XE Variant of Omicron Strain May Lead to Fourth Wave of Pandemic

Highlights:

With COVID-19 making its way back globally, fear of the fourth wave of pandemic swirls in India
Two cases of the new XE variant of Omicron strain have been reported in India so far
Experts mandate the need for additional vaccination campaigns among public

Mutating variants of Coronavirus may give rise to yet another wave of COVID-19, resulting in a never-ending curve of pandemics.

Omicron Variant of COVID-19
Omicron variant is a mutated strain of coronavirus (SARS-CoV-2) with faster transmissibility and enhanced virulence compared to the original COVID-19 virus.

‘With the gradual lifting-off of all COVID-19-related restrictions in India, authorities caution against the emergence of a new recombinant XE variant in the country.’
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What is the XE Variant?

XE variant is defined as the recombinant/sub-variant of Omicron strains — BA.1 and BA.2. Generally, when two or more variants infect an individual, their genetic material mix up within the patient’s body, thereby resulting in the recombinant variant as per the U.K. Health Security Agency ().

Commonly reported symptoms of the new sub-variant include fever, cough, sore throat/scratchy throat, cold, gastrointestinal distress, and skin irritation or discoloration. However, the severity of the symptoms may vary according to the individual’s immunity and vaccination status ().

New COVID Variant 'XE'
A warning has been issued against a new mutant 'XE' variant of Omicron by the World Health Organization. XE variant may be more transmissible.

Reported XE Strains Globally

The XE variant was first detected in the UK on January 19, 2022, with over 600 sequences reported globally as of 29 March 2022, according to World Health Organization () ().

So far, three recombinant lineages — XD, XF (recombination of Delta variant and BA.1 lineage of Omicron), and XE have been reported from SARS-CoV-2 variants of concern by the UK Security Agency in England, on March 25, 2022 ().

Thailand and New Zealand have also detected the XE variant cases (), while XD cases have been detected in France, Denmark, and Belgium and XF has been detected in England ().

However, Britain has accounted for less than 1% of the infection rate from the XE variant with approximately 1,100 confirmed cases as of April 5th, 2022 ().

Are Covid-19 Cases Rising in India?
One third of humanity is not vaccinated and Union Health Secretary Rajesh Bhushan urges people to get themselves vaccinated at the earliest.

Is the XE Variant Dangerous?

XE may be 10% more transmissible than BA.2 variant (). However, the WHO and Indian Council of Medical Research (ICMR) officials await further confirmation to comment on its transmissibility () ().

“XE’s transmissibility is certainly higher than that for BA.1 or BA.2. If people’s international mobility increases, XE has a high chance of replacing the current omicron variants. But we still don’t know the severity of symptoms among the infected people, so we need to examine the epidemiological impact of the variant closely,” says Hiroshi Nishiura, a mathematical modeling expert at Kyoto University ().

Which Countries Have Seen a Rise in Covid-19 Cases?
New Covid-19 cases are on the rise in UK, Italy, China, Thailand, Israel, France, Greece, New Zealand, Hong Kong, the Netherlands, Poland, Belgium and Austria.

Transmissibility Rate in India

The first XE case in India was reported on April 9th, 2022 as a 67-year-old man (Vadodara resident) traveled from Mumbai to Gujarat (confirmed by genetic sequencing results) ().

The man suffered from a mild fever on March 12th and tested positive for COVID-19 on March 13th, 2022, as per the Ministry of Health and Family Welfare. However, the man recovered within a week ().

So far, two cases of the XE variant have been detected in India, one from Maharashtra and the other from Gujarat.

Another case of XE variant in India was reported in a 50-year-old asymptomatic South African National female as per a bulletin issued by The Integrated Disease Surveillance Programme (IDSP) Public Health Department, Maharashtra on Wednesday (April 6th, 2022) ().

The woman tested positive for COVID-19 on February 27th, 2022, with a travel history from South Africa to India on February 10th, 2022.

However, her repeat RTPCR testing, and repeat genomic analysis by Indian SARS-CoV-2 Genomics Consortium (INSACOG) and the Union health ministry denied the genomic constitution of the ‘XE’ variant ().

Should India Worry?

Nevertheless, with rising cases in India, the INSACOG continues to monitor the genome sequencing of the circulating COVID-19 strains ().

“Omicron is giving rise to many new variants. It’s part of the X series like XE & others. These variants will keep on occurring. Nothing to panic about as none of these are causing serious diseases or at the moment from Indian data it doesn’t show a very rapid spread,” says Dr. NK Arora, National Technical Advisory Group on Immunisation (NTAGI) chief and COVID-19 task force chairman to ANI ().

Follow COVID Appropriate Precautions

Globally, the experts recommend the need for country-wide genomic surveillance and implementation of a COVID appropriate behavior including the campaign for additional COVID-19 vaccinations, cautioning for the emergence of the fourth wave between June and August 2022 ().

The cumulative vaccination coverage in India has exceeded 185.20 crores with a 98.76% recovery rate and 0.22% weekly positivity rate ().

“There will be newer variants that appear, and we will need to watch out for those that are more virulent (cause more severe disease). We need to ensure that vulnerable individuals are protected with vaccinations, and boosted when warranted. I do not think we should sensationalize newer variants and cause panic unless they are indeed variants which are likely to cause more severe disease,” says Dr. Lancelot Pinto, consultant pulmonologist and epidemiologist at PD Hinduja Hospital ().

References :

Japan detects first case of omicron XE variant - (https://www.japantimes.co.jp/news/2022/04/11/national/japan- first-omicron-xe-variant/)
Does XE variant spread rapidly? What top government expert said - (https://www.hindustantimes.com/india-news/does-xe-variant- spread-rapidly-what-top-government-expert-said-101649660043755.html)
Nothing to panic, says NTAGI chief after India confirms cases of XE variant of Covid - (https://www.indiatoday.in/coronavirus-outbreak/story/xe-variant- of-covid-confirmed-cases-maharashtra-gujarat-ntagi-chief-1935954-2022-04-11)
New Covid-19 XE variant detected in Gujarat, second case in India so far - (https://www.freepressjournal.in/india/new-covid-19-variant-xe-detected- in-gujurat-second-case-in-india-so-far-reports)
Covid-19: XE variant enters India; here's all you need to know - (https://www.businesstoday.in/coronavirus/story/covid-19-xe-variant- enters-india-heres-all-you-need-to-know-329078-2022-04-07)

Source-Medindia