It is known that viruses change frequently. There are already thousands of variants of the coronavirus SARS-CoV-2. RIVMNational Institute for Public Health and the Environment is conducting laboratory research to see which variants are present in the Netherlands and what that means for the spread of the virus in the Netherlands. This is known as pathogen surveillance. It is mainly important to know whether the variants that are circulating also have new characteristics that pose additional risks. For example if they are more easily transmitted, if they make people more ill, or if the virus variants do not respond as well to vaccination.
Variants in the Netherlands
There are many variants of the coronavirus SARS-CoV-2 circulating worldwide, and a number of those variants are now being monitored and investigated. The World Health Organization (WHO) and the European Centre for Disease prevention and Control (ECDC) publish weekly overviews of Variants of Concern and Variants of Interest. These variants are carefully monitored and mapped due to their (potential) high-risk characteristics and degree of spread. RIVM is following the recommendations of the WHO and the ECDC in this respect. Through the national pathogen surveillance research, we are also working with laboratories in this country to monitor the coronavirus variants present in the Netherlands.
Research on variants of the virus is also taking place in the Netherlands. At the end of 2020, RIVM started pathogen surveillance for the coronavirus, with random samples being examined on a weekly basis. That started with dozens of samples every week. As more and more laboratories join the efforts, RIVM now analyses about 1200 samples a week, about one thousand of those from the samples randomly selected in the context of pathogen surveillance. The table below shows the pathogen surveillance results for the Variants of Concern and Variants of Interest identified by WHO and ECDC.
The total number of samples analysed in the context of pathogen surveillance includes not only the variants in this table, but all other variants as well. These results show the samples that were successfully analysed. The samples that were not successfully analysed are not shown in this table.
|Weeknumber||Total||2021/21||2021/20||2021/19||2021/18||2021/17||2021/16||2021/15||2021/14||2020/49 t/m 2021/13|
|Alpha, B.1.1.7 (UK)||20,938||591||1,102||1,492||1,541||1,637||1,457||1,565||1,437||10,116|
|Alpha B1.1.7 met E484K mutatie||42||2||5||4||2||4||7||6||2||10|
|Beta, B.1.351 (South African)||433||2||3||4||11||8||18||19||27||341|
|Gamma, P.1 (Brazilian||289||8||31||30||32||27||27||21||23||90|
|Delta, B.1.617.2 (Indian)||27||7||6||6||1||5||1||1||0||0|
|Kappa, B.1.617.1 (Indian)||3||0||0||0||0||0||0||1||2||0|
|Eta, B.1.525 + E484K + F888L||31||0||0||1||0||1||4||1||2||22|
|Epsilon, B.1.427/4.29 (California)||4||0||0||0||0||0||0||0||0||4|
|Theta P.3 (Philipines)||4||0||0||0||0||0||0||0||0||4|
The numbers for the UK variant with E484K mutation are included in the total numbers for the UK variant (B.1.1.7). *
Pathogen surveillance data is updated weekly. New reports may be added up to and including week 19 of 2021 from the submissions provided by the (current and new) laboratories participating in pathogen surveillance. In any case, the figures for week 21 are not yet complete. In addition, numbers per week may differ from previous publications due to updates of sample collection dates or reclassification of the sample in the registration system (source and contact tracing instead of random sampling). These weekly figures are updated retroactively.
Difference in proteins
The main difference in the UK, South African and Brazilian variants and the B.1.525 variant seems to be the changes in the ‘spike protein’, the lines bristling out from the coronavirus. The proteins of these virus variants may be able to attach themselves to human cells more effectively.
The UK variant (Alpha, B.1.1.7)
The UK variant of the virus was also found in the Netherlands in December 2020. It was detected during research in the RIVM laboratory. By now, the majority of infections in the Netherlands involve the UK variant.
