51
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Wang Y, Liu P, VanTassell J, Hilton SP, Guo L, Sablon O, Wolfe M, Freeman L, Rose W, Holt C, Browning M, Bryan M, Waller L, Teunis PFM, Moe CL. When case reporting becomes untenable: Can sewer networks tell us where COVID-19 transmission occurs? WATER RESEARCH 2023; 229:119516. [PMID: 37379453 PMCID: PMC9763902 DOI: 10.1016/j.watres.2022.119516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 12/11/2022] [Accepted: 12/18/2022] [Indexed: 06/30/2023]
Abstract
Monitoring SARS-CoV-2 in wastewater is a valuable approach to track COVID-19 transmission. Designing wastewater surveillance (WWS) with representative sampling sites and quantifiable results requires knowledge of the sewerage system and virus fate and transport. We developed a multi-level WWS system to track COVID-19 in Atlanta using an adaptive nested sampling strategy. From March 2021 to April 2022, 868 wastewater samples were collected from influent lines to wastewater treatment facilities and upstream community manholes. Variations in SARS-CoV-2 concentrations in influent line samples preceded similar variations in numbers of reported COVID-19 cases in the corresponding catchment areas. Community sites under nested sampling represented mutually-exclusive catchment areas. Community sites with high SARS-CoV-2 detection rates in wastewater covered high COVID-19 incidence areas, and adaptive sampling enabled identification and tracing of COVID-19 hotspots. This study demonstrates how a well-designed WWS provides actionable information including early warning of surges in cases and identification of disease hotspots.
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Affiliation(s)
- Yuke Wang
- Center for Global Safe Water, Sanitation, and Hygiene, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Pengbo Liu
- Center for Global Safe Water, Sanitation, and Hygiene, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Jamie VanTassell
- Center for Global Safe Water, Sanitation, and Hygiene, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Stephen P Hilton
- Center for Global Safe Water, Sanitation, and Hygiene, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Lizheng Guo
- Center for Global Safe Water, Sanitation, and Hygiene, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Orlando Sablon
- Center for Global Safe Water, Sanitation, and Hygiene, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Marlene Wolfe
- Center for Global Safe Water, Sanitation, and Hygiene, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Lorenzo Freeman
- City of Atlanta Department of Watershed Management, Atlanta, GA 30303, USA
| | - Wayne Rose
- City of Atlanta Department of Watershed Management, Atlanta, GA 30303, USA
| | - Carl Holt
- City of Atlanta Department of Watershed Management, Atlanta, GA 30303, USA
| | - Mikita Browning
- City of Atlanta Department of Watershed Management, Atlanta, GA 30303, USA
| | - Michael Bryan
- Georgia Department of Public Health, Atlanta, GA 30303, USA
| | - Lance Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Peter F M Teunis
- Center for Global Safe Water, Sanitation, and Hygiene, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Christine L Moe
- Center for Global Safe Water, Sanitation, and Hygiene, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
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52
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Li G, Denise H, Diggle P, Grimsley J, Holmes C, James D, Jersakova R, Mole C, Nicholson G, Smith CR, Richardson S, Rowe W, Rowlingson B, Torabi F, Wade MJ, Blangiardo M. A spatio-temporal framework for modelling wastewater concentration during the COVID-19 pandemic. ENVIRONMENT INTERNATIONAL 2023; 172:107765. [PMID: 36709674 PMCID: PMC9847331 DOI: 10.1016/j.envint.2023.107765] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/13/2022] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
The potential utility of wastewater-based epidemiology as an early warning tool has been explored widely across the globe during the current COVID-19 pandemic. Methods to detect the presence of SARS-CoV-2 RNA in wastewater were developed early in the pandemic, and extensive work has been conducted to evaluate the relationship between viral concentration and COVID-19 case numbers at the catchment areas of sewage treatment works (STWs) over time. However, no attempt has been made to develop a model that predicts wastewater concentration at fine spatio-temporal resolutions covering an entire country, a necessary step towards using wastewater monitoring for the early detection of local outbreaks. We consider weekly averages of flow-normalised viral concentration, reported as the number of SARS-CoV-2N1 gene copies per litre (gc/L) of wastewater available at 303 STWs over the period between 1 June 2021 and 30 March 2022. We specify a spatially continuous statistical model that quantifies the relationship between weekly viral concentration and a collection of covariates covering socio-demographics, land cover and virus associated genomic characteristics at STW catchment areas while accounting for spatial and temporal correlation. We evaluate the model's predictive performance at the catchment level through 10-fold cross-validation. We predict the weekly viral concentration at the population-weighted centroid of the 32,844 lower super output areas (LSOAs) in England, then aggregate these LSOA predictions to the Lower Tier Local Authority level (LTLA), a geography that is more relevant to public health policy-making. We also use the model outputs to quantify the probability of local changes of direction (increases or decreases) in viral concentration over short periods (e.g. two consecutive weeks). The proposed statistical framework can predict SARS-CoV-2 viral concentration in wastewater at high spatio-temporal resolution across England. Additionally, the probabilistic quantification of local changes can be used as an early warning tool for public health surveillance.
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Affiliation(s)
- Guangquan Li
- Applied Statistics Research Group, Department of Mathematics, Physics and Electrical Engineering, Northumbria University, Newcastle upon Tyne NE1 8ST, UK; Turing-RSS Health Data Lab, UK
| | - Hubert Denise
- Analytics & Data Science Directorate, UK Health Security Agency, Nobel House, Smith Square, London SW1P 3JR, UK
| | - Peter Diggle
- Lancaster University, Lancaster LA1 4YW, UK; Turing-RSS Health Data Lab, UK
| | - Jasmine Grimsley
- Analytics & Data Science Directorate, UK Health Security Agency, Nobel House, Smith Square, London SW1P 3JR, UK
| | - Chris Holmes
- University of Oxford, Oxford, UK; The Alan Turing Institute, London NW1 2DB, UK; Turing-RSS Health Data Lab, UK
| | - Daniel James
- Analytics & Data Science Directorate, UK Health Security Agency, Nobel House, Smith Square, London SW1P 3JR, UK
| | - Radka Jersakova
- The Alan Turing Institute, London NW1 2DB, UK; Turing-RSS Health Data Lab, UK
| | - Callum Mole
- The Alan Turing Institute, London NW1 2DB, UK; Turing-RSS Health Data Lab, UK
| | - George Nicholson
- University of Oxford, Oxford, UK; Turing-RSS Health Data Lab, UK
| | - Camila Rangel Smith
- The Alan Turing Institute, London NW1 2DB, UK; Turing-RSS Health Data Lab, UK
| | - Sylvia Richardson
- MRC Biostatistics Unit, East Forvie Site, Cambridge CB20SR, UK; Turing-RSS Health Data Lab, UK
| | - William Rowe
- Analytics & Data Science Directorate, UK Health Security Agency, Nobel House, Smith Square, London SW1P 3JR, UK
| | - Barry Rowlingson
- Lancaster University, Lancaster LA1 4YW, UK; Turing-RSS Health Data Lab, UK
| | - Fatemeh Torabi
- Swansea University Medical School, Faculty of Medicine, Health Life Science, Swansea SA2 8PP, UK; Turing-RSS Health Data Lab, UK
| | - Matthew J Wade
- Analytics & Data Science Directorate, UK Health Security Agency, Nobel House, Smith Square, London SW1P 3JR, UK
| | - Marta Blangiardo
- MRC Centre for Environment and Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK; Turing-RSS Health Data Lab, UK
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53
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Vaughan L, Zhang M, Gu H, Rose JB, Naughton CC, Medema G, Allan V, Roiko A, Blackall L, Zamyadi A. An exploration of challenges associated with machine learning for time series forecasting of COVID-19 community spread using wastewater-based epidemiological data. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 858:159748. [PMID: 36306840 PMCID: PMC9597519 DOI: 10.1016/j.scitotenv.2022.159748] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 10/22/2022] [Accepted: 10/22/2022] [Indexed: 05/19/2023]
Abstract
Wastewater-based epidemiology (WBE) has gained increasing attention as a complementary tool to conventional surveillance methods with potential for significant resource and labour savings when used for public health monitoring. Using WBE datasets to train machine learning algorithms and develop predictive models may also facilitate early warnings for the spread of outbreaks. The challenges associated with using machine learning for the analysis of WBE datasets and timeseries forecasting of COVID-19 were explored by running Random Forest (RF) algorithms on WBE datasets across 108 sites in five regions: Scotland, Catalonia, Ohio, the Netherlands, and Switzerland. This method uses measurements of SARS-CoV-2 RNA fragment concentration in samples taken at the inlets of wastewater treatment plants, providing insight into the prevalence of infection in upstream wastewater catchment populations. RF's forecasting performance at each site was quantitatively evaluated by determining mean absolute percentage error (MAPE) values, which was used to highlight challenges affecting future implementations of RF for WBE forecasting efforts. Performance was generally poor using WBE datasets from Catalonia, Scotland, and Ohio with 'reasonable' or better forecasts constituting 0 %, 5 %, and 0 % of these regions' forecasts, respectively. RF's performance was much stronger with WBE data from the Netherlands and Switzerland, which provided 55 % and 45 % 'reasonable' or better forecasts respectively. Sampling frequency and training set size were identified as key factors contributing to accuracy, while inclusion of too many unnecessary variables (or e.g., flow data) was identified as a contributing factor to poor performance. The contribution of catchment population on forecast accuracy was more ambiguous. This study determined that the factors governing RF's forecast performance are complicated and interrelated, which presents challenges for further work in this space. A sufficiently accurate further iteration of the tool discussed within this study would provide significant but varying value for public health departments for monitoring future, or ongoing outbreaks, assisting the implementation of on-time health response measures.
