INDIAN VARIANT. The Indian variant, already present in 17 countries, has made an incursion into France, more precisely in Guadeloupe, New Aquitaine and the Bouches-du-Rhône. What does this mutation consist of? We take stock.
[Mis à jour le 30 avril 2021 à 15h24] Cases of the Indian variant are increasing in Europe, among our direct neighbors, in particular in Italy, Belgium and Switzerland. In France, this B.1.617 mutation made its appearance in Guadeloupe, then in New Aquitaine and in the Bouches-du-Rhône. In all, seven contaminations associated with this double-variant, which came from India, were identified. As gradual deconfinement approaches, scheduled for May 3, the spread of this variant is worrying. If there is still a lot to learn about this mutation, considered (in part) responsible for the epidemic massacre in its country of origin, it is possible that it is more contagious. So far, patients who test positive for this variant are “fine” and not suffering from any “severe form” of the disease. According to the Nouvelle-Aquitaine Regional Health Agency (ARS), the spread of the mutation is also “under control”. Remember that in France, the overwhelming majority of positive cases concern the British variant (more than 80%).
However, suspicions of contamination by this Indian variant have been reported, particularly in Le Havre and Marseille, concerning people who have traveled to the country of the Taj Mahal. “It was said that France had been spared by the Indian variant. Obviously not,” responded infectious disease specialist Karine Lacombe, head of the infectious diseases department at Saint-Antoine hospital, on BFM TV. According to the specialist, “even if our borders are more or less closed, they remain relatively porous”. The uncertainty remains around the dangerousness of this mutation: does it cause more deaths because of its increased severity or because it is more contagious, putting hospital services in difficulty? The World Health Organization (WHO) admits that it does not know. For the time being, the regulator has placed this mutation, detected in at least 17 countries, in the classification “variant of interest” and not “variant of concern”, this second category indicating a more dangerous variant (capable, in particular, of escape vaccine immunizations).
This Friday, April 30, the Regional Health Agency (ARS) Nouvelle-Aquitaine unveiled some elements on the two cases identified in Lot-et-Garonne. They are a couple, in their thirties, parents of a young child and living in Villeneuvois. Not being in school, the child has not tested positive, adds La Dépêche. One of the two people infected with the Indian variant was tested positive on April 29. An isolation protocol was set up and sequencing was carried out at the Toulouse University Hospital. If it is indeed an Indian variant, “it is not the one which is predominant in India”, clarified the ARS. At the regional level, another case was detected in Bordeaux, concerning a person who returned from India for professional reasons. “This is not a serious case,” said the ARS, while adding that ten risky contact cases had been identified in the entourage. The results of the tests, for four of them, are expected this Monday, May 3.
The Ministry of Health also announced Thursday, April 29 in the evening the presence of two cases in the Bouches-du-Rhône, “two people arriving from India, unrelated to each other “. These two people were “quarantined immediately upon arrival” and “tested positive at the very beginning of their quarantine on April 19 and 27 respectively”.
In addition to the five cases of the Indian variant identified in France, two other cases had been previously detected in the Antilles, more precisely in Guadeloupe. According to the authorities, two people “asymptomatic and in transit”, who arrived on March 10 on the island by private jet, tested positive for the B.1.617 variant. At the end of their fortnight in the hospital, these people were tested negative, by PCR, and no secondary cases were detected around these confirmed cases, according to the prefecture and the ARS. According to several local media, these cases imported into the Outremers are two people from India to the Dominican Republic, in transit in Guadeloupe. For the time being, apart from these two people, no other case of this mutation has been identified on the island.
Detectable in PCR tests, the double mutation of coronavirus was therefore detected for the first time on French territory this week. Other tests are also underway, confirms the Ministry of Health. “AT To date, several other suspected infections with the B.1.617 variant have been reported in France in people who have stayed in India. Investigations reinforced by the ARS and the sequencing of samples (…) are in progress “, explains the press release published Thursday, April 29. A suspected case is followed in particular in Bordeaux according to the regional head of the ARS. The results could arrive this Friday.