The reproduction number for the UK variant is estimated to be higher than that of the old variant of the virus. The R number represents the average number of people infected by someone who has COVID-19. This means that this variant is more contagious than the old variant. International researchers are investigating whether this variant causes people to become more seriously ill, and whether people are more likely to die. The various studies published so far do not all present the same overall impression, so the information is uncertain. RIVM monitors such research studies closely.
Children can also become infected with the UK variant, although less frequently than adults. This was shown by research in the municipality of Lansingerland. It seems that children are somewhat more likely to develop (mild) symptoms if they become infected with the UK variant. The symptoms are generally milder in children than in adults. Infected children can pass on the virus within a household and also at school. It is not yet clear whether primary school children also present a lower transmission risk for the virus variants compared to adults, as is the case for the ‘old’ variant. For now, there are no indications the vaccination will not be effective against the UK variant of the virus. This is being monitored closely all over the world.
Concerning change in UK variant (E484K)
Viruses are constantly mutating. Sometimes a virus variant benefits from certain mutations, for example by spreading faster. Mutations of this kind give the virus variants an advantage over the old variants that are already circulating. Some mutations may emerge independently in different variants around the world. The UK previously reported the occurrence of a new mutation (E484K) in the spike protein in the UK variant. Considered cause for concern, this E484K mutation has been detected previously in the variants from South Africa and Brazil. The immune response following vaccination or previous infection with the virus may possibly be less effective against variants with this E484K mutation. The mutation is also likely to affect how strongly the virus can bind to the cell receptors in our bodies. This E484K mutation has also been identified in the Netherlands during pathogen surveillance.
The South African variant (Beta, B.1.351)
The South African variant was detected in the Netherlands in early January 2021. This variant of the virus, like the UK variant, also appears to be more contagious than the variant that we had so far in the Netherlands. How the virus responds to current vaccines is currently being investigated worldwide. So far, there is no reason to assume that the course of illness from the South Africa variant will be different or more severe than the old variant.
The Brazilian variants (Gamma, P.1 and P.2)
Two new variants of the coronavirus SARS-CoV-2 have been found in the Netherlands, both originating from Brazil. This involves the P1 variant and the P2 variant.
The P1 variant of the coronavirus was found mainly in outbreaks in and around Manaus, the capital of the Brazilian state of Amazonas. It is not yet clear whether the course of illness is different for this variant. Among other mutations, the variant has three changes in the spike protein, the lines bristling out from the coronavirus, that are considered cause for concern. These three changes are almost identical to the changes in the South African variant. The immune response due to vaccination or due to previous infection with the virus may possibly be less effective against this variant. This is currently being investigated at the national and international levels.
The P2 variant occurs throughout Brazil. The immune response due to vaccination or due to previous infection with the virus may possibly be less effective against this variant. There is still much to learn about the course of illness from this variant as well.
The Eta variant (B.1.525)
In the context of pathogen surveillance, a new coronavirus variant (B.1.525) was found in the Rotterdam-Rijnmond region and in the Limburg Noord region. This variant was first reported in Denmark. This variant also has the E484K mutation, along with another mutation (F888L) that is being monitored. Further investigation is now taking place in Denmark and the Netherlands.
California variant (Epsilon, B.1.429/497)
The WHO has designated the SARS-CoV-2 strain being referred to as the ‘California variant’, B.1.429/427, as a variant of interest (VOI). This variant was first found in the US state of California in June 2020 and is now circulating throughout the US and 26 other countries. This variant has three mutations in the spike proteins of the virus, including L452R. This variant is being subjected to particular scrutiny by international authorities, because there are indications that the variant may be more contagious than the classical variants, and that certain treatment methods and possibly also the current generation of vaccines may be less effective. This variant has been found in two countries in the Caribbean part of the Kingdom, but has not yet been found in the Netherlands.