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Affiliation(s)
- Liam Vaughan
- Chemical Engineering Department, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia; Water Research Australia, Melbourne Based Team, Melbourne, Australia
| | - Muyang Zhang
- Chemical Engineering Department, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
| | - Haoran Gu
- Chemical Engineering Department, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
| | - Joan B Rose
- Department of Plant, Soil and Microbial Sciences, and Department of Fisheries and Wildlife, Michigan State University, East Lansing, United States of America
| | - Colleen C Naughton
- Civil and Environmental Engineering, University of California Merced, Merced, United States of America
| | - Gertjan Medema
- KWR Water Research Institute, Nieuwegein, the Netherlands
| | | | - Anne Roiko
- School of Pharmacy and Medical Sciences, and Cities Research Institute, Griffith University, Gold Coast, Australia
| | - Linda Blackall
- School of BioSciences, The University of Melbourne, Melbourne, Australia
| | - Arash Zamyadi
- Chemical Engineering Department, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia; Water Research Australia, Melbourne Based Team, Melbourne, Australia.
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54
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Helm B, Geissler M, Mayer R, Schubert S, Oertel R, Dumke R, Dalpke A, El-Armouche A, Renner B, Krebs P. Regional and temporal differences in the relation between SARS-CoV-2 biomarkers in wastewater and estimated infection prevalence - Insights from long-term surveillance. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 857:159358. [PMID: 36240928 PMCID: PMC9554318 DOI: 10.1016/j.scitotenv.2022.159358] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
Wastewater-based epidemiology provides a conceptual framework for the evaluation of the prevalence of public health related biomarkers. In the context of the Coronavirus disease-2019, wastewater monitoring emerged as a complementary tool for epidemic management. In this study, we evaluated data from six wastewater treatment plants in the region of Saxony, Germany. The study period lasted from February to December 2021 and covered the third and fourth regional epidemic waves. We collected 1065 daily composite samples and analyzed SARS-CoV-2 RNA concentrations using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Regression models quantify the relation between RNA concentrations and disease prevalence. We demonstrated that the relation is site and time specific. Median loads per diagnosed case differed by a factor of 3-4 among sites during both waves and were on average 45 % higher during the third wave. In most cases, log-log-transformed data achieved better regression performance than non-transformed data and local calibration outperformed global models for all sites. The inclusion of lag/lead time, discharge and detection probability improved model performance in all cases significantly, but the importance of these components was also site and time specific. In all cases, models with lag/lead time and log-log-transformed data obtained satisfactory goodness-of-fit with adjusted coefficients of determination higher than 0.5. Back-estimation of testing efficiency from wastewater data confirmed state-wide prevalence estimation from individual testing statistics, but revealed pronounced differences throughout the epidemic waves and among the different sites.
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Affiliation(s)
- Björn Helm
- Institute of Urban and Industrial Water Management, Technische Universität Dresden, Helmholtzstrasse 10, 01069 Dresden, Germany.
| | - Michael Geissler
- Institute of Medical Microbiology and Virology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Robin Mayer
- Institute of Urban and Industrial Water Management, Technische Universität Dresden, Helmholtzstrasse 10, 01069 Dresden, Germany
| | - Sara Schubert
- Institute of Clinical Pharmacology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany; Institute of Hydrobiology, Technische Universität Dresden, Helmholtzstrasse 10, 01069 Dresden, Germany
| | - Reinhard Oertel
- Institute of Clinical Pharmacology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Roger Dumke
- Institute of Medical Microbiology and Virology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Alexander Dalpke
- Institute of Medical Microbiology and Virology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany; University Heidelberg, Institute of Medical Microbiology and Hygiene, Heidelberg, Germany
| | - Ali El-Armouche
- Institute of Clinical Pharmacology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany; Institute of Pharmacology and Toxicology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Bertold Renner
- Institute of Clinical Pharmacology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Peter Krebs
- Institute of Urban and Industrial Water Management, Technische Universität Dresden, Helmholtzstrasse 10, 01069 Dresden, Germany
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55
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Reyne MI, Allen DM, Levickas A, Allingham P, Lock J, Fitzgerald A, McSparron C, Nejad BF, McKinley J, Lee A, Bell SH, Quick J, Houldcroft CJ, Bamford CGG, Gilpin DF, McGrath JW. Detection of human adenovirus F41 in wastewater and its relationship to clinical cases of acute hepatitis of unknown aetiology. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 857:159579. [PMID: 36270375 DOI: 10.1016/j.scitotenv.2022.159579] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/22/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
As of 8 July 2022, the World Health Organization (WHO) have reported 1010 probable cases of acute hepatitis of unknown aetiology in children worldwide, including approximately 250 cases in the United Kingdom (UK). Clinical presentations have often been severe, with liver transplantation a frequent clinical outcome. Human adenovirus F41 (HAdV-F41) has been detected in most children with acute hepatitis, but its role in the pathogenesis of this infection has yet to be established. Wastewater-based epidemiology (WBE) has become a well-established tool for monitoring the community spread of SARS-CoV-2, as well as other pathogens and chemicals. In this study, we adopted a WBE approach to monitoring levels of HAdV-F40/41 in wastewater before and during an acute hepatitis outbreak in Northern Ireland. We report increasing detection of HAdV-F40/41 in wastewater, concomitant with increasing numbers of clinical cases. Amplicon whole genome sequencing further classified the wastewater-derived HAdV as belonging to the F41 genotype which in turn was homologous to clinically derived sequences. We propose that WBE has the potential to inform community surveillance of HAdV-F41 and can further contribute to the ongoing global discussion supporting HAdV-F41 involvement in acute hepatitis cases.
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Affiliation(s)
- Marina I Reyne
- School of Biological Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland, UK.
| | - Danielle M Allen
- School of Biological Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland, UK
| | - Ashley Levickas
- School of Biological Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland, UK
| | - Pearce Allingham
- School of Biological Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland, UK
| | - Jonathan Lock
- School of Biological Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland, UK
| | - Arthur Fitzgerald
- School of Biological Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland, UK
| | - Cormac McSparron
- School of Natural and Built Environment, Queen's University Belfast, Elmwood Avenue, Belfast BT9 6AZ, Northern Ireland, UK
| | - Behnam F Nejad
- School of Natural and Built Environment, Queen's University Belfast, Elmwood Avenue, Belfast BT9 6AZ, Northern Ireland, UK
| | - Jennifer McKinley
- School of Natural and Built Environment, Queen's University Belfast, Elmwood Avenue, Belfast BT9 6AZ, Northern Ireland, UK
| | - Andrew Lee
- School of Biological Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland, UK
| | - Stephen H Bell
- School of Biological Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland, UK
| | - Joshua Quick
- School of Biosciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | | | - Connor G G Bamford
- Wellcome-Wolfson Institute for Experimental Medicine (WWIEM), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, UK
| | - Deirdre F Gilpin
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, UK
| | - John W McGrath
- School of Biological Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland, UK
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56
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Marcassoli A, Leonardi M, Passavanti M, De Angelis V, Bentivegna E, Martelletti P, Raggi A. Lessons Learned from the Lessons Learned in Public Health during the First Years of COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1785. [PMID: 36767152 PMCID: PMC9914715 DOI: 10.3390/ijerph20031785] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
(1) Objectives: to investigate the main lessons learned from the public health (PH) response to COVID-19, using the global perspective endorsed by the WHO pillars, and understand what countries have learned from their practical actions. (2) Methods: we searched for articles in PubMed and CINAHL from 1 January 2020 to 31 January 2022. 455 articles were included. Inclusion criteria were PH themes and lessons learned from the COVID-19 pandemic. One hundred and forty-four articles were finally included in a detailed scoping review. (3) Findings: 78 lessons learned were available, cited 928 times in the 144 articles. Our review highlighted 5 main lessons learned among the WHO regions: need for continuous coordination between PH institutions and organisations (1); importance of assessment and evaluation of risk factors for the diffusion of COVID-19, identifying vulnerable populations (2); establishment of evaluation systems to assess the impact of planned PH measures (3); extensive application of digital technologies, telecommunications and electronic health records (4); need for periodic scientific reviews to provide regular updates on the most effective PH management strategies (5). (4) Conclusion: lessons found in this review could be essential for the future, providing recommendations for an increasingly flexible, fast and efficient PH response to a healthcare emergency such as the COVID-19 pandemic.
