The routine detection, surveillance, and reporting of novel SARS-CoV-2 variants is crucial, as these threaten to hinder global vaccination efforts. Herein we report a novel local variant with a non-synonymous mutation in the spike (S) protein P681H. This local Israeli variant was not associated with a higher infection rate or higher prevalence. Furthermore, the local variant was successfully neutralized by sera from fully vaccinated individuals at a comparable level to the B.1.1.7 variant and an Israel wild-type strain. While it is not a variant of concern, routine monitoring by sequencing is still required.

Enterovirus D68 (EVD68) was recently identified as an important cause of respiratory illness and acute flaccid myelitis (AFM), mostly in children. Here, we examined 472 pediatric patients diagnosed with severe respiratory illness and screened for EVD68 between April and October 2021. In parallel, samples collected from a wastewater treatment plant (WWTP) covering the residential area of the hospitalized patients were also tested for EVD68. Of the 472 clinical samples evaluated, 33 (7%) patients were positive for EVD68 RNA. All wastewater samples were positive for EVD68, with varying viral genome copy loads. Calculated EVD68 genome copies increased from the end of May until July 2021 and dramatically decreased at the beginning of August. A similar trend was observed in both clinical and wastewater samples during the period tested. Sequence analysis of EVD68-positive samples indicated that all samples originated from the same branch of subclade B3. This study is the first to use wastewater-based epidemiology (WBE) to monitor EVD68 dynamics by quantitative detection and shows a clear correlation with clinically diagnosed cases. These findings highlight the potential of WBE as an important tool for continuous surveillance of EVD68 and other enteroviruses.

Background: Influenza virus A(H1N1)pdm09 first appeared in Israel in late April 2009, disappeared in mid‐March 2010, and reappeared in late October 2010. Symptoms were mostly mild without need for medical care.Objectives: To provide targets for future pandemic preparedness and response by evaluating the dynamics and cumulative incidence of A(H1N1)pdm09 infection, the virus‐specific seroprevalence (HI antibody titer >1:40) at the height of the pandemic, during its decline and thereafter.Methods: A cross‐sectional seroepidemiological study was conducted on 6911 serum samples collected before, during, and after the pandemic.Results: Cumulative incidence of infection derived from the differences between post‐ and pre‐pandemic seroprevalence was 54·1%, 32·9%, 22·9%, 14·8%, and 6·3% in age‐groups 0–9, 10–19, 20–49, 50–79, and ≥80 years, respectively, and 28·5% for all age‐groups combined. Vaccination could have contributed at the most 4·6% to the post‐pandemic population seroprevalence. High pre‐pandemic immune response (47·4%) found in a cohort aged 15–18 year was strongly associated with birth years 1990–1993. Morbidity began to decline in mid‐November 2009 at 32·8% population seroprevalence (45% in ages 0–19 year) and stopped in March 2010 at 43·4% population seroprevalence in February 2010 (70% in ages 0–19 year). Between February and September 2010, seroprevalence declined by 12·2% allowing virus recirculation from October 2010.Conclusions: Our study provides targets for controlling future influenza pandemics in Israel. Vaccination should focus on the younger age‐groups (0–19 year) which played a key role in transmission of the A(H1N1)pdm09 due to lack of background immunity (ages 0–9 year) and high exposure rates (ages 10–19 year).

In this report, we describe a national-scale monitoring of the SARS-CoV-2 (SC-2) variant dynamics in Israel, using multiple-time sampling of 13 wastewater treatment plants. We used a combination of inclusive and selective quantitative PCR assays that specifically identify variants A19/A20 or B.1.1.7 and tested each sample for the presence and relative viral RNA load of each variant. We show that between December 2020 and March 2021, a complete shift in the SC-2 variant circulation was observed, where the B.1.1.7 replaced the A19 in all examined test points. We further show that the normalized viral load (NVL) values and the average new cases per week reached a peak in January 2021 and then decreased gradually in almost all test points, in parallel with the progression of the national vaccination campaign, during February–March 2021. This study demonstrates the importance of monitoring SC-2 variant by using a combination of inclusive and selective PCR tests on a national scale through wastewater sampling, which is far more amendable for high-throughput monitoring compared with sequencing. This approach may be useful for real-time dynamics surveillance of current and future variants, such as the Omicron (BA.1, BA.2) and other variants.