First Case of Brazil COVID-19 Variant (P.1) Identified in Lake County, Illinois

Lake County Health Department Urges Taking Precautions to Limit Spread of COVID-19

Lake County, Ill. — The Lake County Health Department on Wednesday morning March 17, 2021 announced the report of the first case of the Coronavirus Disease (COVID-19) P.1 variant (Brazil) in Lake County. Health Department staff are investigating. The person’s travel history is not known at this time.

“This is the second new variant of COVID-19 to be identified in Lake County since February, and the rise of these new variants could impact the progress we have made this year,” said Mark Pfister, Executive Director of the Lake County Health Department. “We can’t afford to let our guard down. Please continue wearing masks, washing hands, keeping 6 feet of distance from others, and avoiding crowds and poorly ventilated spaces to keep our communities safe.”

Researchers from Fiocruz Amazônia announce the discovery of a variant of strain B.1.1.28 (now called P.1.) in Amazonas state capitol of Manaus on January 13, 2021. According to Felipe Naveca, a scientist at the Oswaldo Cruz Foundation, there is no doubt that the variant appeared in the Amazon, and may be more contagious [Link to article in Portuguese]. In the view of the researcher Jesem Orellana, from Fiocruz-Alazonia, “the new variant is the “most plausible explanation” for the recent explosion of cases”

The discovery of the P.1 variant was first reported in Superinteressante (“Super Interesting”) — a Portuguese language science and culture magazine in Brazil

Viruses constantly change and new variants are expected. In addition to the P.1 variant in Brazil, the B.1.1.7 variant first identified in the United Kingdom (UK) and 1.351 variant in South Africa have recently emerged. These variants seem to spread more easily and quickly than other variants, which may lead to more cases of COVID-19. An increase in the number of cases will put more strain on health care resources, lead to more hospitalizations, and potentially more deaths.

The Lake County Health Department has investigated multiple cases of the B.1.1.7 (UK) variant identified since the first case was identified in the county on February 5, 2021, most of which were related to domestic or international travel. No cases of the 1.351 (South African) variant have been identified in Lake County to date.

“While we have identified a limited numbers of variant cases in our county, they are most certainly an underestimate of the number of actual cases,” said Dr. Sana Ahmed, Medical Epidemiologist for the Lake County Health Department. “We need our community’s help to curb the spread of the virus while we work to vaccinate our residents as quickly as possible. It is crucial to continue to follow quarantine recommendations if you have traveled or have been in close contact with someone who has tested positive for COVID-19. Wearing masks, washing your hands, and keeping your distance from others continue to be effective in preventing the spread of the virus, regardless of the strain.”

The P.1 variant was first identified in travelers from Brazil, who were tested during routine screening at an airport in Japan, in early January. It was first detected in the US at the end of January 2021. This variant contains a set of additional mutations that may affect its ability to be recognized by antibodies.

So far, studies suggest that currently authorized vaccines in the United States recognize and are effective for these known variants. This is being closely investigated and more studies are underway, according to the Lake County Health Department.

Brazil COVID-19 Crisis and Possible Causes

Around January 27, 2021 Brazil reached 220,000 deaths as the country’s health care resources were overwhelmed by the COVID-19 pandemic. Also on January 27, 2021 British medical journal The Lancet published an article listing four non-mutually exclusive possible explanations for the resurgence of COVID-19 in Manaus in Brazil.

Over-Estimated Attack Rate with Below-Threshhold Herd Immunity

First, the SARS-CoV-2 attack rate could have been overestimated during the first wave, and the population may have remained below the herd immunity threshold until the beginning of December 2020. The Attack Rate is the percentage of new cases compared to the population that has no immunity (the “at risk population”) during a specified time interval. According to The Lancet, the resurgence could be explained by a greater mixing of infected and susceptible individuals during December 2020. Hospitalizations in Manaus, where an estimated 76% of the population had been infected by October 2020, had remained at low levels for seven months from May to November 2020.