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Affiliation(s)
- Alessia Marcassoli
- Neurology, Public Health, Disability Unit and Coma Research Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit and Coma Research Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Marco Passavanti
- Neurology, Public Health, Disability Unit and Coma Research Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Valerio De Angelis
- Department of Clinical and Molecular Medicine, Sapienza University, 00189 Rome, Italy
| | - Enrico Bentivegna
- Department of Clinical and Molecular Medicine, Sapienza University, 00189 Rome, Italy
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University, 00189 Rome, Italy
| | - Alberto Raggi
- Neurology, Public Health, Disability Unit and Coma Research Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
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57
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Jones DL, Rhymes JM, Wade MJ, Kevill JL, Malham SK, Grimsley JMS, Rimmer C, Weightman AJ, Farkas K. Suitability of aircraft wastewater for pathogen detection and public health surveillance. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 856:159162. [PMID: 36202356 PMCID: PMC9528016 DOI: 10.1016/j.scitotenv.2022.159162] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 09/25/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
International air travel is now widely recognised as one of the primary mechanisms responsible for the transnational movement and global spread of SARS-CoV-2. Monitoring the viral load and novel lineages within human-derived wastewater collected from aircraft and at air transport hubs has been proposed as an effective way to monitor the importation frequency of viral pathogens. The success of this approach, however, is highly dependent on the bathroom and defecation habits of air passengers during their journey. In this study of UK adults (n = 2103), we quantified the likelihood of defecation prior to departure, on the aircraft and upon arrival on both short- and long-haul flights. The results were then used to assess the likelihood of capturing the signal from infected individuals at UK travel hubs. To obtain a representative cross-section of the population, the survey was stratified by geographical region, gender, age, parenting status, and social class. We found that an individual's likelihood to defecate on short-haul flights (< 6 h in duration) was low (< 13 % of the total), but was higher on long-haul flights (< 36 %; > 6 h in duration). This behaviour pattern was higher among males and younger age groups. The maximum likelihood of defecation was prior to departure (< 39 %). Based on known SARS-CoV-2 faecal shedding rates (30-60 %) and an equal probability of infected individuals being on short- (71 % of inbound flights) and long-haul flights (29 %), we estimate that aircraft wastewater is likely to capture ca. 8-14 % of SARS-CoV-2 cases entering the UK. Monte Carlo simulations predicted that SARS-CoV-2 would be present in wastewater on 14 % of short-haul flights and 62 % of long-haul flights under current pandemic conditions. We conclude that aircraft wastewater alone is insufficient to effectively monitor all the transboundary entries of faecal-borne pathogens but can form part of a wider strategy for public heath surveillance at national borders.
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Affiliation(s)
- Davey L Jones
- Centre for Environmental Biotechnology, Bangor University, Bangor, Gwynedd LL57 2UW, UK; Food Futures Institute, Murdoch University, Murdoch, WA 6105, Australia.
| | - Jennifer M Rhymes
- Centre for Environmental Biotechnology, Bangor University, Bangor, Gwynedd LL57 2UW, UK; UK Centre for Ecology and Hydrology, Bangor, Gwynedd LL57 2UW, UK
| | - Matthew J Wade
- Newcastle University, School of Engineering, Cassie Building, Newcastle-upon-Tyne NE1 7RU, UK; UK Health Security Agency, Environmental Monitoring for Health Protection, Windsor House, London SW1H 0TL, UK
| | - Jessica L Kevill
- Centre for Environmental Biotechnology, Bangor University, Bangor, Gwynedd LL57 2UW, UK
| | - Shelagh K Malham
- School of Ocean Sciences, Bangor University, Menai Bridge, Anglesey LL59 5AB, UK
| | - Jasmine M S Grimsley
- UK Health Security Agency, Environmental Monitoring for Health Protection, Windsor House, London SW1H 0TL, UK; The London Data Company, London EC2N 2AT, UK
| | - Charlotte Rimmer
- Centre for Environmental Biotechnology, Bangor University, Bangor, Gwynedd LL57 2UW, UK
| | - Andrew J Weightman
- Microbiomes, Microbes and Informatics Group, School of Biosciences, Cardiff University, Cardiff CF10 3AX, UK
| | - Kata Farkas
- Centre for Environmental Biotechnology, Bangor University, Bangor, Gwynedd LL57 2UW, UK; The London Data Company, London EC2N 2AT, UK
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58
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Maal-Bared R, Qiu Y, Li Q, Gao T, Hrudey SE, Bhavanam S, Ruecker NJ, Ellehoj E, Lee BE, Pang X. Does normalization of SARS-CoV-2 concentrations by Pepper Mild Mottle Virus improve correlations and lead time between wastewater surveillance and clinical data in Alberta (Canada): comparing twelve SARS-CoV-2 normalization approaches. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 856:158964. [PMID: 36167131 PMCID: PMC9508694 DOI: 10.1016/j.scitotenv.2022.158964] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/13/2022] [Accepted: 09/19/2022] [Indexed: 05/02/2023]
Abstract
Wastewater-based surveillance (WBS) data normalization is an analyte measurement correction that addresses variations resulting from dilution of fecal discharge by non-sanitary sewage, stormwater or groundwater infiltration. No consensus exists on what WBS normalization parameters result in the strongest correlations and lead time between SARS-CoV-2 WBS data and COVID-19 cases. This study compared flow, population size and biomarker normalization impacts on the correlations and lead times for ten communities in twelve sewersheds in Alberta (Canada) between September 2020 and October 2021 (n = 1024) to determine if normalization by Pepper Mild Mottle Virus (PMMoV) provides any advantages compared to other normalization parameters (e.g., flow, reported and dynamic population sizes, BOD, TSS, NH3, TP). PMMoV concentrations (GC/mL) corresponded with plant influent flows and were highest in the urban centres. SARS-CoV-2 target genes E, N1 and N2 were all negatively associated with wastewater influent pH, while PMMoV was positively associated with temperature. Pooled data analysis showed that normalization increased ρ-values by almost 0.1 and was highest for ammonia, TKN and TP followed by PMMoV. Normalization by other parameters weakened associations. None of the differences were statistically significant. Site-specific correlations showed that normalization of SARS-CoV-2 data by PMMoV only improved correlations significantly in two of the twelve systems; neither were large sewersheds or combined sewer systems. In five systems, normalization by traditional wastewater strength parameters and dynamic population estimates improved correlations. Lead time ranged between 1 and 4 days in both pooled and site-specific comparisons. We recommend that WBS researchers and health departments: a) Investigate WWTP influent properties (e.g., pH) in the WBS planning phase and use at least two parallel approaches for normalization only if shown to provide value; b) Explore normalization by wastewater strength parameters and dynamic population size estimates further; and c) Evaluate purchasing an influent flow meter in small communities to support long-term WBS efforts and WWTP management.
