Cases of Covid-19 caused by the XBB.1.5 subvariant of the coronavirus have been increasing in the United States in recent weeks. THE Center for Disease Control and Prevention (CDC) estimates that the strain represents about 28% of the diagnoses of the disease in the country and is already among the most prevalent, putting health authorities on alert in the fourth year of the pandemic.

Studies on XBB.1.5, dubbed by some scientists as Kraken – a kind of monster from Norse mythology that threatened navigators –, try to predict whether it would be capable of causing a new global wave of Covid-19.

The World Health Organization (WHO) believes so, however, classifies the risk assessment of the strain as “low”. “Based on its genetic characteristics and estimates of the initial growth rate, XBB.1.5 may contribute to increases in case incidence,” states the WHO Technical Advisory Group on Virus Evolution (TAG-VE).

TAG-VE representatives met last week to address the new subvariant and carry out a risk assessment based on available evidence. They recommend that countries prioritize studies to properly address uncertainties related to growth advantage, antibody leakage, and severity of XBB.1.5.

more transmissible

XBB.1.5 is a strain of XBB, a recombinant of two BA.2 strains, and carries a mutation seen infrequently, but which may increase its infectivity and ensure its survival. WHO director Maria Van Kerkhove called it the “most transmissible disease ever identified”.

“The reason for this is the mutations that are within this Omicron subvariant, allowing this virus to adhere to the cell and replicate easily. We are concerned about its growth advantage, in particular in European countries and the United States”, said Maria in a press conference on January 4th.

XBB.1.5 in the world

Specialists believe that, as happened in past waves, XBB.1.5 should become dominant in some countries because there are no competitors compatible with its characteristics.

Between October 22, 2022 and January 11, 2023, genetic sequencing tests confirmed 5,288 cases of Covid-19 by XBB.1.5 in 38 countries. The United States concentrates the vast majority of them (82.2%), followed by the United Kingdom (8.1%) and Denmark (2.2%).

The first Brazilian case was confirmed last Friday (6/1). The patient is a 54-year-old woman who lives in the city of Indaiatuba, in São Paulo. She traveled to the United States in October 2022 and collected the coronavirus detection test the following month.

The city hall reported, in a note, that the patient had only mild symptoms and did not need hospitalization. Her husband and two children also completed home isolation, although they did not show symptoms.

The professor of the Department of Collective Health at the University of Brasília (DSC/Faculdade UnB Ceilândia), Wildo Navegantes de Araújo, believes that the virus is already circulating in the country. “When a laboratory detects the presence of a virus, it has probably already been in circulation for some time. It could be in other Brazilian territories”, he evaluates.

Araújo claims that the risk of a new wave is linked to the behavior of the population. “The emergence of new subvariants by itself should not trigger new waves. What influences is human behavior. If we position ourselves to do our part, completing the vaccination scheme and, whenever possible, respecting the use of masks, we will avoid more serious cases, with the risk of death, ”he says.

The specialist assesses that the return to “normal life”, with meetings at the end of the year festivities, vacations, followed by back to school and Carnival, can contribute to the transmission of the new subvariant in the country.

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Monitoring

Since the peak of the Omicron variant in February 2022, the amount of shared virus sequences has dropped by more than 90% worldwide and the number of countries sharing this information has been reduced to two-thirds, according to the Director General of the WHO, Tedros Adhanom Ghebreyesus, this week.

Testing and sequencing are key to understanding the behavior of the virus in the population and tracking the emergence of new variants or strains.

“Monitoring is the way we have to detect the emergence of a new variant of concern, contributing to managers’ decision-making not being late and causing more complex phenomena”, explains the UnB professor specializing in Collective Health.

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