Waning COVID-19 Immunity by December 2020

Second, immunity against infection might have already begun to wane by December, 2020, because of a general decrease in immune protection against SARS-CoV-2 after a first exposure. Waning of anti-nucleocapsid IgG antibody titres observed in blood donors might reflect a loss of immune protection, although immunity to SARS-CoV-2 depends on a combination of B-cell and T-cell responses.

SARS-CoV-2 Variants Might Evade Immunity Generated by Previous Infection

Third, SARS-CoV-2 lineages (e.g., P.1 variant) might evade immunity generated in response to previous infection. Three recently detected SARS-CoV-2 lineages (B.1.1.7, B.1.351, and P.1), are unusually divergent and each possesses a unique constellation of mutations of potential biological importance, according to The Lancet article.

Among these three variants, two are circulating in Brazil (B.1.1.7 and P.1) and one (P.1) was detected in Manaus on January 12, 2021. One case of SARS-CoV-2 reinfection has been associated with the P.1 lineage in Manaus that accrued ten unique spike protein mutations, including E484K and N501K.16, according to a documented article sourced in The Lancet article.

Moreover, the newly classified P.2 lineage (sublineage of B.1.128 that independently accrued the spike E484K mutation) has now been detected in several locations in Brazil, including Manaus. P.2 variants with the E484K mutation have been detected in two people who have been reinfected with SARS-CoV-2 in Brazil, according to a documented article sourced in The Lancet article. Also, there is in-vitro (laboratory) evidence that the presence of the E484K mutation reduces neutralization by polyclonal antibodies in convalescent sera (serum of convalescent patients who are successfully recovering).

SARS-CoV-2 Variants Might Be More Contagious

Fourth, SARS-CoV-2 lineages circulating in the second wave might have higher inherent transmissibility than pre-existing lineages circulating in Manaus. The P.1 lineage was first discovered in Manaus. In a preliminary study, the P.1 lineage reached a high frequency (42%, 13 of 31) among genome samples obtained from COVID-19 cases in December, 2020, but was absent in 26 samples collected in Manaus between March and November, 2020.
Initially, little is known about the transmissibility of the P.1 lineage, but it shares several independently acquired mutations with the B.1.1.7 (N501Y) and the B.1.325 (K417N/T, E484K, N501Y) lineages circulating in the UK and South Africa, which seem to have increased transmissibility.

Contact tracing and outbreak investigation data are needed to better understand relative transmissibility of the lineage (e.g., (P.1 variant), according to The Lancet article. Transmissibility is the effectiveness of the passing of a pathogen causing communicable disease (SARS-CoV2 virus) from an infected host individual or group to a particular individual or group, regardless of whether the other newly-infected individual was previously infected.

For more information on new COVID-19 variants, visit the Centers for Disease Control and Prevention (CDC) website or the Illinois Department of Public Health (IDPH) website.

See also …

Sabino EC, Buss LF, Carvalho MPS, Prete CA Jr, Crispim MAE, Fraiji NA, Pereira RHM, Parag KV, da Silva Peixoto P, Kraemer MUG, Oikawa MK, Salomon T, Cucunuba ZM, Castro MC, de Souza Santos AA, Nascimento VH, Pereira HS, Ferguson NM, Pybus OG, Kucharski A, Busch MP, Dye C, Faria NR. Resurgence of COVID-19 in Manaus, Brazil, despite high seroprevalence. Lancet. 2021 Feb 6;397(10273):452-455. doi: 10.1016/S0140-6736(21)00183-5. Epub 2021 Jan 27. PMID: 33515491; PMCID: PMC7906746.

SUPER INTERESSANTE | O que se sabe sobre a nova variante de coronavírus detectada em Manaus
[PORTUGUESE language … you can translate with translate.google.com]

AMAZONAS | Covid em Manaus: nova variante pode estar por trás de caos no Amazonas, dizem pesquisadores [PORTUGUESE language … you can translate with translate.google.com]