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Affiliation(s)
- Rasha Maal-Bared
- Quality Assurance and Environment, EPCOR Water, Edmonton, Alberta, Canada.
| | - Yuanyuan Qiu
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Qiaozhi Li
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Tiejun Gao
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Steve E Hrudey
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Sudha Bhavanam
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Norma J Ruecker
- Water Quality Services, City of Calgary, Calgary, Alberta, Canada
| | - Erik Ellehoj
- Ellehoj Redmond Consulting, Edmonton, Alberta, Canada
| | - Bonita E Lee
- Department of Paediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Xiaoli Pang
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada; Public Health Laboratories (ProvLab), Alberta Precision Laboratories (APL), Edmonton, Alberta, Canada
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59
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Rainey AL, Buschang K, O’Connor A, Love D, Wormington AM, Messcher RL, Loeb JC, Robinson SE, Ponder H, Waldo S, Williams R, Shapiro J, McAlister EB, Lauzardo M, Lednicky JA, Maurelli AT, Sabo-Attwood T, Bisesi J. Retrospective Analysis of Wastewater-Based Epidemiology of SARS-CoV-2 in Residences on a Large College Campus: Relationships between Wastewater Outcomes and COVID-19 Cases across Two Semesters with Different COVID-19 Mitigation Policies. ACS ES&T WATER 2023; 3:16-29. [PMID: 37552720 PMCID: PMC9762499 DOI: 10.1021/acsestwater.2c00275] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 06/18/2023]
Abstract
Wastewater-based epidemiology (WBE) has been utilized for outbreak monitoring and response efforts in university settings during the coronavirus disease 2019 (COVID-19) pandemic. However, few studies examined the impact of university policies on the effectiveness of WBE to identify cases and mitigate transmission. The objective of this study was to retrospectively assess relationships between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) wastewater outcomes and COVID-19 cases in residential buildings of a large university campus across two academic semesters (August 2020-May 2021) under different COVID-19 mitigation policies. Clinical case surveillance data of student residents were obtained from the university COVID-19 response program. We collected and processed building-level wastewater for detection and quantification of SARS-CoV-2 RNA by RT-qPCR. The odds of obtaining a positive wastewater sample increased with COVID-19 clinical cases in the fall semester (OR = 1.50, P value = 0.02), with higher odds in the spring semester (OR = 2.63, P value < 0.0001). We observed linear associations between SARS-CoV-2 wastewater concentrations and COVID-19 clinical cases (parameter estimate = 1.2, P value = 0.006). Our study demonstrated the effectiveness of WBE in the university setting, though it may be limited under different COVID-19 mitigation policies. As a complementary surveillance tool, WBE should be accompanied by robust administrative and clinical testing efforts for the COVID-19 pandemic response.
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Affiliation(s)
- Andrew L. Rainey
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Emerging Pathogens Institute, University
of Florida, Gainesville, Florida32610, United
States
| | - Katherine Buschang
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Emerging Pathogens Institute, University
of Florida, Gainesville, Florida32610, United
States
- Center for Environmental and Human Toxicology,
University of Florida, Gainesville, Florida32611,
United States
| | - Amber O’Connor
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Center for Environmental and Human Toxicology,
University of Florida, Gainesville, Florida32611,
United States
| | - Deirdre Love
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Center for Environmental and Human Toxicology,
University of Florida, Gainesville, Florida32611,
United States
| | - Alexis M. Wormington
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Center for Environmental and Human Toxicology,
University of Florida, Gainesville, Florida32611,
United States
| | - Rebeccah L. Messcher
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Emerging Pathogens Institute, University
of Florida, Gainesville, Florida32610, United
States
| | - Julia C. Loeb
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Emerging Pathogens Institute, University
of Florida, Gainesville, Florida32610, United
States
| | - Sarah E. Robinson
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Emerging Pathogens Institute, University
of Florida, Gainesville, Florida32610, United
States
- Center for Environmental and Human Toxicology,
University of Florida, Gainesville, Florida32611,
United States
| | - Hunter Ponder
- UF Health Screen, Test, and Protect,
University of Florida, Gainesville, Florida32611,
United States
- Florida Department of
Health, Alachua County, Gainesville, Florida32641, United
States
| | - Sarah Waldo
- UF Health Screen, Test, and Protect,
University of Florida, Gainesville, Florida32611,
United States
- Florida Department of
Health, Alachua County, Gainesville, Florida32641, United
States
| | - Roy Williams
- UF Health Screen, Test, and Protect,
University of Florida, Gainesville, Florida32611,
United States
- Florida Department of
Health, Alachua County, Gainesville, Florida32641, United
States
| | - Jerne Shapiro
- UF Health Screen, Test, and Protect,
University of Florida, Gainesville, Florida32611,
United States
- Florida Department of
Health, Alachua County, Gainesville, Florida32641, United
States
- Department of Epidemiology, College of Public
Health and Health Professions and College of Medicine, Gainesville,
Florida32611, United States
| | | | - Michael Lauzardo
- Emerging Pathogens Institute, University
of Florida, Gainesville, Florida32610, United
States
- UF Health Screen, Test, and Protect,
University of Florida, Gainesville, Florida32611,
United States
- Department of Medicine, College of Medicine,
University of Florida, Gainesville, Florida32611,
United States
| | - John A. Lednicky
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Emerging Pathogens Institute, University
of Florida, Gainesville, Florida32610, United
States
| | - Anthony T. Maurelli
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Emerging Pathogens Institute, University
of Florida, Gainesville, Florida32610, United
States
| | - Tara Sabo-Attwood
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Emerging Pathogens Institute, University
of Florida, Gainesville, Florida32610, United
States
- Center for Environmental and Human Toxicology,
University of Florida, Gainesville, Florida32611,
United States
| | - Joseph
H. Bisesi
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Emerging Pathogens Institute, University
of Florida, Gainesville, Florida32610, United
States
- Center for Environmental and Human Toxicology,
University of Florida, Gainesville, Florida32611,
United States
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60
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Hopkins L, Persse D, Caton K, Ensor K, Schneider R, McCall C, Stadler LB. Citywide wastewater SARS-CoV-2 levels strongly correlated with multiple disease surveillance indicators and outcomes over three COVID-19 waves. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 855:158967. [PMID: 36162580 PMCID: PMC9507781 DOI: 10.1016/j.scitotenv.2022.158967] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
Public health surveillance systems for COVID-19 are multifaceted and include multiple indicators reflective of different aspects of the burden and spread of the disease in a community. With the emergence of wastewater disease surveillance as a powerful tool to track infection dynamics of SARS-CoV-2, there is a need to integrate and validate wastewater information with existing disease surveillance systems and demonstrate how it can be used as a routine surveillance tool. A first step toward integration is showing how it relates to other disease surveillance indicators and outcomes, such as case positivity rates, syndromic surveillance data, and hospital bed use rates. Here, we present an 86-week long surveillance study that covers three major COVID-19 surges. City-wide SARS-CoV-2 RNA viral loads in wastewater were measured across 39 wastewater treatment plants and compared to other disease metrics for the city of Houston, TX. We show that wastewater levels are strongly correlated with positivity rate, syndromic surveillance rates of COVID-19 visits, and COVID-19-related general bed use rates at hospitals. We show that the relative timing of wastewater relative to each indicator shifted across the pandemic, likely due to a multitude of factors including testing availability, health-seeking behavior, and changes in viral variants. Next, we show that individual WWTPs led city-wide changes in SARS-CoV-2 viral loads, indicating a distributed monitoring system could be used to enhance the early-warning capability of a wastewater monitoring system. Finally, we describe how the results were used in real-time to inform public health response and resource allocation.
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Affiliation(s)
- Loren Hopkins
- Houston Health Department, 8000 N. Stadium Dr., Houston, TX, United States of America; Department of Statistics, Rice University, 6100 Main Street MS 138, Houston, TX, United States of America
| | - David Persse
- Houston Health Department, 8000 N. Stadium Dr., Houston, TX, United States of America; Department of Medicine and Surgery, Baylor College of Medicine, Houston, TX, United States of America; City of Houston Emergency Medical Services, Houston, TX, United States of America
| | - Kelsey Caton
- Houston Health Department, 8000 N. Stadium Dr., Houston, TX, United States of America
| | - Katherine Ensor
- Department of Statistics, Rice University, 6100 Main Street MS 138, Houston, TX, United States of America
| | - Rebecca Schneider
- Houston Health Department, 8000 N. Stadium Dr., Houston, TX, United States of America
| | - Camille McCall
- Department of Civil and Environmental Engineering, Rice University, 6100 Main Street MS-519, Houston, TX, United States of America
| | - Lauren B Stadler
- Department of Civil and Environmental Engineering, Rice University, 6100 Main Street MS-519, Houston, TX, United States of America.
