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- W3131159097 abstract "We read with interest on the case of SARS-CoV-2 re-infection on the importance of genomic information in understanding the true burden of COVID-19 [[1]Prado-Vivar B Becerra-Wong M Guadalupe JJ et al.A case of SARS-CoV-2 reinfection in Ecuador.Lancet Infect Dis. 2020; Summary Full Text Full Text PDF PubMed Scopus (53) Google Scholar]. After the emergence of SARS-CoV-2 in China, initial cases in Japan were travel-associated cases from affected areas, as determined by the viral sequence analyses. In concordance with global COVID-19 epidemic, the Asian SARS-CoV-2 clades were dominant until the beginning of March, 2020 [[2]Furuse Y Ko YK Saito M et al.Epidemiology of COVID-19 outbreak in Japan, from January-March 2020.Jpn J Infect Dis. 2020; 73: 391-393Crossref PubMed Scopus (62) Google Scholar]. However, as of April, with the emergence of European clades (20A, 20B, 20C) as the dominant clade in Japan, there were no reports on local transmission of the Asian clades (19A and 19B) within the following weeks (figure). Our analysis however indicates the Asian clade remains in circulation, with at least two strains confirmed locally. Both strains (Japan/Nagasaki-24_7-1/2020 and Japan/Nagasaki-24_7-2/2020), isolated in July 2020, belonged to the “diminished” Asian clade, 19B (figure). In addition to the 628 isolates from Japan, and the 4981 globally isolated strains, we observed that both of the sampled strains were of an orphaned monophyletic clade, in which the next closest strain of this clade was a locally strain that was isolated in January (Japan/TY-WK-521/2020) (Fig. 1). While there may be limited sampling in certain geographical areas, we are confident that this distinct clade represents initial introduction from China, followed by basal amplification and persistent community maintenance of transmission cycle. While outbreaks may derive from local spread after introduction events, these events can generally be traced by using phylogenetically ancestral viruses of outbreak clades. In this context, the detection of persistent transmission of an orphan clade that is unique to Japan indicates local transmission that may remain undetected by the Japanese surveillance mechanism. While mortality rate is low with advanced healthcare in Japan, there remains major challenges in Japan's response to COVID-19: publicly available SARS-CoV-2 genomes were not sampled in strict proportion to the reflect the national burden of infection, and genetic information processing and there may be time-lag between information sharing. Although both traditional public health surveillance and genomic epidemiology has provided insights into outbreak events [[4]Tabata S Imai K Kawano S et al.Clinical characteristics of COVID-19 in 104 people with SARS-CoV-2 infection on the Diamond Princess cruise ship: a retrospective analysis.Lancet Infect Dis. 2020; 20: 1043-1050Summary Full Text Full Text PDF PubMed Scopus (167) Google Scholar], in this instance, blackouts in information sharing and transparency can potentially lead to information disparity. Additionally, genetic information may offer crucial evidence for re-infection and elucidation of disease burden. As genetic relationships can shed light on the underlying transmission patterns of spread in Japan and, considering the rapid global expansion of COVID-19 epidemic, our results highlight that policies to include real-time public-sharing, transparency and empowering of new systems for infectious disease surveillance would be critical in the control of SARS-CoV-2 transmission. We declare no competing interests. We thank health care practitioners of the clinics and hospitals in Japan who supported the study. This research was supported by Japan Agency for Medical Research and Development (AMED) under Grant Number JP20wm0125006 (Japan Program for Infectious Diseases Research and Infrastructure), and the Japan Society for the Promotion of Science KAKENHI (JP19K24679). WHO Global Reference Laboratory for COVID-19, WHO Collaborating Center for Reference and Research on Tropical and Emerging Virus Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan (TN, SI, MMNT, MLM, KM), Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan, Department of Infectious Diseases (TT, NA, TM, HM), Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (TT, TM, KI), Infection Control and Education Center, Nagasaki University Hospital, Nagasaki, Japan (KI)." @default.
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- W3131159097 date "2021-02-01" @default.
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- W3131159097 title "COVID-19 cryptic transmission and genetic information blackouts: Need for effective surveillance policy to better understand disease burden" @default.
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- W3131159097 doi "https://doi.org/10.1016/j.lanwpc.2021.100104" @default.
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