Coronavirus Brazil: Woman, 45, reinfected with new variant

A Brazilian nurse who fought off coronavirus and got reinfected with the country’s new variant has sparked fears the mutation could hamper immunity.

The variant, which today spooked ministers into banning all flights to the UK from South America, carries a mutation that may make the virus able to get past immunity developed from older versions of the virus.

The unnamed 45-year-old fell ill with the new variant in October — five months after she recovered from Covid caused by an older strain, and her symptoms were worse the second time.

Researchers from the Oswaldo Cruz Foundation, a science institute in Rio de Janeiro, warned that mutations on the new variant could increase the risk of reinfection.

They wrote that ‘viral evolutions may favour reinfections’, claiming recently spotted variants ‘have raised concern on their potential impact in infectivity and immune escape’.

Amid growing fears about the Brazilian variant, the UK Government today banned all travellers from Portugal, South America, Panama and Cape Verde in a bid to stop it from wreaking havoc in Britain.

Transport Secretary Grant Shapps said he had broadened the ban from just Brazil in order to ‘reduce the risk of importing infections’.

A virus researcher today told MailOnline it was ‘entirely possible’ there are already cases here but Public Health England said it had not yet detected any cases. 

And the UK’s chief scientific adviser, Sir Patrick Vallance, admitted last night that ‘we don’t know for sure’ how the new variant will affect vaccines and immunity.

The new variant to have emerged in Brazil looks extremely similar to the ones that were found in Kent and South Africa, but it has not yet been discovered on British soil (stock image)

The new variant to have emerged in Brazil looks extremely similar to the ones that were found in Kent and South Africa, but it has not yet been discovered on British soil (stock image)

All three of the mutated versions of the coronavirus found in recent weeks ¿ the ones from Kent, South Africa and Brazil ¿ have had a change on the spike protein of the virus called N501Y, which scientists say makes it better able to latch onto the body and spread

All three of the mutated versions of the coronavirus found in recent weeks – the ones from Kent, South Africa and Brazil – have had a change on the spike protein of the virus called N501Y, which scientists say makes it better able to latch onto the body and spread 

The Oswaldo Cruz Foundation paper — which hasn’t been peer-reviewed by fellow scientists — last week reported the case of a woman in Salvador, Brazil, who got Covid a second time amid an outbreak of the new variant.

She had been diagnosed with coronavirus for the first time on May 26, 2020, when she had diarrhoea, muscle aches and general weakness.

She took an asthma steroid called prednisone and recovered within three weeks without any long-lasting problems, the researchers said.

But in October, she became ill again with similar symptoms – diarrhoea, headache, coughing and a sore throat – and again tested positive for coronavirus.

Her symptoms got even worse than they had been the first time around and she developed breathing difficulties, shortness of breath, muscle pains and insomnia.

WHAT DO WE KNOW ABOUT THE BRAZIL VARIANT? 

Name: B.1.1.248 or P.1

Date: Discovered in Tokyo, Japan, in four travellers arriving from Manaus, Brazil, on January 2.

Is it in the UK? Public health officials and scientists randomly sample around 1 in 10 coronavirus cases in the UK and they have not yet reported any cases of B.1.1.248, but this doesn’t rule it out completely.

Why should we care? The variant has the same spike protein mutation as the highly transmissible versions found in Kent and South Africa – named N501Y – which makes the spike better able to bind to receptors inside the body.

It has a third, less well-studied mutation called K417T, and the ramifications of this are still being researched. 

What do the mutations do?

The N501Y mutation makes the spike protein better at binding to receptors in people’s bodies and therefore makes the virus more infectious. 

Exactly how much more infectious it is remains to be seen, but scientists estimate the similar-looking variant in the UK is around 56 per cent more transmissible than its predecessor. 

Even if the virus doesn’t appear to be more dangerous, its ability to spread faster and cause more infections will inevitably lead to a higher death rate.

Another key mutation in the variant, named E484K, is also on the spike protein and is present in the South African variant. 

E484K may be associated with an ability to evade parts of the immune system called antibodies, researchers from the Federal University of Rio de Janeiro said in a scientific paper published online.

However, there are multiple immune cells and substances involved in the destruction of coronavirus when it gets into the body so this may not translate to a difference in how people get infected or recover.

Will our vaccines still protect us?

There is no reason to believe that already-developed Covid vaccines will not protect against the variant.

The main and most concerning change to this version of the virus is its N501Y mutation.

Pfizer, the company that made the first vaccine to get approval for public use in the UK, has specifically tested its jab on viruses carrying this mutation in  a lab after the variants emerged in the UK and South Africa.

They found that the vaccine worked just as well as it did on other variants and was able to ignore the change.

And, as the South African variant carries another of the major mutations on the Brazilian strain (E484K) and the Pfizer jab worked against that, too, it is likely that the new mutation would not affect vaccines. 

The immunity developed by different types of vaccine is broadly similar, so if one of them is able to work against it, the others should as well.

