COVID-19変異株NB.1.8.1が世界的に拡大中 – 知っておくべきこと | 公衆衛生
hey everybody and welcome back to another episode here at Whiteboard Medicine we appreciate you checking it out today we’re going to be doing something we haven’t done in a minute and that is an update on COVID 19 particularly a variant that people have started talking about called NV181 there’s been some news headlines about this and growing numbers and all that stuff so we thought we’d dive into it for you today um pull the curtain back so that we have a better understanding of it um we will start with an overview of it we’ll talk about global spread and prevalence we’ll dive into key differences from previous variants clinical presentation symptoms severity of illness transmission dynamics vaccine stuff and public health considerations uh to hopefully get us all up to speed on this as a reminder none of these videos are intended to be acted upon as medical advice i should say none of these episodes cuz we have a podcast now as well uh please stick around to the end of the episode for the full disclaimer and then as a couple shameless plugs uh we have a podcast and a YouTube channel uh we’d love for you to check those out subscribe follow along we also have a Patreon page with both free membership and paid membership that we’re pretty active on and then we also have a weekly newsletter so all that will be linked in the episode’s description and again we’d love for you to have you uh we’d love to have you so check it out no further ado done with the shameless plugs let’s talk about NB181 so what is NB181 why are we talking about this well MB181 was actually recently identified uh as a variant of SARS Kovv2 obviously SARS Kovv2 being the viral name for the virus that causes CO 19 and this variant NB-181 was classified as a variant under monitoring by the World Health Organization it’s a descendant of the Omacron lineage lots of the variants we’ve had over the last gosh year plus have been descendants of Omron um and if this is confusing you know there’s the SARS KV2 virus and the SARS KV2 virus mutates just like all viruses do mutates over time and those mutations start to lead to variants that are kind of further and further from the original SARS KV2 virus and these variants we give names to but they keep mutating so we give more and more names so SARS COV2 mutated and at some point we decided to call one of like the kind of larger mutations omccrron but then omocrron kept mutating as well and now we have kind of omocrron lineage lineage variants one of which is NB181 sorry our allergies are getting us but um this particularly arose from a variant in the omocrron lineage known as XDV151 not super important except for those of you uh out there just like us who really nerd out on stuff uh but yeah that is the uh recominant variant uh lineage that it came from it was first detected actually in January of 2025 um so what is it now june about 6ish months ago a little less than that uh and since then it spread to multiple countries including China which is a lot of where the press on it started uh Australia and then the United States as well and we’ll get more into that so speaking of which when we talk about global spread and prevalence we said that it was first kind of noticed in China and Hong Kong first is relative but it started to spread there and it’s actually become the dominant strain the dominant variant in China and there have been some reports of things like increased hospitalizations and emergency room visits we’ll get into if this variant seems to cause any more severe disease but we al are seeing increased hospitalizations in China we then found it in Australia where it is currently causing about 40% of cases in Victoria Australia and about 50% of cases in Western Australia so it’s quickly becoming dominant in Australia as well and it continued to spread towards the United States we’ve now found it in several states California Ohio Rhode Island Hawaii Washington and Virginia uh and we’ve seen it in India too so some very populous countries cases of surge particularly in we’re going to totally butcher these names Kerala and Maharashtra um with this NB181 among circulating variants so we’ve seen in a bunch of highdensity countries uh including the United States and it most likely will keep spreading and most likely will become dominant in some of these places while other variants emerge so what are the key differences what makes this variant different from previous ones why you know why are we talking about it why might it be becoming dominant well it does have some genetic mutations that are important to note and we wrote that what the mutations are but again the the detail of that is probably only interesting to some of the folks out there who are really kind of into this type of thing but it has several mutations in the spike protein and this fact is more important so I’ll talk about what the mutations are then we’ll talk about the spike protein these mutations include T-22N F-59S G184S A435SV 445H and T471i very interesting right so what is the spike protein for those of you that don’t know many of you probably do but the SARS KV2 virus is a virus and like all viruses it has these proteins on the outside of its viral shell uh on the inside it obviously has genetic material and these proteins on the outside are called spike proteins or the S- protein and these spike proteins are what actually attach to the human cell to then allow the virus to infect the human cell so any mutation in these spike proteins are always worth paying attention to because there’s a chance that it would make the virus uh kind of give it a stronger affinity to bind to human cell receptors and thus make it more infectious all right these mutations as we just talked about may enhance the virus’s ability to bind to the human A2 receptor which could increase its infectivity and that’s the human receptor that’s primarily responsible for binding to the virus is this human A2 receptor we’ve talked about a bunch of those things we actually have a huge COVID playlist we’ll link it in the description um it has a lot of videos from the past uh not a ton of videos from recent but there are a couple in there but check it out we’ve talked about H2 receptor and spike proteins and all that uh a whole bunch of times for any of the OGs out there who’ve been following the channel even when it was called Whiteboard Doctor uh give a shout out in the comments uh we’d love to say hello all right other things so we said that it has genetic mutations in the spike protein that could make it more readily able to attach to the human A2 receptor and infect human cells it also has some signs of immune evasion or you know escaping the human immune system and particularly in laboratory studies it looked like there was a 1.5 to 1.6fold reduction in the ability of our antibodies to neutralize the virus so our immune cells particularly B cells produce all these antibodies these antibodies are uh molecules that are floating around and they’re just looking for SARS KV2 virus to attach to and neutralize okay same thing with a bunch of other viruses there’s antibodies floating around our body to a whole a whole slew of viruses but it looks like some of the antibodies that we’ve produced to SARS COV2 virus our own bodies just from being exposed in the past aren’t as as good