Intended for healthcare professionals


Covid-19: New “Pirola” variant BA.2.86 continues to spread in UK and US

BMJ 2023; 382 doi: (Published 13 September 2023) Cite this as: BMJ 2023;382:p2097
  1. Elisabeth Mahase
  1. The BMJ

The new BA.2.86 variant of SARS-CoV-2—nicknamed “Pirola”—is now likely to be spreading in the community in the UK, the government has said after an outbreak was reported at a care home.

The variant, which contains many mutations to the spike gene and was first detected in Denmark in late July,1 has been identified in several countries including Canada, Israel, Portugal, South Africa, and Sweden, as well as the UK and the US.

The UK Health Security Agency (UKHSA) had detected 34 cases in England to 4 September, of which five people were admitted to hospital.2 Notably, 28 cases were from a single outbreak in a Norfolk care home. The UKHSA has said that there is currently “not enough evidence to know if the variant has altered clinical severity or will predominate in the UK.”

In the US the Centers for Disease Control and Prevention (CDC) had reported cases of the variant in nine states as of 8 September. Despite this it has said that the current increases in covid-19 cases and hospital admissions “are not being driven by BA.2.86 and instead are being caused by other predominantly circulating viruses.”3

The US—which is expected to roll out its 2023-24 covid-19 vaccine from mid-September—reported an 8.7% rise in hospital admissions in the week to 2 September, while deaths increased by 10.5% over the same period. The CDC said that early analysis suggested that “existing antibodies work against the new BA.2.86 variant.”

Booster rollout

Commenting on the situation, the UKHSA’s incident director, Renu Bindra, said, “It is clear that there is some degree of widespread community transmission, both in the UK and globally, and we are working to ascertain the full extent of this. In the meantime, it remains vital that all those eligible come forward to receive their autumn vaccine as soon as it is offered to them.”

England reported 8961 cases of SARS-CoV-2 in the week to 2 September, up 22.6% (1649) on the previous week.4 In response to the emergence of the BA.2.86 variant the Department of Health and Social Care has brought forward the rollout of the autumn vaccine booster in England to 11 September “as a precautionary measure.”

Steve Russell, NHS director of vaccinations and screening, said, “With concerns arising over new covid variants, it’s vital we adapt the programme and bring it forward for those most at risk, and so I strongly urge everyone eligible to come forward as soon as they can for this important protection in colder months.”

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