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This story is from June 24, 2021

Delta variant of Covid-19 mutates into Delta Plus: All you need to know

Delta variant of Covid-19 mutates into Delta Plus: All you need to know
NEW DELHI: Around 40 cases of the Delta plus variant, classified as a variant of concern (VOC), have been detected sporadically in Maharashtra, Kerala and Madhya Pradesh, the Union health ministry said on Wednesday.
The govt has written to these states to take up immediate containment measures in the districts where Delta Plus variant, categorized as a 'Variant of Concern', has been detected.

The highly infectious Delta variant (B.1.617.2) of Covid-19 that first surfaced in India is feared to have mutated into a more virulent version called AY.1 or Delta Plus — one that is possibly capable of resisting even the monoclonal antibodies cocktail currently being prescribed as a cure.
Here is all you need to know about Delta Plus:
  • The new Delta plus variant has been formed due to a mutation in the Delta or B.1.617.2 variant.
  • There is no indication yet of the severity of the disease due to the new variant.
  • Delta Plus (AY.1) is resistant to monoclonal antibodies cocktail
  • It is not yet a variant of concern (VoC) in India, due to low incidence.
  • One of the emerging variants is B.1.617.2.1 or AY.1 is characterized by the acquisition of K417N mutation.
  • The mutation is in the spike protein of SARS-COV-2, which helps the virus enter and infect the human cells.
  • 63 genomes of Delta (B.1.617.2) with the new K417N mutation have been identified by the GISAID so far.
  • Delta plus was present in six genomes from India as of June 7, as per Public Health England (PHE).
  • The variant frequency for K417N is not much in India at this point in time. The sequences are mostly from Europe, Asia and America.
  • The earliest sequence of this genome was found in Europe in late March this year.

Delta Plus cases in India & world
As per Public Health England (PHE), an executive agency of the UK government's health and social care department, 63 genomes of Delta (B.1.617.2) with the new K417N mutation had been identified so far on the global science initiative GISAID.
Delta Plus in India and world

In its June 11 report on Covid-19 variants, India has reported six cases of Delta plus as of June 7.
Delta Plus cases around the world include one case each in Canada, Germany and Russia, two from Nepal, four from Switzerland, nine from Poland, 12 from Portugal, 13 from Japan and 14 from the US.

How did Delta variant mutate into Delta Plus
PHE's report said the Delta-AY.1 version was found through routine scanning of variations in Delta. A small number of detected sequences had acquired the spike protein mutation K417N, it said.
Scientists attribute the earliest such sequence to Europe in late March with 127 sequences added from Europe, Asia and America, said Dr Vinod Scaria, clinician and computational biologist at Delhi's Institute of Genomics and Integrative Biology.
Several genomes now available across the world were part of the AY.1 or B.1.617.2.1 lineage. The sequences are mostly from Europe, Asia and America, said Scaria.
The K417N mutation is also found in Beta or B.1.351, which is regarded as a variant of concern.
Delta Plus resistant to antibody cocktail
Scaria said an important point to consider regarding K417N was "evidence suggesting resistance to monoclonal antibodies Casirivimab and Imdevimab".
This cocktail recently received emergency-use authorization in the country from the Central Drugs Standard Control Organisation. Drug majors Roche India and Ciplas have priced the antibody cocktail at a steep Rs 59,750 per dose.
Similar to antibodies which are proteins that the body naturally produces to defend itself against the disease, monoclonal antibodies are artificially created in a lab and tailor-made to fight the disease they treat.
Casirivimab and Imdevimab are monoclonal antibodies that are specifically directed against the spike protein of SARS-CoV-2 and designed to block the virus' attachment and entry into human cells.
Scaria also indicated the mutation may be associated with the ability to escape the immune response against the virus.
Allaying fears, immunologist Vineeta Bal noted that while there may be some setback in the use of commercial antibody cocktail due to the new variant, resistance to the therapy is not an indication of higher virulence or severity of a disease.
She also noted that the quality and quantity of neutralising antibodies, responsible for defending cells from pathogens, generated in the individual infected with the new variant is unlikely to be affected because of the mutation.
“Thus in individuals catching infection with the new variant, it may not be a matter worth worrying,” she added.
Pulmonologist and medical researcher Anurag Agrawal concurred.
“There is no cause of concern due to the new variant in India as of now,” Agrawal, the director of CSIR-IGIB, told PTI.
The scientist said the blood plasma from many fully vaccinated individuals will have to be tested against this variant to determine whether it shows any significant immune escape.
(With inputs from agencies)
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