Indian variant (Delta/Kappa, B.1.617)
The B.1.617 variant was first found in December 2020 in India. There are three different strains of this variant: B1.617.1, B1.617.2 and B.1.617.3. The B.1.617.2 variant is the strain found most frequently in various European countries, including the Netherlands. The prevalence of the B.1617.2 variant is increasing rapidly in the UK. It was first introduced via travellers from India, but is now also spreading through transmission within the local population. The three strains of the B.1.617 variant are different from each other due to multiple minor changes, making it necessary to assess the risks for each strain of the variant. Initial studies in the UK suggest that a single dose of vaccine offers less effective protection against this variant, and that the B.1.617.2 variant is slightly more contagious than the UK variant (B.1.1.7) of the virus. Protection after full vaccination does seem to be effective. The B.1.617.2 variant does not yet seem to be rising in Denmark and Germany. Further research will be needed on vaccine efficacy and protection and on the severity of illness in relation to this variant .
Prevent infection with variants
Regardless of which virus variant is involved: follow the measures. Get tested as soon as possible if you have any (mild) symptoms and strictly follow isolation and quarantine measures. If an infection with one of the variants is found, the Municipal Public Health Services (GGDs) will launch source and contact tracing.
Frequently asked questions
Will the vaccine also work against the virus variant circulating in the United Kingdom?
There are currently no indications that the vaccine would be less effective against the virus variant in the UK. Read more about how RIVMNational Institute for Public Health and the Environment National Institute for Public Health and the Environment is conducting pathogen surveillance to research how the virus is changing and what this means for the spread of the virus in the Netherlands.
How can you tell which variant of the coronavirus someone has?
If you test positive for COVID-19, the test results do not tell you which coronavirus variant you have. When analysing a COVID-19 test, a laboratory technician cannot see which variant of the coronavirus SARS-CoV-2 caused the infection. This requires further research, known as sequencing. This means further investigation of the virus sample that was taken with a cotton swab in the nose and throat. Sequencing looks at the building blocks of the virus. By looking at how the virus is constructed, it is possible to recognise characteristic ‘building blocks’ of a variant. Sequencing is performed on random samples in the context of pathogen surveillance.
What makes the UK variant, the South African variant, and the Brazilian variants different from the ‘old’ COVID-19 variant?
It is estimated that there are thousands of variants of the coronavirus SARS-CoV-2 by now. The main difference seems to be the changes in the ‘spike protein’, the lines bristling out from the coronavirus. These four variants appear to be more contagious than the old variant. The proteins of these virus variants may be able to attach themselves to human cells more effectively. The immune response due to vaccination or due to previous infection with the virus may possibly be less effective against the Brazilian P1 variant. This is currently being researched in various countries.
What is known about the French variant?
A previously unknown variant of the virus has been found in eight people in France, according to reports from the French Ministry of Health on 15 March 2021. The eight people were tested as part of a cluster and initially tested negative. The test they were given only used a nose swab. The new variant was discovered during further investigation of the genetic building blocks of the virus found in the hospital test samples. Initial indications are that this variant is not more contagious than other variants, and is not more likely to cause severe illness. It does look like this variant can be detected by the PCR tests used in the Netherlands. This is based on the information currently available regarding mutations in this new variant. It is possible, however, that this variant may be more difficult to detect from a sample taken from a nose swab. It seems possible that this variant is less present in the nose, and is instead found mainly in the lower respiratory tract. The new variant is being subjected to further research. This French variant has not yet been found in pathogen surveillance in the Netherlands.
Is the coronavirus variant from India concerning?
The media is reporting on a variant of the virus in India, the B.1.6.17 lineage. Reports indicate that the virus variant is spreading rapidly. However, not much is known about this variant at this time. The rapid spread of the virus in India could mean that the variant is more contagious. However, it could also be attributed to the specific circumstances in India. We do not know enough yet to say. RIVM is keeping a close eye on the spread of this and other variants. The virus variant was also found in two people in the Netherlands in the context of pathogen surveillance. Both had a travel history that included India. The variant has also been detected in 16 other countries, including the Netherlands Antilles.