In French airports, the fear of this Indian variant begins to be felt. Friday, April 23, the staff of the Red Cross asserted their right of withdrawal in the waiting zone for pending persons (Zapi) of Roissy, where many travelers from India meet. Announced this Sunday in the columns of the Parisian, this right of withdrawal marks a great concern among airport workers. But what is a waiting area? This is a place where people who cannot justify their regular travel are helped. However, according to the Parisian, this Friday, at Roissy airport, the number of people present in the area was estimated at 120 travelers, including ten coming from India. “A great promiscuity”, according to the Red Cross, which fears a future cluster, with a presence of the Indian variant. On Tuesday April 27, this decision was followed by another organization, the National Association of Border Assistance for Foreigners (Anafé). At the microphone of Franceinfo on Tuesday, President Laura Palun declared: “In the waiting area, there is no natural ventilation of the premises. The corridors are cramped, physical distancing is not possible”. And to add: “Since April 1, we have had about fifteen cases of people who had been detected, suffering from the coronavirus or contact case. And the fear currently is that this number is increasing given the conditions at the inside the waiting area. “
For a few days now, travelers coming from India no longer have any question of arriving freely in France. Since Wednesday April 21, they have been forced into isolation for ten days, an announcement made by government spokesman Gabriel Attal in reaction to the strong spread of the Indian variant in Europe. However, no case has yet been declared to date in France. But the executive prefers to anticipate and not let this new “double mutant” virus slow down the vaccination campaign in France.
What about the situation in India? The epidemic affecting India is currently very worrying and the health situation is deteriorating in the country. In just 24 hours, this Thursday, the country counted 3,645 additional deaths from Covid-19 and India can no longer control the epidemic for lack of equipment. In April, the country has nearly six million infections, and 380,000 only in the last 24 hours, according to reports from the Indian Ministry of Health. This weekend, the European Union, the United States and the United Kingdom pledged substantial aid to the country.
After the Brazilian variant which seems to be more resistant to vaccines, the double mutation of the strain of the coronavirus could be problematic in the face of vaccines. According to the member of the Scientific Council Karine Lacombe invited to franceinfo on April 21, this Indian variant could prove resistant to all vaccines and treatments. “In particular, it has two mutations, which have appeared in the Spike protein. It may be resistant to vaccination or to treatment.” A position not yet shared by the scientific community like Catherine Hill who wants to be optimistic. “Of course, we must monitor, study the variants and verify that the vaccines work well on them but, for the moment, we see that the vaccines protect against them, continues the epidemiologist. There is just the Astrazeneca which s ‘is shown to be somewhat less effective on the South African variant. “
On this question, Bruno Lina, member of the Scientific Council, wants to be reassuring. “For the moment, the first data we have from the Indians is that vaccines protect against this virus (…) and it does not seem that this virus replaces the British variant, it circulates with it” , he explained at the microphone of RTL, this Thursday.
Why is it called a “double mutant”? This variant is in fact the result of an encounter between the Californian strain, L452R, and the South African mutation, E484K. But this Indian virus could contain other mutations which could even turn it into a “triple mutant”. E484Q and L452R allow the coronavirus to attach better to cells to spread more easily. In addition, recent studies show that L452R is more resistant to antibodies, “explains in Le Figaro Prof. Gautam Menon, professor of physics and biology at Ashoka University, near New Delhi.
As with other variants, the levels of transmission are often faster for these mutant viruses. What about the Indian variant? “It took a long time to understand that we were in the presence of a real variant. We had the confirmation in December and, today, it is spreading very very quickly and we find it in more and more samples, ”replies geneticist Rakesh Mishra, director of the Center for Molecular and Cellular Biology (CCMB), in the columns of the World. Indeed, according to the daily, for the months of February and March, the B.1.617 virus was taken in 24% of samples from Indian patients infected and having participated in genetic sequencing, against 13% for the British variant.
But beware of rumors that show this Indian variant as undetectable in PCR tests. “These tests have a sensitivity rate of 70 to 80%, which means that a number of them give rise to false negative results. At the moment, there is no evidence to say that the Indian variant slips through the cracks, ”Mr. Mishra told Le Monde newspaper.
But the Indian variant is also worrying because of its fairly rapid circulation outside the subcontinent. This new form of Covid-19 has already been seen in Great Britain, Germany, Belgium and Canada. But Professor Bruno Lina recalls: “It is present in many countries, but in very small quantities”. And to confirm: “For the moment, we have not detected it in France”. But for how long ? On franceinfo, infectious disease specialist Karine Lacombe thinks that her presence in our territory is a simple matter of days. “It is obvious that this variant will arrive, it is a matter of days and it is probably already in France.”
Anurag Agarwal, director of the Institute of Genomics and Integrative Biology in Delhi, explained to Le Figaro that patients suffer “from headaches, nasal congestion, sore throats, muscle pain. We see them suffering from diarrhea, as happened in New York last year. ” “And with the climate being hot and dry this season, some people bleed from their nose or throat because they cough or sneeze more.”
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