European Centre for Disease Prevention and Control BA.4 and BA.5

https://www.ecdc.europa.eu/en/....covid-19/variants-co

https://www.ecdc.europa.eu/en/....news-events/epidemio

12th May, ECDC reclassified omicron subvariants, BA.4 and BA.5 as VOCs

First detected in South Africa in January and February 2022

Now dominant in SA

Both lineages contain L452R, F486V, and R493Q in the spike receptor binding domain

Significant change in antigenic properties of BA.4 and BA.5 compared to BA.1 and BA.2

Portugal

BA.5, increasing trend in variant proportions

With increase in case numbers and test positivity rate

Portuguese National Institute of Health

BA.5 already accounted for ~37% of positive cases as of 8 May

Daily growth advantage for BA.5 over BA.2 is 13%

(SA estimated 12% daily growth advantage)

BA.5 will become the dominant variant in Portugal by 22 May 2022

Growth advantage for BA.4 and BA.5

Evade immune protection induced by prior infection and/or vaccination,

particularly if this has waned over time

BA.4 and BA.5 are capable of escaping immune protection induced by infection with BA.1

No indication of any change in severity for BA.4/BA.5 compared to previous Omicron lineages.

These variants could cause a significant overall increase in cases in Europe

If COVID-19 case numbers increase substantially, some level of increased hospital

Countries should have plans in place for the rapid deployment of booster doses in these population groups.

Our world in data

https://ourworldindata.org/coronavirus

US variant nowcast

https://covid.cdc.gov/covid-da....ta-tracker/#variant-

South Africa

https://www.nicd.ac.za/disease....s-a-z-index/disease-

SARS-CoV-2 variants of concern and variants under investigation in England

Technical briefing 41

https://assets.publishing.serv....ice.gov.uk/governmen

V-22APR-03 (Omicron sub-lineage BA.4) and V-22APR-04 (Omicron sub-lineage BA.5)
As of 3 May 2022

BA.4 40 genomes

BA.5 19 genomes

Monkeypox update

https://pubmed.ncbi.nlm.nih.gov/23142251/

Massachusetts public health officials confirm case of monkeypox

https://www.mass.gov/news/mass....achusetts-public-hea

An adult male with recent travel to Canada

Australia

https://www.theguardian.com/au....stralia-news/2022/ma

Victoria, man 30s traveller from UK

NSW, man 40s traveller from Europe

Jennifer McQuiston at the US Centers for Disease Control and Prevention

https://www.statnews.com/2022/05/18/spain-portugal-report-monkeypox-cases-raising-specter-of-wider-outbreak/?utm_source=Nature+Briefing&utm_campaign=7a51987021-briefing-dy-20220519&utm_medium=email&utm_term=0_c9dfd39373-7a51987021-44762053

We’re seeing this expansion of confirmed and suspect cases globally

We have a sense that no one has their arms around this to know how large and expansive it might be

Maria Van Kerkhove, emerging diseases and zoonoses unit, World Health Organization

Positive cases identified in the U.K., Portugal, and Spain (Sweden)

And we expect there will be others