Professor Ravi Gupta, a microbiologist at the University of Cambridge, said: ‘Vaccines are still likely to be effective as a control measure if coverage rates are high and transmission is limited as far as possible.’

When the researchers compared her positive test samples from the two episodes they found that the latter one had mutations now known to be a key component of the Brazilian variant.

The genetic mutation, called E484K, changes the shape of the spike protein on the outside of the virus in a way that might make it less recognisable to an immune system trained to spot versions of the virus that don’t have the mutation, scientists say.

E484K is thought to change the virus in a way which makes it more difficult for antibodies to bind to it and prevent it entering the body.

Antibodies are a part of the immune system that can cripple viruses or attach to them and flag them up as targets for other killer white blood cells.

In this case, the part of the spike protein that gets changed is called the ‘receptor binding domain’, or the RBD, which the virus uses to latch onto the body.

The Oswaldo Cruz researchers wrote: ‘Mutation analysis demonstrated, for the first time, a reinfection case with a viral variant harboring the mutation E484K, located in a key residue of the receptor binding domain, that seems to modestly enhance binding between the Spike protein and the [body].’

The scientists said this woman’s case was the first time that someone had been infected for a second time with the variant, with the second case coming from this new variant.

They suggest the differences the mutation caused to the spike protein meant that the natural immunity her body developed after the first infection did not protect her from the second one. 

The woman is thought to have recovered from her illness, and tested positive for antibodies to the new strain on November 23, the paper said.

Her case report has emerged as scientists debate whether the discovery of the new variant is likely to affect how well Britain’s existing Covid vaccines work.

Sir Patrick Vallance, the Government’s chief scientific adviser, told ITV’s Peston show last night there was no evidence any of the variants led to more severe disease or could get around the immune system.

He said: ‘There’s no evidence at all with any of these variants that it makes the disease itself more severe. 

‘So the changes that we’re seeing with the variants are largely around increased transmission.

‘[There’s] no evidence yet for the UK version that it makes a difference in terms of how the immune system recognises it, and if you’ve been exposed to the old variant or you’ve had a vaccine, it looks like that’s gonna work just as well with this new variant for the UK one.

‘The South African one and Brazilian one, we don’t know for sure. There’s a bit more of a risk that this might make a change to the way the immune system recognises it but we don’t know. Those experiments are underway.’

Dr Simon Clarke, a microbiologist at the University of Reading, told MailOnline today that even if the mutation did affect the immune system it wasn’t likely to scupper existing vaccines completely.

He said: ‘We know where the mutations are. I think it’s fair to say we don’t have a good picture on how easily it spreads or how quickly it spreads. 

‘Some of the changes, not all, are in the spike protein. The only one we have good data on in terms of the ability to spread is the Kent strain. 

‘The changes to the spike mean that they could make it more difficult for antibodies to bind to. If there is an effect, and it’s a big if, I would assume it would reduce their [vaccines] efficacy not abolish it, it wouldn’t render it useless but it might not be effective.’

In response to the new variant the UK is banning all travellers from South America, Panama and Cape Verde, as well as Portugal.

Transport Secretary Grant Shapps said he was taking ‘urgent’ action in an effort to prevent the mutant version getting into Britain.

 No-one who has been in any of the listed countries in the previous 10 days will be granted entry.

The measures are even wider than had been expected – although British and Irish nationals will not be subject to the total block, and must merely isolate for 10 days.

Mr Shapps tweeted: ‘I’ve taken the urgent decision to BAN ARRIVALS from ARGENTINA, BRAZIL, BOLIVIA, CAPE VERDE, CHILE, COLOMBIA, ECUADOR, FRENCH GUIANA, GUYANA, PANAMA, PARAGUAY, PERU, SURINAME, URUGUAY AND VENEZUELA – from TOMORROW, 15 JAN at 4AM following evidence of a new variant in Brazil.’

He added: ‘Travel from PORTUGAL to the UK will also be suspended given its strong travel links with Brazil – acting as another way to reduce the risk of importing infections.

‘However, there is an exemption for hauliers travelling from Portugal (only), to allow transport of essential goods.’ 

The curbs, confirmed by the Covid O Cabinet sub-committee, mirror beefed-up rules brought in for South Africa due to its own mutant Covid strain, which is extremely similar.

Boris Johnson admitted yesterday that officials were ‘concerned’ about the variant and claimed the Government was ‘taking steps’ to ensure it doesn’t spread in Britain.

Brazil has already banned travellers from the UK, starting on December 25, because of the variant that emerged here. 

Airlines appear to have taken matters into their own hands, with all five flights scheduled between Brazil and Heathrow cancelled, and none due from other UK airports.

Public Health England (PHE) said it hasn’t picked up any cases of the variant yet, but wouldn’t rule out its already being in Britain.

Variants can generally only be picked up by detailed examination of randomly-picked test samples so don’t show up until they are already widespread. The South African variant, for example, can’t be distinguished from others in test results alone.

source: dailymail.co.uk