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European Centre for Disease Prevention and Control BA.4 and BA.5 https://www.ecdc.europa.eu/en/covid-19/variants-concern https://www.ecdc.europa.eu/en/news-events/epidemiological-update-sars-cov-2-omicron-sub-lineages-ba4-and-ba5 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-data-tracker/#variant-proportions South Africa https://www.nicd.ac.za/diseases-a-z-index/disease-index-covid-19/surveillance-reports/daily-hospital-surveillance-datcov-report/ SARS-CoV-2 variants of concern and variants under investigation in England Technical briefing 41 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1073698/Technical-Briefing-41.pdf 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confirm case of monkeypox https://www.mass.gov/news/massachusetts-public-health-officials-confirm-case-of-monkeypox---unpublished An adult male with recent travel to Canada Australia https://www.theguardian.com/australia-news/2022/may/20/australias-first-probable-case-of-monkeypox-virus-identified-in-nsw 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/ 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