![]() The two lineages differ only outside of the spike region. The spike proteins of BA.4 and BA.5 are identical, and similar to BA.2 except for the addition of 69–70 deletion (present in the Alpha variant and the BA.1 lineage), L452R (present in the Delta variant), F486V and the wild-type amino acid at Q493. We have now identified two new lineages, BA.4 and BA.5, responsible for a fifth wave of infections. ![]() Three lineages (BA.1, BA.2 and BA.3) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant of concern predominantly drove South Africa’s fourth Coronavirus Disease 2019 (COVID-19) wave. Nature Medicine volume 28, pages 1785–1790 ( 2022) Cite this article Emergence of SARS-CoV-2 Omicron lineages BA.4 and BA.5 in South Africa
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