NgoDisemba 14, 2020, i-United Kingdom yabikaokuhlukile kwe-SARS-CoV-2 yokukhathazeka (VOC), uzalo B.1.1.7,ebizwa nangokuthi i-VOC 202012/01 noma 20I/501Y.V1.*B.1.1.7 okuhlukile kulinganiselwa ukuthi kwavela ngoSepthemba2020 futhi isibe yisona esihamba phambili ngokusheshaOkuhlukile kwe-SARS-CoV-2 e-England (1).B.1.1.7 kubekutholwe emazweni angaphezu kuka-30, kuhlanganise ne-United States.Njengobayango-January 13, 2021, cishe izigameko ezingu-76 ze-B.1.1.7 zinekutholwe ezifundazweni eziyi-12 zase-US.Imigqa eminingi yobufakazizikhombisa ukuthi i-B.1.1.7 isakazwa ngendlela ephumelela kakhulu kunaleyoezinye izinhlobo ze-SARS-CoV-2 (1-3).I-trajectory enemodeli yelokhu okuhlukile e-US kubonisa ukukhula okusheshayo ekuqaleni kuka-2021,ibe yinhlobonhlobo ehamba phambili ngoMashi.KwandiswaUkudluliselwa kwe-SARS-CoV-2 kungase kusongela ukunakekelwa kwezempilo okuqinileizinsiza, zidinga ukuqaliswa okunwetshiwe nokuqine kakhuluzamasu ezempilo yomphakathi (4), futhi andise amaphesentiUkuvikeleka kwesibalo sabantu kuyadingeka ekulawuleni ubhubhane.Ukuthathaizinyathelo zokunciphisa ukudluliswa manje zinganciphisa amandlaumthelela we-B.1.1.7 futhi uvumele isikhathi esibalulekile sokwandisa umgomoukusabalala.Ngokuhlangene, ukubhekwa kwe-genomic okuthuthukisiwekuhlanganiswe nokuqhubeka nokulandela umphakathi ngempumeleloizinyathelo zempilo, okuhlanganisa ukugoma, ukuqhela ngokomzimba,ukusetshenziswa kwezifihla-buso, inhlanzeko yezandla, kanye nokuzihlukanisa kanye nokuvalelwa yedwa, kuzokwenzaKubalulekile ukunqanda ukusabalala kwe-SARS-CoV-2, igciwaneebangela isifo se-coronavirus 2019 (COVID-19).Amaqhingaukuhlolwa kwabantu abangenazo izimpawu kodwa abasengozini enkulu yokuukutheleleka, njengalabo abachayeke ku-SARS-CoV-2 noma abanayoukuxhumana njalo okungagwemeki nomphakathi, kunikeza okunyeithuba lokunciphisa ukusabalala okuqhubekayo.

I-Global genomic surveillance kanye ne-shar yomthombo ovulekile osheshayoUkulandelana kwe-viral genome kwenze kwaba lula ngesikhathi sangempelaukutholwa, ukuqhathanisa, kanye nokulandelelwa kokuvela kwe-SARS-CoV-2okuhlukile okungazisa imizamo yezempilo yomphakathi yokulawulaubhubhane.Nakuba ezinye izinguquko ku-genome yegciwaneukuphuma bese kuhlehla, abanye bangase banikeze i-advan ekhethiwetage kokuhlukile, okuhlanganisa ukudluliseka okuthuthukisiwe, ukuzeokuhlukile okunjalo kungabusa ngokushesha ezinye izinhlobo ezijikelezayo.

Ekuqaleni kwalolu bhubhane, izinhlobonhlobo ze-SARS-CoV-2 eziquketheukuguqulwa kwe-D614G kuphrotheni ye-spike (S) eyandayoukukhuthala kokubopha ama-receptor ngokushesha kwaba namandla kwabaningiizifunda zezwe (5,6).Ekupheleni kuka-2020, amazwe amaningi abike ukuthi atholileIzinhlobonhlobo ze-SARS-CoV-2 ezisabalala ngokuphumelelayo.Ngaphezu kwalokhokuya kokuhlukile kwe-B.1.1.7, okuhlukile okuphawulekayo kufaka phakathi i-B.1.351Uzalo lwaqala ukutholakala eNingizimu Afrika kanye nalolo olusanda kuhlonzwaB.1.1.28 isigatshana (seqanjwe kabusha“P.1”) kutholwe kubahambi abanekusuka eBrazil ngesikhathi sokuhlolwa okujwayelekile eHaneda (Tokyo)isikhumulo sezindiza.§ Lezi zinhlobonhlobo ziphethe umlaza we-genetic mutations, okufaka phakathi isizinda esibopha i-S protein receptor,okubalulekile ekubopheni i-angiotensin cell cell-ukuguqula i-enzyme-2 (ACE-2) receptor ukuze kube lula igciwaneukungena.Ubufakazi bubonisa ukuthi ezinye izinguquko ezitholakala kuleziokuhlukile kungase kunikeze hhayi kuphela ukwanda kokudluliseka kodwaingase futhi ithinte ukusebenza kwesinye isikhathi sangempela sokuxilongaukuhlehla okulotshiweyo-i-polymerase chain reaction (RT-PCR)ukuhlola¶ futhi unciphise amathuba okuba sengozini yokuqeda amasosha omzimba(2,3,5-10).Umbiko wecala wakamuva ubhale icala lokuqala leI-SARS-CoV-2 iphinde yatheleleka e-Brazil ngokuhlukile kwe-SARS-CoV-2ebiqukethe ukuguqulwa kwe-E484K,** okubonisiweukunciphisa ukungathathi hlangothi nge-convalescent sera kanye ne-monoclonalamasosha omzimba (9,10).

