Update on new strains of SARS-COV-2: first case of South African strain in US reported: B.1.351 in two people in South Carolina with no travel history

The first cases of COVID-19 caused by the South African variant, designated B.1.351, were found in two people in South Carolina who reported no travel history, South Carolina Department of Health and Environmental Control (DHEC) announced in a news release on January 28, 2021.

They reported that the Centers for Disease Control (CDC) had advised them late yesterday of a LabCorp (a large hospital and outpatient laboratory company) report of a positive sample with the South African variant. The DHEC had tested another sample on January 25 that turned out to be positive for the same variant yesterday.

The South African variant has been discovered in patients in more than 30 countries, but these are the first known cases in the United States. South Africa has been suffering with a huge wave of new cases and deaths due to the new variant. This variant is able to elude some of the antibodies against the original variant and renders some antibody treatments ineffective; vaccines also may be affected by this evasion.

The South Carolina DHEC has been performing sequencing on random samples of virus isolates since June 2020 to look for mutations that indicate new strains. Sequencing is a valuable tool for detecting mutations and helps for contact tracing of infections. Unfortunately, sequencing is performed on an ad hoc basis in with surplus funding in this country rather than being organized nationally, and thus is not done in most cases.

The news release states that the currently available vaccines appear to be effective against the South African variant; while it is more transmissible, it doesn’t cause more severe disease.

The news release emphasizes that preventive measures including mask-wearing, washing hands, and social distancing are equally effective against the new variant and should be carefully followed. Other sources have also suggested doubling up on masks, and this represents a useful addition to prevention given that most masks are not as effective as the N-95 masks mainly used by medical professionals.

Not mentioned by the news release is the detail that cases with no travel history suggest the possibility of community transmission. The two (unrelated) cases announced today may have been contracted from someone else in the community who traveled to South Africa (or one of the 30 countries in which the variant has been discovered), or may be part of a chain of transmission from a traveler.

This detail has potentially grave implications, as most virus isolates are not sequenced and the traveler from overseas may have been asymptomatic.

In other South Carolina news, a rabid otter was found in Ridgeway, Kershaw County. It is the fifth animal in South Carolina this year with rabies, while an average of 148 cases a year are found. “Keeping your pets up to date on their rabies vaccination is the easiest way to protect you and your family from this deadly virus,” said Terri McCollister, Rabies Program Team Leader. (This tidbit was included to help you keep the current pandemic in perspective.)

(sars-cov-2 virions by electron microscopy: NIAID)