at neutralizing the MB181 variant okay so it suggests a modest decrease in vaccine induced antibbody effectiveness as well well so the vaccines still work against this variant but there’s a slight reduction in the efficacy of the vaccines against this variant and then last is transmissibility so we talked about the spike protein mutations we talked about immune evasion what about transmissibility well NB-181 seems to have a higher growth advantage over several of the co-irculating variants um and this growth advantage then can lead to increased transmissibility between people all right what about clinical presentation common symptoms well most of the common symptoms are things we’ve seen from CO in the past with one possible exception and the common symptoms are things like fevers and chills cough shortness of breath sore throat runny nose i have one of those but it’s from allergies fatigue bodyaches headache some GI system symptoms like nausea and vomiting or these are although these are less common and then still you know those classic loss of taste and smell which we saw much more kind of in the OG co variants um but the thing that you might notice is all these are kind of generic symptoms of viruses you know these are symptoms you could subscribe to the flu virus or adno virus or you know a whole bunch of upper respiratory viruses floating around out there so none of this is kind of specific to co uh now it could be from co but it could be from these other things too there has been one symptom that people have talked about and frankly I have no idea if this is actually true or not but you do see it out there so I just wanted to at least say it uh people are saying that horarsseness they’re noticing more horarsseness with this variant NB181 compared to earlier strains so a horse voice you know it seems maybe like a stretch uh at the hospital i certainly see patients with horse voices from all sorts of different viruses but uh people are talking about it so I just wanted to throw it out there there might be some correlation with horarsseness in this variant all right severity of illness does it cause more severe illness we said it might attach more strongly to the human A2 receptor it might be more able to evade our immune system should we be worried are we going to go back to bunch of hospitalizations well the good answer is probably not current data does not suggest that this virus uh this variant causes more severe illness than any previous variants out there hospitalizations have seemed to increase increase in areas where the variant is prevalent but we tend to see that right just when case counts increase um there tends to be more hospitalizations because we know people at higher risk can still get sick from COVID um I see it in my day-to-day in the intensive care unit it’s not as common uh and we don’t see as many healthy people get as sick but still elderly folks folks with a lot of coorbidity still can get sick from COVID so if cases go up because this NB uh 181 is causing more cases you will see hospitalizations go up too but it doesn’t seem that this variant at least per the data we have thus far causes any more severe disease which is a good thing okay there’s no significant uptick in ICU admissions or mortality rates that have been observed so far as for transmission dynamics uh we talked about this a little bit already this will not be any new stuff but it does seem like there’s some enhanced infectivity uh by NB181 having more robust binding to that human A2 receptor which may facilitate easier cell entry and increased transmission and then the global spread mechanics here we’ve seen this variant spreading in multiple countries with some degree of rapid increase in prevalence uh and that does underscore that it probably does have this heightened transmissibility once we see variants start to kind of spread to multiple countries uh and cause kind of rapid increases so we most likely will see continued increase in cases of ND181 although again reassured that it doesn’t seem to cause more severe disease although you still can get sick from it right you absolutely can so you still got to be careful especially if you fall in a high-risisk category vaccine effectiveness uh lots of discussion out there on CO vaccines uh COVID 19 vaccines right now uh they are still expected to remain effective against NB181 in preventing severe disease and hospitalizations although there is maybe some slight decrease in their efficacy based on lab studies um but they still should prevent severe disease and hospitalizations as far as anyone is aware right now all right public health considerations uh there is currently surveillance on this variant so we should have some updated information as time goes on with how it is spreading um normal preventative measures for those in high-risisk groups uh or if you’re just worried about it and vaccine campaigns again you can still get sick from COVID uh choose your own destiny certainly uh but those at higher risk do have a risk and if CO cases are going up it means more people will get sick from COVID just as a a natural pace of case counts going up just like if it was flu or anything else so in summary ND181 does seem to be rapidly spreading it is an omccrron subvariant it seems to have increased transmissibility and some modest immune evasion um it does not appear to cause more severe illness which is great um but given its widespread presence uh stay vigilant you know watch yourself if you’re in high-risisk group uh and we’ll try to keep you all updated best we can that’s all we have for you today hopefully that was kind of a quick and dirty update on MB181 provided some more context information uh I think you’ll probably see some more headlines on this variant moving forward and if something changes significantly we’ll certainly provide another update but let us know what thoughts comments questions you have certainly appreciate you checking out the episode check out that Patreon page weekly newsletter all that good stuff that’s actually the fastest way to get information from us because we tend to be able to post stuff on those in real time um so if you’re interested in kind of the most up-to-date stuff that we’re doing uh definitely check those out and uh either way stay well keep learning we’ll see you next time welcome to Whiteboard Medicine we appreciate you checking out the video here at Whiteboard Medicine our goal is to create medical education content for all types of interested learners that includes videos practice questions study resources and 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A new COVID-19 subvariant, NB.1.8.1, is making headlines as it spreads rapidly across multiple countries. In this video, we break down what scientists and public health officials currently know about NB.1.8.1: its mutations, symptoms, transmissibility, vaccine effectiveness, and how it compares to other Omicron subvariants like XBB and KP.2.
0:00 – 2:59 – Overview, Variant Under Monitoring
3:00 – 4:15 – Global Spread, China, Australia, India, USA
4:16 – 7:48 – Mutations, Spike Protein, Immune Evasion, Transmissibility
7:49 – 9:12 – Symptoms, General Symptoms, Unique Symptom
9:13 – 11:08 – Severity, Transmissibility
11:09 – 13:25 – Vaccine Effectiveness, Public Health Measures
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