Lo mbiko ugxile ekuveleni kokuhluka kwe-B.1.1.7e-United States.Kusukela ngomhlaka-12 Januwari 2021, akukho noyedwaB.1.351 noma okuhlukile kwe-P.1 kutholwe ku-I-united states.Ukuze uthole ulwazi mayelana ne-SARS-CoV-2 abasafufusaIzinhlobonhlobo zokukhathazeka, i-CDC igcina ikhasi lewebhu elinikezelweukuhlinzeka ngolwazi ngezinhlobonhlobo ze-SARS-CoV-2 ezisafufusa.††

 B.1.1.7 uhlu lozalo (20I/501Y.V1)

Okuhlukile kwe-B.1.1.7 kuphethe ukuguqulwa kwephrotheni ye-S(N501Y) ethinta ukwakheka kokubopha kwama-receptorisizinda.Lokhu okuhlukile kunezinye ezingu-13 ze-B.1.1.7 lineage-definingmutations (Ithebula), eziningana zazo ziku-S protein,kufaka phakathi ukususwa ezikhundleni 69 kanye no-70 (del69-70) lokhokwavela ngokuzenzakalelayo kwezinye izinhlobo ze-SARS-CoV-2 futhi kunjalokucatshangelwe ukwandisa ukudluliseka (2,7).Ukususwaezikhundleni ezingu-69 nezingu-70 kubangela ukwehluleka kwethagethi ye-S-gene (SGTF)okungenani ku-RT-PCR eyodwa-i-diagnostic assay esekelwe (okungukuthi, nge-I-ThermoFisher Taq Path COVID-19 assay, i-B.1.1.7 variintuthwane nokunye okuhlukile nge-del69-70 akhiqiza negativeumphumela wethagethi ye-S-gene kanye nomphumela omuhle kwabanye ababiliokuhlosiwe);I-SGTF isebenze njengommeleli e-United Kingdomyokuhlonza B.1.1.7 amacala (1).Imigqa eminingi yobufakazi ikhombisa ukuthi i-B.1.1.7 ingaphezuluisakazwa kahle uma iqhathaniswa namanye ama-SARS-CoV-2izinhlobonhlobo ezijikelezayo e-United Kingdom.Izifunda zase-UK ngeingxenye ephezulu yokulandelana kwe-B.1.1.7 ibe nobhubhane olusheshayoukukhula kunezinye izindawo, ukuxilonga nge-SGTF kwandangokushesha kunokuxilonga okungeyona i-SGTF ezindaweni ezifanayo, kanye aingxenye ephezulu yabathintwayo yangenwa iziguli ezinenkombaabanezifo ezingu-B.1.1.7 kuneziguli ezinenkomba enazoezinye izinhlobo (1,3).Okuhlukile okungu-B.1.1.7 kunamandla okwandisa i-US pani-demic trajectory ezinyangeni ezizayo.Ukukhombisa lo mphumela,kwasungulwa imodeli yekhompathi elula enezinhlobonhlobo ezimbili.Ukuvama kwamanje kwe-US kwe-B.1.1.7 phakathi kwakho konke okujikelezayoamagciwane awaziwa kodwa kucatshangwa ukuthi <0.5% ngokususelwa ku-inombolo elinganiselwe yezigameko ezitholiwe kanye nedatha ye-SGTF (8).Ngobaimodeli, ukuqagela kokuqala kwakuhlanganisa ukusabalala kwe-B.1.1.7ka-0.5% kuzo zonke izifo, ukungatheleleki kwe-SARS-CoV-2 kusukaukutheleleka kwangaphambilini okungu-10%-I-30%, ukuzala okuhlukahluka kwesikhathiinombolo (R t) ka-1.1 (ukudluliselwa okuncishisiwe kodwa okukhulayo)noma 0.9 (ukwehla kokudluliselwa) kwezinhlobonhlobo zamanje, futhi kubikwe izehlakalo zamacala angama-60 kubantu abayi-100,000 ngosukuJanuwari 1, 2021. Lokhu kuqagela akumeli ngokunembilenoma iyiphi indawo yase-US, kodwa kunalokho, ikhombisa ukwenziwa okuvamile kweizimo ezijwayelekile ezweni lonke.Ushintsho ku-R