JN.1 variant in enduring COVID-19 pandemic: is it a variety of interest (VoI) or variety of concern (VoC)?

The emergence of the SARS-CoV-2 Omicron variant, classified as a Variant of Concern (VoC) in November 2021, marked a significant shift in the COVID-19 landscape. This study investigates the subsequent development of a novel Omicron sublineage, JN.1, which displays distinctive mutations in the spike protein. The study delves into the phylogenetic differences between these variants and their potential implications. A comprehensive analysis of the genomic profiles and mutation patterns of JN.1 and BA.2.86 was conducted, utilizing SARS-CoV-2 database. The study explores the unique mutations, such as S:L455S in JN.1, associated with increased transmissibility and immune escape. Furthermore, a comparison with prevalent strains like XBB.1.5 and HV.1 highlights the substantial genetic divergence of JN.1. JN.1, first detected in August 2023, exhibits a notable spike protein mutation profile, including the reappearance of earlier variants' mutations (E484K and P681R). The variant's increased transmissibility and immune evasion potential are attributed to specific spike protein mutations like R21T, S50L, V127F, R158G, and others. The study also explores the distribution and prevalence of JN.1 globally, with a focus on the rising cases in India. JN.1 poses a unique challenge as one of the most immune-evading variants, with potential implications for COVID-19 transmission. The study emphasizes the importance of monitoring and understanding emerging variants, especially those with distinct spike protein mutations. The observed cases in India highlight the need for vigilance and prompt public health responses. As JN.1 continues to evolve, ongoing surveillance, vaccination strategies, and adherence to preventive measures are crucial to mitigating its potential impact on global public health.

Acquired methaemoglobinaemia in infancy associated with acute diarrhoea: A case series.

Acute diarrhoeal illness remains a common medical problem in children with nearly 1.7 billion cases globally every year. We report five infants who, following severe diarrhoea, developed methaemoglobinemia. This is an altered state of haemoglobin presenting with cyanosis and can pose a diagnostic dilemma. It should be suspected in young infants without cyanotic heart disease presenting with severe diarrhoea, sepsis and cyanosis disproportionate to their clinical status. Its outcome depends on prompt treatment, the severity of underlying sepsis and co-morbidity.