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61
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Martin M, Goethals P, Newhart K, Rhodes E, Vogel J, Stevenson B. Optimization of sewage sampling for wastewater-based epidemiology through stochastic modeling. JOURNAL OF ENGINEERING AND APPLIED SCIENCE 2023; 70:11. [PMCID: PMC9930068 DOI: 10.1186/s44147-023-00180-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
The proliferation of the SARS-CoV-2 global pandemic has brought to attention the need for epidemiological tools that can detect diseases in specific geographical areas through non-contact means. Such methods may protect those potentially infected by facilitating early quarantine policies to prevent the spread of the disease. Sampling of municipal wastewater has been studied as a plausible solution to detect pathogen spread, even from asymptomatic patients. However, many challenges exist in wastewater-based epidemiology such as identifying a representative sample for a population, determining the appropriate sample size, and establishing the right time and place for samples. In this work, a new approach to address these questions is assessed using stochastic modeling to represent wastewater sampling given a particular community of interest. Using estimates for various process parameters, inferences on the population infected are generated with Monte Carlo simulation output. A case study at the University of Oklahoma is examined to calibrate and evaluate the model output. Finally, extensions are provided for more efficient wastewater sampling campaigns in the future. This research provides greater insight into the effects of viral load, the percentage of the population infected, and sampling time on mean SARS-CoV-2 concentration through simulation. In doing so, an earlier warning of infection for a given population may be obtained and aid in reducing the spread of viruses.
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Affiliation(s)
- Max Martin
- grid.419884.80000 0001 2287 2270United States Corps of Cadets, United States Military Academy, West Point, New York, USA
| | - Paul Goethals
- grid.419884.80000 0001 2287 2270Department of Mathematical Sciences, United States Military Academy, West Point, New York, USA
| | - Kathryn Newhart
- grid.419884.80000 0001 2287 2270Department of Geography & Environmental Engineering, United States Military Academy, West Point, New York, USA
| | - Emily Rhodes
- grid.266900.b0000 0004 0447 0018School of Civil Engineering and Environmental Science, University of Oklahoma, Norman, Oklahoma, USA
| | - Jason Vogel
- grid.266900.b0000 0004 0447 0018School of Civil Engineering and Environmental Science, University of Oklahoma, Norman, Oklahoma, USA
| | - Bradley Stevenson
- grid.266900.b0000 0004 0447 0018Microbiology and Plant Biology, University of Oklahoma, Norman, Oklahoma, USA
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62
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Domínguez D JF, Truong J, Burnett J, Satyen L, Akhlaghi H, Stella J, Rushworth N, Caeyenberghs K. Effects of the Response to the COVID-19 Pandemic on Assault-Related Head Injury in Melbourne: A Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:63. [PMID: 36612383 PMCID: PMC9819794 DOI: 10.3390/ijerph20010063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
Assault is the leading preventable cause of death, traumatic brain injury (TBI), and associated mental health problems. The COVID-19 pandemic has had a profound impact on patterns of interpersonal violence across the world. In this retrospective cross-sectional study, we analysed medical records of 1232 assault victims (domestic violence: 111, random assault: 900, prison assault: 221) with head injuries who presented to the emergency department (ED) at St Vincent's Hospital in Melbourne, Australia, a city with one of the longest and most severe COVID-19 restrictions worldwide. We examined changes in prevalence in the assault group overall and in domestic violence, random assault, and prison assault victims, comparing data from 19.5 months before and after the first day of COVID-19 restrictions in Melbourne. Moreover, we investigated differences driven by demographic factors (Who: age group, sex, and nationality) and clinical variables (Where: assault location, and When: time of arrival to the ED and time from moment of injury until presentation at ED). Descriptive statistics and chi-square analyses were performed. We found the COVID-19 pandemic significantly affected the Where of assault-related TBI, with a shift in the location of assaults from the street to the home, and the increase at home being driven by random assaults on middle-aged adults. Overall, we observed that 86% of the random assault cases were males, whereas 74% of the domestic assault cases were females. Meanwhile, nearly half (44%) of the random assault victims reported alcohol consumption versus a fifth (20%) of domestic violence victims. These findings will have direct implications for developing screening tools and better preventive and ameliorative interventions to manage the sequelae of assault TBI, particularly in the context of future large-scale health crises or emergencies.
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Affiliation(s)
- Juan F Domínguez D
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC 3220, Australia
| | - Johnny Truong
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC 3220, Australia
| | - Jake Burnett
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC 3220, Australia
| | - Lata Satyen
- School of Psychology, Deakin University, Burwood, VIC 3125, Australia
| | - Hamed Akhlaghi
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC 3220, Australia
- Department of Emergency Medicine, St. Vincent’s Hospital, Melbourne, VIC 3065, Australia
| | - Julian Stella
- Department of Emergency Medicine, Geelong Hospital, Geelong, VIC 3220, Australia
| | | | - Karen Caeyenberghs
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC 3220, Australia
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63
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D'Aoust PM, Tian X, Towhid ST, Xiao A, Mercier E, Hegazy N, Jia JJ, Wan S, Kabir MP, Fang W, Fuzzen M, Hasing M, Yang MI, Sun J, Plaza-Diaz J, Zhang Z, Cowan A, Eid W, Stephenson S, Servos MR, Wade MJ, MacKenzie AE, Peng H, Edwards EA, Pang XL, Alm EJ, Graber TE, Delatolla R. Wastewater to clinical case (WC) ratio of COVID-19 identifies insufficient clinical testing, onset of new variants of concern and population immunity in urban communities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 853:158547. [PMID: 36067855 PMCID: PMC9444156 DOI: 10.1016/j.scitotenv.2022.158547] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/10/2022] [Accepted: 09/01/2022] [Indexed: 05/14/2023]
Abstract
Clinical testing has been the cornerstone of public health monitoring and infection control efforts in communities throughout the COVID-19 pandemic. With the anticipated reduction of clinical testing as the disease moves into an endemic state, SARS-CoV-2 wastewater surveillance (WWS) will have greater value as an important diagnostic tool. An in-depth analysis and understanding of the metrics derived from WWS is required to interpret and utilize WWS-acquired data effectively (McClary-Gutierrez et al., 2021; O'Keeffe, 2021). In this study, the SARS-CoV-2 wastewater signal to clinical cases (WC) ratio was investigated across seven cities in Canada over periods ranging from 8 to 21 months. This work demonstrates that significant increases in the WC ratio occurred when clinical testing eligibility was modified to appointment-only testing, identifying a period of insufficient clinical testing (resulting in a reduction to testing access and a reduction in the number of daily tests) in these communities, despite increases in the wastewater signal. Furthermore, the WC ratio decreased significantly in 6 of the 7 studied locations, serving as a potential signal of the emergence of the Alpha variant of concern (VOC) in a relatively non-immunized community (40-60 % allelic proportion), while a more muted decrease in the WC ratio signaled the emergence of the Delta VOC in a relatively well-immunized community (40-60 % allelic proportion). Finally, a significant decrease in the WC ratio signaled the emergence of the Omicron VOC, likely because of the variant's greater effectiveness at evading immunity, leading to a significant number of new reported clinical cases, even when community immunity was high. The WC ratio, used as an additional monitoring metric, could complement clinical case counts and wastewater signals as individual metrics in its potential ability to identify important epidemiological occurrences, adding value to WWS as a diagnostic technology during the COVID-19 pandemic and likely for future pandemics.
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Affiliation(s)
- Patrick M D'Aoust
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada
| | - Xin Tian
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada
| | | | - Amy Xiao
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States of America
| | - Elisabeth Mercier
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada
| | - Nada Hegazy
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada
| | - Jian-Jun Jia
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada
| | - Shen Wan
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada
| | - Md Pervez Kabir
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada
| | - Wanting Fang
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada
| | - Meghan Fuzzen
- Department of Biology, University of Waterloo, Waterloo, Canada
| | - Maria Hasing
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada
| | - Minqing Ivy Yang
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Canada
| | - Jianxian Sun
- Department of Chemistry, University of Toronto, Toronto, Canada
| | - Julio Plaza-Diaz
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Zhihao Zhang
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada
| | - Aaron Cowan
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada
| | - Walaa Eid
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Sean Stephenson
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Mark R Servos
- Department of Biology, University of Waterloo, Waterloo, Canada
| | - Matthew J Wade
- Data, Analytics and Surveillance Group, UK Health Security Agency, London, United Kingdom
| | - Alex E MacKenzie
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Hui Peng
- Department of Chemistry, University of Toronto, Toronto, Canada
| | - Elizabeth A Edwards
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Canada
| | - Xiao-Li Pang
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada
| | - Eric J Alm
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States of America
| | - Tyson E Graber
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Robert Delatolla
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada.
