. The disease is technically not transmitted sexually, but initial reports on the outbreak found that gays and bisexual people accounted for most of the cases. 

Since the virus spreads via contact with body fluids and sores, it can be passed to other people through sexual intercourse, intimate contact and even shared beddings. This prompted the public health agency to issue safer sex guidelines earlier this month. 

The CDC encouraged the public not to kiss and have sex if their partner has monkeypox symptoms or recently developed unexplained rashes or sores. The agency also advised against sharing towels, fetish gear, sex toys and other personal items to avoid the spread of the disease. 

Health officials have warned that the main driver of the growing number of monkeypox cases is making close contact, especially sexual contact. They also singled out the people who should be getting jabbed with the monkeypox vaccine to prevent the outbreak from getting bigger. 

Per the CDC recommendations, the following should receive the Jynneos vaccine for monkeypox: people who have had close contact with a monkeypox patient, men who have sex with men, sexually active transgender people, health care workers who have come in contact with the virus and people who have traveled outside of the U.S. to places with confirmed monkeypox activity. 

The World Health Organization (WHO) noted that transgender people and gender-diverse people could be vulnerable in the context of the monkeypox outbreak, so they should get vaccinated. However, the organization pointed out that regardless of sexuality, everyone is at risk of contracting or passing on the virus. 

Since its detection outside Africa in May, the virus has already spread to 48 countries and infected over 3,500 people. In a new study published this week, scientists said the rapid transmission of the disease could be a product of the virus’ “accelerated evolution.”

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US Secures 105 Million Doses Of Pfizer Vaccine For Fall



Third COVID-19 Vaccine Dose Protection Only Good For 3 Months?

The United States on Wednesday announced an agreement with Pfizer and BioNTech for 105 million doses of Covid vaccine for Americans this fall.

The $3.2 billion contract, signed between the companies and the US health and defense departments, includes vaccines for babies, young children, teens and adults, and may include Omicron-specific vaccines, which a panel of government experts recommended on Tuesday.

Delivery will begin in late summer and continue into the fourth quarter, the companies said. The contract gives the US the option to procure up to 300 million doses.

“The Biden-Harris Administration is committed to doing everything we can to continue to make vaccines free and widely available to Americans – and this is an important first step to preparing us for the fall,” Health and Human Services Secretary Xavier Becerra said in a statement.

President Joe Biden’s administration has asked Congress for $23.5 billion in additional Covid funding, but a bill has not yet been passed.

As a result, the federal government “was forced to reallocate $10 billion in existing funding, pulling billions of dollars from Covid-19 response efforts” the statement said, with the new vaccines procured through this reallocation.

White House officials have previously said that without new funding, future vaccines might only be given for free to those at highest risk.

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