Early transmission of SARS-CoV-2 in South Africa: An epidemiological and phylogenetic report

University of KwaZulu-Natal. School of Laboratory Medicine & Medical Sciences. KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP). Durban, South Africa.
University of KwaZulu-Natal. School of Laboratory Medicine & Medical Sciences. KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP). Durban, South Africa.
University of KwaZulu-Natal. School of Laboratory Medicine & Medical Sciences. KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP). Durban, South Africa.
University of KwaZulu-Natal. School of Laboratory Medicine & Medical Sciences. KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP). Durban, South Africa.
University of KwaZulu-Natal. School of Chemistry and Physics. Quantum Research Group. Durban, South Africa / National Institute for Theoretical Physics (NITheP). KwaZulu-Natal, South Africa.
University of KwaZulu-Natal. School of Chemistry and Physics. Quantum Research Group. Durban, South Africa.
University of Oxford. Department of Zoology. Oxford, UK.
University of KwaZulu-Natal. School of Laboratory Medicine & Medical Sciences. KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP). Durban, South Africa.
University of KwaZulu-Natal. School of Laboratory Medicine & Medical Sciences. KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP). Durban, South Africa / University of Oxford. Department of Zoology. Oxford, UK.
University of Oxford. Department of Zoology. Oxford, UK.
University of KwaZulu-Natal. School of Laboratory Medicine & Medical Sciences. KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP). Durban, South Africa.
University of KwaZulu-Natal. School of Laboratory Medicine & Medical Sciences. KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP). Durban, South Africa.
University of KwaZulu-Natal. School of Laboratory Medicine & Medical Sciences. KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP). Durban, South Africa.
University of KwaZulu-Natal. School of Laboratory Medicine & Medical Sciences. KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP). Durban, South Africa.
University of KwaZulu-Natal. School of Laboratory Medicine & Medical Sciences. KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP). Durban, South Africa / Universidade Federal de Minas Gerais. Instituto de Ciências Biológicas. Laboratório de Genética Celular e Molecular. Belo Horizonte, MG, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Flavivírus. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Flavivírus. Rio de Janeiro, RJ, Brasil.
Universidade Federal de Minas Gerais. Instituto de Ciências Biológicas. Laboratório de Genética Celular e Molecular. Belp Horizonte, MG, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Flavivírus. Rio de Janeiro, RJ, Brasil.
University of KwaZulu-Natal. School of Chemistry and Physics. Quantum Research Group. Durban, South Africa / National Institute for Theoretical Physics (NITheP). KwaZulu-Natal, South Africa.
University of KwaZulu-Natal. School of Laboratory Medicine & Medical Sciences. KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP). Durban, South Africa / Centre for Aids Programme of Research in South Africa (CAPRISA). Durban, South Africa / University of Washington. Department of Global Health. Seattle, Washington, USA.

Abstract

Objectives: The Network for Genomic Surveillance in South Africa (NGS-SA) was formed to investigate the introduction and understand the early transmission dynamics of the SARS-CoV-2 epidemic in South- Africa. Design: This paper presents the first results from this group, which is a molecular epidemiological study of the first 21 SARS-CoV-2 whole genomes sampled in the first port of entry – KwaZulu-Natal (KZN) – during the first month of the epidemic. By combining this with calculations of the effective reproduction number (R), it aimed to shed light on the patterns of infections in South Africa. Results: Two of the largest provinces – Gauteng and KZN – had a slow growth rate for the number of detected cases, while the epidemic spread faster in the Western Cape and Eastern Cape. The estimates of transmission potential suggested a decrease towards R = 1 since the first cases and deaths, but a subsequent estimated R average of 1.39 between 6–18 May 2020. It was also demonstrated that early transmission in KZN was associated with multiple international introductions and dominated by lineages B1 and B. Evidence for locally acquired infections in a hospital in Durban within the first month of the epidemic was also provided. Conclusion: The COVID-19 pandemic in South Africa was very heterogeneous in its spatial dimension, with many distinct introductions of SARS-CoV2 in KZN and evidence of nosocomial transmission, which inflated early mortality in KZN. The epidemic at the local level was still developing and NGS-SA aimed to clarify the dynamics in South Africa and devise the most effective measures as the outbreak evolved. © 2020 Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

Keywords in Portuguese

SARS-CoV-2
África do Sul
Epidemiologia
Sequenciamento da próxima geração
Phylogenetic
Genômica de transmissão
COVID-19

Keywords

SARS-CoV-2
South Africa
NGS-SA
Next Generation Sequencing
Epidemiology
Phylogenetic
Transmission genomics
COVID-19

Publisher

Elsevier

Citation

GIANDHARI, Jennifer et al. Early transmission of SARS-CoV-2 in South Africa: An epidemiological and phylogenetic report. International Journal of Infectious Diseases, v. 103, p. 234-241, 2021.

DOI

10.1016/j.ijid.2020.11.128

ISSN

1201-9712

Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/45822

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Open access

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