What is P.1? US confirms its first case of contagious Covid-19 variant from Brazil in Minnesota patient
The first case of a highly infectious coronavirus variant, which originated in Brazil, has reached the US. Health officials confirmed that the first known case of P.1 Covid-19 strain in the US has been identified in a patient in Minnesota. The Minnesota Department of Health (MDH) announced on January 25 that its public health laboratory has found the P.1 variant in a “specimen from a Minnesota resident with recent travel history to Brazil.”
The announcement came as President Joe Biden signed an order extending a travel ban barring nearly all non-US citizens who have recently been to Brazil, South Africa, the UK, Ireland, and 26 other European countries from entering the US.
Cases of the British coronavirus variant have also been identified in Minnesota in the past few weeks. “These cases illustrate why it is so important to limit travel during a pandemic as much as possible. If you must travel, it is important to watch for symptoms of Covid-19, follow public health guidance on getting tested prior to travel, use careful protective measures during travel, and quarantine and get tested after travel,” suggests state epidemiologist Dr Ruth Lynfield.
P.1 lineage
Several new coronavirus variants emerged in the fall of 2020, most notably, the UK one that is known as 20I/501Y.V1, VOC 202012/01, or B.1.1.7; the South African variant called 20H/501Y.V2 or B.1.351, and the P.1 strain.
The P.1 variant emerged in Brazil and was first reported by the National Institute of Infectious Diseases (NIID) in Japan in four travelers from Brazil, who were tested during routine screening at Haneda airport outside Tokyo, Japan. This variant has 17 unique mutations, including three in the receptor-binding domain of the spike protein.
“There is evidence to suggest that some of the mutations in the P.1 variant may affect its transmissibility and antigenic profile, which may affect the ability of antibodies generated through a previous natural infection or through vaccination to recognize and neutralize the virus,” caution researchers.
Analysis indicates that P.1 accounted for 42% of confirmed cases in Manaus, Brazil, in mid/late-December. “In this region, it is estimated that approximately 75% of the population had been infected with SARS-CoV2 as of October 2020. However, since mid-December, the region has observed a surge in cases. The emergence of this variant raises concerns of a potential increase in transmissibility or propensity for SARS-CoV-2 re-infection of individuals,” emphasize experts.
While 293 cases of the UK variant have been detected in the US so far, this is the nation's first known coronavirus case associated with Brazil's P.1 variant. According to the US Centers for Disease Control and Prevention (CDC), all three variants seem to spread more easily and quickly than other variants, which may lead to more cases of Covid-19. Scientists are working to learn more about these variants to better understand how easily they might be transmitted and the effectiveness of currently authorized vaccines against them. They also want to ascertain how the disease caused by these new variants differs from the disease caused by other variants that are currently circulating.
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“While this (P.1) variant is thought to be more transmissible than the initial strain of the virus that causes Covid-19 disease, it is not yet known whether the variant causes more severe illness,” notes MDH.
How was it identified?
The variant was discovered through the MDH’s variant surveillance program. Each week, this program collects 50 random samples from the University of Minnesota clinical laboratories, Infinity Biologix Laboratory in Oakdale, and other testing partners and then conducts special testing using a process called whole genome sequencing. The goal is to develop a more accurate picture of what specific forms of Covid-19 are circulating in Minnesota.
The patient with the P.1 variant is a resident of the Twin Cities metro area. The person became ill during the first week of January and the specimen was collected on January 9. The patient spoke with MDH case investigators after the initial test came back positive for coronavirus and reported traveling to Brazil before falling sick.
As per standard protocol, the individual was advised during the interview to isolate themself from others and have any other others who come in contact with them also observe quarantine. With the new lab information showing the case to be the P.1 variant, MDH epidemiologists are re-interviewing the person to get more details about the illness, travel, and contacts.
According to Minnesota Commissioner of Health Jan Malcolm, the new finding underscores the importance of Covid-19 testing as well as continued efforts by all Minnesotans to limit the spread of the disease.
“We know that even as we work hard to defeat Covid-19, the virus continues to evolve as all viruses do. That’s yet another reason why we want to limit coronavirus transmission — the fewer people who get Covid-19, the fewer opportunities the virus has to evolve. The good news is that we can slow the spread of this variant and all Covid-19 variants by using the tried-and-true prevention methods of wearing masks, keeping social distance, staying home when sick, and getting tested when appropriate,” says Malcolm.
Stating that testing is a key tool to mitigate the impact of this pandemic, MDH assistant commissioner Dan Huff recommends “test, isolate, quarantine, practice social distancing, wear a mask, avoid gatherings outside your household whenever possible, and stay home if you are ill.”
Two cases of the B.1.1.7 variant have also been identified through last week’s coronavirus variant surveillance testing. Of the two new cases with the UK variant detected by MDH, both are Twin Cities metro area residents and both reported recent travel to California. One had no symptoms but sought testing following their travel, as recommended by MDH and CDC guidelines. One had a symptom onset date of January 3, 2021.
“MDH also reported that the CDC identified one additional patient with the variant — also a metro area resident — with recent travel history to the Dominican Republic. This case had a symptom onset date of January 10, 2021. With these latest cases, a total of eight UK variant cases now have been identified in Minnesota, although more are suspected to exist,” informs the department.