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64
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Cantillon D, Roberts AP. Development and evaluation of TaqMan-based, one-step, real-time RT-PCR assays for pepper mild mottle virus detection for near source tracking and wastewater-based epidemiology validation. PLoS One 2022; 17:e0278784. [PMID: 36534927 PMCID: PMC9762892 DOI: 10.1371/journal.pone.0278784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
Emergence of novel human pathogens pose significant challenges to human health as highlighted by the SARS-CoV-2 pandemic. Wastewater based epidemiology (WBE) has previously been employed to identify viral pathogens and outbreaks by testing samples from regional wastewater treatment plants. Near source tracking (NST) allows for more targeted WBE by analysing samples from individual buildings such as schools or even individual floors such as in multi-floor office buildings. Despite the public health advantages of WBE, few strategies exist for optimising NST sampling methodologies. Therefore, we developed a protocol to evaluate virus detection in NST sampling using Pepper Mild Mottle Virus (PMMoV) as a proxy for RNA viruses. PMMoV is the most abundant enteric human associated RNA virus and is present in peppers/pepper-containing foods. Two bespoke TaqMan RT-PCR assays were developed to detect a PMMoV genomic 5' region and a capsid associated gene. To evaluate the protocol against field samples, pepper homogenates were flushed down an in-use toilet (Liverpool School of Tropical Medicine, UK) to spike wastewater with PMMoV on multiple days, and samples collected from two sewage access points to validate NST samplers. These wastewater samples were assessed for PMMoV based on Ct values and results compared to pepper and Tabasco derived PMMoV positive controls. Positive detection of PMMoV was comparable and consistent in ten independent samples across two NST samplers regardless of pepper homogenate spiking. We have developed two novel one step TaqMan assays that amplify both PMMoV targets in viral RNA extractions from peppers, Tabasco, and wastewater samples with cDNA synthesis through to RT-PCR results taking approximately 30 minutes. Pepper homogenate flushing was not required to detect PMMoV in our wastewater samples, however this strategy of flushing PMMoV containing materials outlined here could be valuable in assessing and validating NST in buildings with no previous or current sewage flow.
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Affiliation(s)
- Daire Cantillon
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- * E-mail:
| | - Adam P. Roberts
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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65
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Verani M, Federigi I, Muzio S, Lauretani G, Calà P, Mancuso F, Salvadori R, Valentini C, La Rosa G, Suffredini E, Carducci A. Calibration of Methods for SARS-CoV-2 Environmental Surveillance: A Case Study from Northwest Tuscany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16588. [PMID: 36554466 PMCID: PMC9778686 DOI: 10.3390/ijerph192416588] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/02/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
The current pandemic has provided an opportunity to test wastewater-based epidemiology (WBE) as a complementary method to SARS-CoV-2 monitoring in the community. However, WBE infection estimates can be affected by uncertainty factors, such as heterogeneity in analytical procedure, wastewater volume, and population size. In this paper, raw sewage SARS-CoV-2 samples were collected from four wastewater treatment plants (WWTPs) in Tuscany (Northwest Italy) between February and December 2021. During the surveillance period, viral concentration was based on polyethylene glycol (PEG), but its precipitation method was modified from biphasic separation to centrifugation. Therefore, in parallel, the recovery efficiency of each method was evaluated at lab-scale, using two spiking viruses (human coronavirus 229E and mengovirus vMC0). SARS-CoV-2 genome was found in 80 (46.5%) of the 172 examined samples. Lab-scale experiments revealed that PEG precipitation using centrifugation had the best recovery efficiency (up to 30%). Viral SARS-CoV-2 load obtained from sewage data, adjusted by analytical method and normalized by population of each WWTP, showed a good association with the clinical data in the study area. This study highlights that environmental surveillance data need to be carefully analyzed before their use in the WBE, also considering the sensibility of the analytical methods.
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Affiliation(s)
- Marco Verani
- Laboratory of Hygiene and Environmental Virology, Department of Biology, University of Pisa, Via S. Zeno 35/39, 56127 Pisa, Italy
| | - Ileana Federigi
- Laboratory of Hygiene and Environmental Virology, Department of Biology, University of Pisa, Via S. Zeno 35/39, 56127 Pisa, Italy
| | - Sara Muzio
- Laboratory of Hygiene and Environmental Virology, Department of Biology, University of Pisa, Via S. Zeno 35/39, 56127 Pisa, Italy
| | - Giulia Lauretani
- Laboratory of Hygiene and Environmental Virology, Department of Biology, University of Pisa, Via S. Zeno 35/39, 56127 Pisa, Italy
| | - Piergiuseppe Calà
- Tuscany Region-Health, Department of Prevention Local Health Authority Tuscany Center, Via S. Salvi 12, 50135 Firenze, Italy
| | - Fabrizio Mancuso
- Ingegnerie Toscane-Area R&D, Via Bellatalla 1, 56121 Pisa, Italy
| | | | | | - Giuseppina La Rosa
- Department of Environment and Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Elisabetta Suffredini
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Annalaura Carducci
- Laboratory of Hygiene and Environmental Virology, Department of Biology, University of Pisa, Via S. Zeno 35/39, 56127 Pisa, Italy
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66
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Amman F, Markt R, Endler L, Hupfauf S, Agerer B, Schedl A, Richter L, Zechmeister M, Bicher M, Heiler G, Triska P, Thornton M, Penz T, Senekowitsch M, Laine J, Keszei Z, Klimek P, Nägele F, Mayr M, Daleiden B, Steinlechner M, Niederstätter H, Heidinger P, Rauch W, Scheffknecht C, Vogl G, Weichlinger G, Wagner AO, Slipko K, Masseron A, Radu E, Allerberger F, Popper N, Bock C, Schmid D, Oberacher H, Kreuzinger N, Insam H, Bergthaler A. Viral variant-resolved wastewater surveillance of SARS-CoV-2 at national scale. Nat Biotechnol 2022; 40:1814-1822. [PMID: 35851376 DOI: 10.1038/s41587-022-01387-y] [Citation(s) in RCA: 74] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 06/07/2022] [Indexed: 01/14/2023]
Abstract
SARS-CoV-2 surveillance by wastewater-based epidemiology is poised to provide a complementary approach to sequencing individual cases. However, robust quantification of variants and de novo detection of emerging variants remains challenging for existing strategies. We deep sequenced 3,413 wastewater samples representing 94 municipal catchments, covering >59% of the population of Austria, from December 2020 to February 2022. Our system of variant quantification in sewage pipeline designed for robustness (termed VaQuERo) enabled us to deduce the spatiotemporal abundance of predefined variants from complex wastewater samples. These results were validated against epidemiological records of >311,000 individual cases. Furthermore, we describe elevated viral genetic diversity during the Delta variant period, provide a framework to predict emerging variants and measure the reproductive advantage of variants of concern by calculating variant-specific reproduction numbers from wastewater. Together, this study demonstrates the power of national-scale WBE to support public health and promises particular value for countries without extensive individual monitoring.