t phezuisikhathi esibangelwa ukungatheleleki okutholiwe kanye nokwanda kwe-prevai-lence ye-B.1.1.7, yamodela, kwacatshangwa ukuthi i-B.1.1.7 R tukuze kube njalo izikhathi ezingu-1.5 i-R t yezinhlobonhlobo zamanje, ngokusekelwe kuizilinganiso zokuqala ezivela e-United Kingdom (1,3).Okulandelayo, umthelela ongaba khona wokugoma wamodelakucatshangwa ukuthi imithamo yokugoma eyisigidi esisodwa yanikezwa umuntu ngamunyeusuku oluqala ngoJanuwari 1, 2021, kanye nalokho kungavikeleki okungama-95%.kufinyelelwe ezinsukwini eziyi-14 ngemuva kokuthola imithamo emi-2.Ngokuqondile,ukungatheleleki ekuthelelekeni ngezinhlobonhlobo zamanje nomaB.1.1.7 okuhlukile kwacatshangelwa, nakuba ukusebenza ngempumelelo kanyeisikhathi sokuvikeleka ekuthelelekeni asiqiniseki,ngoba lezi bekungezona iziphetho eziyinhloko zokuhlolwa komtholampiloemithini yokugoma yokuqala.Kulo modeli, ukusabalala kwe-B.1.1.7 kuphansi ekuqaleni, nokho ngenxa yokuthiidluliseka kakhulu kunezinhlobonhlobo zamanje, iyabonisaukukhula okusheshayo ekuqaleni kuka-2021, kwaba ukuhlukahluka okuveleleintuthwane ngoMashi (Umfanekiso 1).Ukuthi ukudluliswa kwamanjeokuhlukile kuyanda (i-R t yokuqala = 1.1) noma kuncipha kancane(i-R t yokuqala = 0.9) ngoJanuwari, i-B.1.1.7 yenza ushintsho olukhulukumzila wokudlulisela kanye nesigaba esisha sokuchayekaukukhula.Ngomgomo ovikela ukutheleleka, iizindlela zobhubhane zakuqala azishintshi futhi B.1.1.7 ukusabalalakusenzeka (Umfanekiso 2).Nokho, ngemva B.1.1.7 ibaukuhluka okuvelele, ukudluliswa kwayo kwehliswe kakhulu.Umthelela wokugoma ekwehliseni ukusulelana esikhathini esiseduzeIsikhathi sasisikhulu kakhulu esimweni lapho ukudluliswa bekukhonakakade iyancipha (i-R t yokuqala = 0.9) (Umfanekiso 2).Imizamo yokuqala ukuthiingakhawulela ukusabalala kokuhluka kwe-B.1.1.7, okufana nendawo yonke kanyeukwanda kokuhambisana namasu okunciphisa impilo yomphakathi,kuzovumela isikhathi esengeziwe sokuthi ukugoma okuqhubekayo kufinyelele phezuluukungavikeleki kwezinga labantu.

Ingxoxo

Njengamanje, awukho umehluko owaziwayo emiphumeleni yomtholampilookuhlotshaniswa nokuhluka okuchazwe kwe-SARS-CoV-2;Nokho,izinga eliphezulu lokudlulisela lizoholela ezimweni eziningi, ukwandainani labantu bebonke abadinga ukunakekelwa komtholampilo, liyakhulaukwethula umthwalo ohlelweni lokunakekelwa kwezempilo oseluvele lunzima,futhi kubangele ukufa okwengeziwe.Ukubhekwa kwe-genomic okuqhubekayoukuhlonza amacala B.1.1.7, kanye nokuvela kwamanyeizinhlobonhlobo zokukhathazeka e-United States, kubalulekile ukuzeImpendulo yezempilo yomphakathi ye-COVID-19.Nakuba imiphumela ye-SGTFingasiza ekuhlonzeni izimo ezingaba khona ze-B.1.1.7 ezingaqinisekiswangokulandelanisa, ukukhomba okuhlukile okubalulekile okungabonisiI-SGTF ithembele ngokukhethekile ekugadeni okusekelwe ngokulandelana.