Scientists examining SARS-CoV-2 wastewater samples in Southeast Asia have detected a few samples containing the BA.2.87.1 variant, the first known detection outside of South Africa.

In a post on X (formerly Twitter), Leshan Wannigama, MD, PhD, a clinical microbiologist and infectious disease specialist in the department of infectious diseases and infection control at Japan's Yamagata Prefectural Central Hospital, said the team found a "handful" of samples and that transmission seems to be very low.

He added that the variant was found in samples from the last week of December 2023 and the second week of January 2024.

South African scientists identified a small number of BA.2.87.1 sequences in samples collected from September to December, while noting the virus wasn't causing an increase in cases. The virus is distinct from other circulating variants and has 100 mutations when compared to the BA.2 parent lineage and contains changes that could prompt an antigenic shift.

Agencies monitoring developments

In mid February, the Centers for Disease Control and Prevention (CDC) said it is closely monitoring BA.2.87.1 because it has more than 30 changes in the spike protein compared to XBB.1.5, the variant covered by the current monovalent (single-strain) vaccines.

The CDC said viruses with multiple spike protein changes could increase the potential for immune escape from earlier infection or vaccination. It emphasized that experience with BA.2.86 and its JN.1 offshoot serves as a reminder that variant transmissibility can change quickly over time.

The European Centre for Disease Prevention and Control has also designated BA.2.87.1 as a variant under monitoring.

Women vaccinated against COVID-19 in the first half of their menstrual cycle (follicular phase) are more likely to see slight, short-term changes in cycle length than those vaccinated in the second half (luteal phase), concludes a large study published in Obstetrics & Gynecology.

A team led by Oregon Health & Science University (OHSU) parsed data on the effect of COVID-19 vaccination timing during the menstrual cycles of 19,497 women of reproductive age using a birth-control app. Menstrual-cycle outcomes among the vaccinated women were compared with those of an unvaccinated control group. Most participants (80.1%) were younger than 35 years and were from North America (28.6%), Europe (33.5%), or the United Kingdom (31.7%).

In the follicular phase of menstruation, eggs begin to develop in small sacs called follicles, one of which could be released for fertilization during ovulation, while the luteal phase occurs after ovulation.

1-day average difference

Women who received their first or second COVID-19 vaccine dose in the follicular phase noted that their cycle lasted, on average, 1 day longer than before vaccination (first dose, 1.0 day; second dose, 1.1 days). Those vaccinated in the luteal phase and unvaccinated participants saw no change in cycle length (first dose, −0.09 days; second dose, 0.06 days; unvaccinated notional first dose, 0.08 days; second notional dose, 0.17 days).

We hope this work helps validate the public's experiences and ease fears and anxiety around vaccination.

The biological mechanisms for the menstrual changes, which the authors said are not clinically significant for most women, may have to do with the body's immune response to vaccines, lead author Alison Edelman, MD, MPH, of OHSU, said in a university news release.

"Understanding these changes on a population level allows us to more effectively counsel patients about what to expect with a COVID-19 vaccine," she said. "We hope this work helps validate the public's experiences and ease fears and anxiety around vaccination."

A new randomized control trial from the United Kingdom shows that using ivermectin during COVID-19 infections provided little improvement in recovery rates in patients treated in clinics. The study appeared in the Journal of Infection.

The anti-parasitic drug has been investigated since 2020 as a potential treatment for COVID-19. Some early trials suggested the drug was able to reduce mortality rates and improve outcomes, but several of them had serious flaws, the authors noted. Subsequent trials and systematic reviews have largely disproved those earlier results.

The present, open-arm study compared outcomes among 8,811 SARS-CoV-2–positive participants (median symptom duration, 5 days), who were randomized to outpatient treatment with ivermectin (2,157), standard care (3,256), and other treatments (3,398) from June 23, 2021, to July 1, 2022. All participants were followed up for 28 days.

Slight increase in well-being at 6 months

The observed median time to first recovery was 14 days in the ivermectin group and 15 in the usual-care group. The authors said this result was statistically significant (hazard ratio 1.14; 95% confidence interval [CI], 1.07 to 1.23), but the estimated hazard ratio was less than the pre-specified meaningful effect of 1.2.

Ivermectin also did not reduce the number of hospitalizations. Use of the drug, however, was associated with a slight increase in the proportion of participants feeling fully recovered at 3, 6 and 12 months. At 6 months, 74% of respondents in the ivermectin group and 71% in the usual care group reported feeling fully recovered from the original COVID-19 illness (rate ratio 1.05; 95% CI, 1.02 to 1.08).

Overall, these findings, while evidencing a small benefit in symptom duration, do not support the use of ivermectin as treatment for COVID-19.

"Overall, these findings, while evidencing a small benefit in symptom duration, do not support the use of ivermectin as treatment for COVID-19 in the community among a largely vaccinated population at the dose and duration we used," the authors wrote.