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Affiliation(s)
- Fabian Amman
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria.,Institute of Hygiene and Applied Immunology, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Rudolf Markt
- Department of Microbiology, Universität Innsbruck, Innsbruck, Austria
| | - Lukas Endler
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria.,Institute of Hygiene and Applied Immunology, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Sebastian Hupfauf
- Department of Microbiology, Universität Innsbruck, Innsbruck, Austria
| | - Benedikt Agerer
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Anna Schedl
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria.,Institute of Hygiene and Applied Immunology, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Lukas Richter
- Austrian Agency for Health and Food Safety (AGES), Vienna, Austria
| | | | - Martin Bicher
- dwh GmbH, Vienna, Austria.,Institute for Information Systems Engineering, Technische Universität Wien, Vienna, Austria
| | - Georg Heiler
- Complexity Science Hub, Vienna, Austria.,Institute of Information Systems Engineering, Technische Universität Wien, Vienna, Austria
| | - Petr Triska
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria.,Institute of Hygiene and Applied Immunology, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Matthew Thornton
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria.,Institute of Hygiene and Applied Immunology, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Thomas Penz
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Martin Senekowitsch
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Jan Laine
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Zsofia Keszei
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Peter Klimek
- Complexity Science Hub, Vienna, Austria.,Section for Science of Complex Systems, Medical University of Vienna, Vienna, Austria
| | - Fabiana Nägele
- Department of Microbiology, Universität Innsbruck, Innsbruck, Austria
| | - Markus Mayr
- Department of Microbiology, Universität Innsbruck, Innsbruck, Austria
| | - Beatrice Daleiden
- Institute of Legal Medicine and Core Facility Metabolomics, Medical University of Innsbruck, Innsbruck, Austria
| | - Martin Steinlechner
- Institute of Legal Medicine and Core Facility Metabolomics, Medical University of Innsbruck, Innsbruck, Austria
| | - Harald Niederstätter
- Institute of Legal Medicine and Core Facility Metabolomics, Medical University of Innsbruck, Innsbruck, Austria
| | - Petra Heidinger
- Austrian Centre of Industrial Biotechnology GmbH, Graz, Austria
| | - Wolfgang Rauch
- Department of Infrastructure, Universität Innsbruck, Innsbruck, Austria
| | | | - Gunther Vogl
- Institut für Lebensmittelsicherheit, Veterinärmedizin und Umwelt des Landes Kärnten, Klagenfurt am Wörthersee, Austria
| | - Günther Weichlinger
- Abteilung 12 - Wasserwirtschaft, Amt der Kärntner Landesregierung, Klagenfurt am Wörthersee, Austria
| | | | - Katarzyna Slipko
- Institute for Water Quality and Resource Management, Technische Universität Wien, Vienna, Austria
| | - Amandine Masseron
- Institute for Water Quality and Resource Management, Technische Universität Wien, Vienna, Austria
| | - Elena Radu
- Institute for Water Quality and Resource Management, Technische Universität Wien, Vienna, Austria.,Ştefan S. Nicolau Institute of Virology, Bucharest, Romania
| | | | - Niki Popper
- dwh GmbH, Vienna, Austria.,Institute for Information Systems Engineering, Technische Universität Wien, Vienna, Austria
| | - Christoph Bock
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria.,Institute of Artificial Intelligence, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Daniela Schmid
- Austrian Agency for Health and Food Safety (AGES), Vienna, Austria
| | - Herbert Oberacher
- Institute of Legal Medicine and Core Facility Metabolomics, Medical University of Innsbruck, Innsbruck, Austria
| | - Norbert Kreuzinger
- Institute for Water Quality and Resource Management, Technische Universität Wien, Vienna, Austria
| | - Heribert Insam
- Department of Microbiology, Universität Innsbruck, Innsbruck, Austria
| | - Andreas Bergthaler
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria. .,Institute of Hygiene and Applied Immunology, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
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67
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Fang Z, Roberts AMI, Mayer CD, Frantsuzova A, Potts JM, Cameron GJ, Singleton PTR, Currie I. Wastewater monitoring of COVID-19: a perspective from Scotland. JOURNAL OF WATER AND HEALTH 2022; 20:1688-1700. [PMID: 36573673 DOI: 10.2166/wh.2022.082] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Scotland introduced wastewater monitoring for COVID-19 early in the pandemic. From May 2020, samples have been taken and analysed using quantitative polymerase chain reaction (qPCR). The programme was expanded to over 100 sites accounting for around 80% of the population. Data are presented publicly via a dashboard and regular reports are produced for both the public and health professionals. Wastewater-based epidemiology (WBE) offers opportunities and challenges. It offers an objective means of measuring COVID-19 prevalence and can be more practical or timely than other methods of mass testing. However, it also has substantial variability impacted by multiple environmental factors. Methods for data collection and analysis have developed significantly through the pandemic, reflecting the evolving situation and policy direction. We discuss the Scottish experience of wastewater monitoring for COVID-19, with a focus on the analysis of data. This includes our approach to flow normalisation, our experience of variability in measurements and anomalous values, and the visualisation and presentation of data to stakeholders. Summarising the Scottish methodology as of March 2022, we also discuss how wastewater data were used for informing policy and public health actions. We draw lessons from our experience and consider future directions for WBE in Scotland.
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Affiliation(s)
- Zhou Fang
- Biomathematics & Statistics Scotland, James Clerk Maxwell Building, King's Buildings, Peter Guthrie Tait Road, Edinburgh EH9 3FD, UK E-mail:
| | - Adrian M I Roberts
- Biomathematics & Statistics Scotland, James Clerk Maxwell Building, King's Buildings, Peter Guthrie Tait Road, Edinburgh EH9 3FD, UK E-mail:
| | - Claus-Dieter Mayer
- Biomathematics & Statistics Scotland, James Clerk Maxwell Building, King's Buildings, Peter Guthrie Tait Road, Edinburgh EH9 3FD, UK E-mail:
| | - Anastasia Frantsuzova
- Biomathematics & Statistics Scotland, James Clerk Maxwell Building, King's Buildings, Peter Guthrie Tait Road, Edinburgh EH9 3FD, UK E-mail:
| | - Jackie M Potts
- Biomathematics & Statistics Scotland, James Clerk Maxwell Building, King's Buildings, Peter Guthrie Tait Road, Edinburgh EH9 3FD, UK E-mail:
| | - Graeme J Cameron
- Scottish Environment Protection Agency, Strathallan House, Castle Business Park, Stirling FK9 4TZ, UK
| | - Peter T R Singleton
- Scottish Environment Protection Agency, Strathallan House, Castle Business Park, Stirling FK9 4TZ, UK
| | - Iona Currie
- Scottish Government, Rural and Environment Science and Analytical Services, 5 Atlantic Quay, Atlantic Quay, 150 Broomielaw, Glasgow G28LU, UK
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68
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Silva CS, Tryndyak VP, Camacho L, Orloff MS, Porter A, Garner K, Mullis L, Azevedo M. Temporal dynamics of SARS-CoV-2 genome and detection of variants of concern in wastewater influent from two metropolitan areas in Arkansas. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 849:157546. [PMID: 35914602 PMCID: PMC9338166 DOI: 10.1016/j.scitotenv.2022.157546] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/14/2022] [Accepted: 07/17/2022] [Indexed: 06/15/2023]
Abstract
Although SARS-CoV-2 can cause severe illness and death, a percentage of the infected population is asymptomatic. This, along with other factors, such as insufficient diagnostic testing and underreporting due to self-testing, contributes to the silent transmission of SARS-CoV-2 and highlights the importance of implementing additional surveillance tools. The fecal shedding of the virus from infected individuals enables its detection in community wastewater, and this has become a valuable public health tool worldwide as it allows the monitoring of the disease on a populational scale. Here, we monitored the presence of SARS-CoV-2 and its dynamic genomic changes in wastewater sampled from two metropolitan areas in Arkansas during major surges of COVID-19 cases and assessed how the viral titers in these samples related to the clinical case counts between late April 2020 and January 2022. The levels of SARS-CoV-2 RNA were quantified by reverse-transcription quantitative polymerase chain reaction (RT-qPCR) using a set of TaqMan assays targeting three different viral genes (encoding ORF1ab polyprotein, surface glycoprotein, and nucleocapsid phosphoprotein). An allele-specific RT-qPCR approach was used to screen the samples for SARS-CoV-2 mutations. The identity and genetic diversity of the virus were further investigated through amplicon-based RNA sequencing, and SARS-CoV-2 variants of concern were detected in wastewater samples throughout the duration of this study. Our data show how changes in the virus genome can affect the sensitivity of specific RT-qPCR assays used in COVID-19 testing with the surge of new variants. A significant association was observed between viral titers in wastewater and recorded number of COVID-19 cases in the areas studied, except when assays failed to detect targets due to the presence of particular variants. These findings support the use of wastewater surveillance as a reliable complementary tool for monitoring SARS-CoV-2 and its genetic variants at the community level.
