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Consistent long term surveillance is vital for public health action and research Japan announced on 26 June 2023 that it may have entered its ninth wave of covid-19 infections.1 Epidemiologists detected an increase in SARS-CoV-2 positive cases based on the national sentinel surveillance system, which includes some 5000 medical institutions across the country. The average weekly number of covid-19 cases per sentinel site increased from 1.12 in the week of 29 May to 5.11 in the week of 5 June 2023.2 XBB lineages were identified in most of the cases.34 Since XBB was first identified in India in August 2022, XBB lineages have spread across the world and have become the most common variant in various parts of the world.56 XBB lineages have a remarkable growth advantage over other omicron variants, such as BA.5 and BA.2.75. Once it enters the population, the XBB lineage spreads and becomes predominant much more quickly than other variants.7 XBB lineages are one …

Hong kongKayoko shiodaInternational pathogen surveillance networkCenters for diseaseWorld health organizationDisease control