America's first recorded case of the SARS-CoV-2 variant that originated in Brazil happened in Minnesota, and the CDC has released a report revealing how it came here and how it was investigated.
The Minnesota Department of Health confirmed the first case of the P.1 variant on Jan. 25, a few weeks after the variant was first confirmed in travelers from Brazil during a routine inspection at an airport in Tokyo.
The variant, which may be up to 2.2 times more transmissible than the initial COVID strain and has mutations to the spike protein receptor-binding that has raised concerns it can evade vaccine and naturally-built immunity, emerged amid an ongoing disaster in Brazil, whose president Jair Bolsanaro has been criticized for failing to implement measures to contain COVID and roll out vaccinations, and derided COVID as "a little flu" despite it claiming more than 250,000 lives in his country.
The first U.S. case was reported in Minnesota after a person became symptomatic in early January and was hospitalized for 9 days.
During the case investigation, it emerged they had traveled to southeastern Brazil within the 14 days before symptoms started, and their travel partner – who lives in the same household – also tested positive after returning.
The Minnesota Department of Health has since December been testing 100 specimens of COVID per week for possible variants, and genome sequencing of the two samples confirmed the P.1 variant in both.
So far, the two cases remain the only confirmed P.1 variants in Minnesota, per CDC figures, whereas the more widespread B.1.1.7 UK variant has seen 78 cases. Given the limits of MDH's genome sequencing however, there may be more than have been discovered.
The CDC says the hospitalized patient interacted with four health care facilities while he had the virus, with testing offered to 111 healthcare workers who came into contact with them, but no high-risk exposures.
Subsequently, 22 workers took COVID tests and none were positive.
MSP Airport was also informed because the pair who had the variant traveled internationally and arrived on a domestic flight into MSP, but because "19 days had passed since the flights, CDC did not initiate a full aircraft contact investigation."
It did however obtain the information of potentially exposed passengers and notified the health departments where they lived. A further 42 people who might have had close contact with the pair in Minnesota were also offered testing. Twenty of them took tests, all were negative.
The CDC says the discovery of the P.1 variant "underscores the importance of community prevention strategies to slow transmission of SARS-CoV-2," including use of "well-fitting masks," social distancing, washing hands, regular testing, and the use of quarantines and isolation for anyone who tests positive or who has symptoms.