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Affiliation(s)
- Camila S Silva
- Division of Biochemical Toxicology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR, USA.
| | - Volodymyr P Tryndyak
- Division of Biochemical Toxicology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR, USA
| | - Luísa Camacho
- Division of Biochemical Toxicology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR, USA
| | - Mohammed S Orloff
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Center for the Studies of Tobacco, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Austin Porter
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Arkansas Department of Health, Little Rock, AR, USA
| | - Kelley Garner
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Arkansas Department of Health, Little Rock, AR, USA
| | - Lisa Mullis
- Division of Microbiology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR, USA
| | - Marli Azevedo
- Division of Microbiology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR, USA
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69
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Zillien C, Posthuma L, Roex E, Ragas A. The role of the sewer system in estimating urban emissions of chemicals of emerging concern. RE/VIEWS IN ENVIRONMENTAL SCIENCE AND BIO/TECHNOLOGY 2022; 21:957-991. [PMID: 36311376 PMCID: PMC9589831 DOI: 10.1007/s11157-022-09638-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/02/2022] [Indexed: 05/28/2023]
Abstract
UNLABELLED The use of chemicals by society has resulted in calls for more effective control of their emissions. Many of these chemicals are poorly characterized because of lacking data on their use, environmental fate and toxicity, as well as lacking detection techniques. These compounds are sometimes referred to as contaminants of emerging concern (CECs). Urban areas are an important source of CECs, where these are typically first collected in sewer systems and then discharged into the environment after being treated in a wastewater treatment plant. A combination of emission estimation techniques and environmental fate models can support the early identification and management of CEC-related environmental problems. However, scientific insight in the processes driving the fate of CECs in sewer systems is limited and scattered. Biotransformation, sorption and ion-trapping can decrease CEC loads, whereas enzymatic deconjugation of conjugated metabolites can increase CEC loads as metabolites are back-transformed into their parent respective compounds. These fate processes need to be considered when estimating CEC emissions. This literature review collates the fragmented knowledge and data on in-sewer fate of CECs to develop practical guidelines for water managers on how to deal with in-sewer fate of CECs and highlights future research needs. It was assessed to what extent empirical data is in-line with text-book knowledge and integrated sewer modelling approaches. Experimental half-lives (n = 277) of 96 organic CECs were collected from literature. The findings of this literature review can be used to support environmental modelling efforts and to optimize monitoring campaigns, including field studies in the context of wastewater-based epidemiology. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s11157-022-09638-9.
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Affiliation(s)
- Caterina Zillien
- Department of Environmental Science, Radboud University, Nijmegen, The Netherlands
| | - Leo Posthuma
- Department of Environmental Science, Radboud University, Nijmegen, The Netherlands
- Centre for Sustainability, Environment and Health, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Erwin Roex
- Centre for Zoonoses and Environmental Microbiology, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Ad Ragas
- Department of Environmental Science, Radboud University, Nijmegen, The Netherlands
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70
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Kim K, Ban MJ, Kim S, Park MH, Stenstrom MK, Kang JH. Optimal allocation and operation of sewer monitoring sites for wastewater-based disease surveillance: A methodological proposal. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2022; 320:115806. [PMID: 35926387 PMCID: PMC9342910 DOI: 10.1016/j.jenvman.2022.115806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
Wastewater-based epidemiology (WBE) is drawing increasing attention as a promising tool for an early warning of emerging infectious diseases such as COVID-19. This study demonstrated the utility of a spatial bisection method (SBM) and a global optimization algorithm (i.e., genetic algorithm, GA), to support better designing and operating a WBE program for disease surveillance and source identification. The performances of SBM and GA were compared in determining the optimal locations of sewer monitoring manholes to minimize the difference among the effective spatial monitoring scales of the selected manholes. While GA was more flexible in determining the spatial resolution of the monitoring areas, SBM allows stepwise selection of optimal sampling manholes with equiareal subcatchments and lowers computational cost. Upon detecting disease outbreaks at a regular sewer monitoring site, additional manholes within the catchment can be selected and monitored to identify source areas with a required spatial resolution. SBM offered an efficient method for rapidly searching for the optimal locations of additional sampling manholes to identify the source areas. This study provides strategic and technical elements of WBE including sampling site selection with required spatial resolution and a source identification method.
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Affiliation(s)
- Keugtae Kim
- Department of Environmental and Energy Engineering, The University of Suwon, 17 Wauan-gil, Bongdam-eup, Hwaseong-si, Gyeonggi-do, 18323, Republic of Korea
| | - Min Jeong Ban
- Department of Civil and Environmental Engineering, Dongguk University-Seoul, 30, Pildong-ro 1gil, Jung-gu, Seoul, 04620, Republic of Korea
| | - Sungpyo Kim
- Department of Environmental Engineering, Korea University-Sejong, 2 511, Sejong-ro, Sejong City, 30019, Republic of Korea
| | - Mi-Hyun Park
- Department of Civil and Environmental Engineering, Korea Advanced Institute of Science and Technology, 291 Daehak-ro, Yuseong-gu, Daejeon, 34141, Republic of Korea
| | - Michael K Stenstrom
- Department of Civil and Environmental Engineering, University of California, Los Angeles, CA, 90096, USA
| | - Joo-Hyon Kang
- Department of Civil and Environmental Engineering, Dongguk University-Seoul, 30, Pildong-ro 1gil, Jung-gu, Seoul, 04620, Republic of Korea.
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Guerrero-Latorre L, Collado N, Abasolo N, Anzaldi G, Bofill-Mas S, Bosch A, Bosch L, Busquets S, Caimari A, Canela N, Carcereny A, Chacón C, Ciruela P, Corbella I, Domingo X, Escoté X, Espiñeira Y, Forés E, Gandullo-Sarró I, Garcia-Pedemonte D, Girones R, Guix S, Hundesa A, Itarte M, Mariné-Casadó R, Martínez A, Martínez-Puchol S, Mas-Capdevila A, Mejías-Molina C, Rafa MMI, Munné A, Pintó RM, Pueyo-Ros J, Robusté-Cartró J, Rusiñol M, Sanfeliu R, Teichenné J, Torrell H, Corominas L, Borrego CM. The Catalan Surveillance Network of SARS-CoV-2 in Sewage: design, implementation, and performance. Sci Rep 2022; 12:16704. [PMID: 36202959 PMCID: PMC9537440 DOI: 10.1038/s41598-022-20957-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 09/21/2022] [Indexed: 11/09/2022] Open
Abstract
Wastewater-based epidemiology has shown to be an efficient tool to track the circulation of SARS-CoV-2 in communities assisted by wastewater treatment plants (WWTPs). The challenge comes when this approach is employed to help Health authorities in their decision-making. Here, we describe the roadmap for the design and deployment of SARSAIGUA, the Catalan Surveillance Network of SARS-CoV-2 in Sewage. The network monitors, weekly or biweekly, 56 WWTPs evenly distributed across the territory and serving 6 M inhabitants (80% of the Catalan population). Each week, samples from 45 WWTPs are collected, analyzed, results reported to Health authorities, and finally published within less than 72 h in an online dashboard (https://sarsaigua.icra.cat). After 20 months of monitoring (July 20–March 22), the standardized viral load (gene copies/day) in all the WWTPs monitored fairly matched the cumulative number of COVID-19 cases along the successive pandemic waves, showing a good fit with the diagnosed cases in the served municipalities (Spearman Rho = 0.69). Here we describe the roadmap of the design and deployment of SARSAIGUA while providing several open-access tools for the management and visualization of the surveillance data.
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Affiliation(s)
- Laura Guerrero-Latorre
- Catalan Institute for Water Research (ICRA), Emili Grahit 101, 17003, Girona, Catalonia, Spain.,Universitat de Girona, 17003, Girona, Catalonia, Spain
| | - Neus Collado
- Catalan Institute for Water Research (ICRA), Emili Grahit 101, 17003, Girona, Catalonia, Spain.,Universitat de Girona, 17003, Girona, Catalonia, Spain
| | - Nerea Abasolo
- Centre for Omic Sciences (COS), Joint Unit Universitat Rovira i Virgili-EURECAT, Unique Scientific and Technical Infrastructures (ICTS), Eurecat, Centre Tecnològic de Catalunya, Avinguda Universitat 1, 43204, Reus, Catalonia, Spain
| | - Gabriel Anzaldi
- Applied Artificial Intelligence Technological Unit, Eurecat, Centre Tecnològic de Catalunya, Science and Technology Park, H3, 25003, Lleida, Catalonia, Spain
| | - Sílvia Bofill-Mas
- Laboratory of Viruses Contaminants of Water and Food, Department of Genetics, Microbiology and Statistics, School of Biology, University of Barcelona, 08028, Barcelona, Catalonia, Spain
| | - Albert Bosch
- Enteric Virus Laboratory, Section of Microbiology, Virology and Biotechnology, Department of Genetics, Microbiology and Statistics, School of Biology, University of Barcelona, 08028, Barcelona, Catalonia, Spain.,Research Institute of Nutrition and Food Safety (INSA), University of Barcelona, 08921, Santa Coloma de Gramenet, Catalonia, Spain
| | - Lluís Bosch
- Catalan Institute for Water Research (ICRA), Emili Grahit 101, 17003, Girona, Catalonia, Spain.,Universitat de Girona, 17003, Girona, Catalonia, Spain
| | - Sílvia Busquets
- Catalan Institute for Water Research (ICRA), Emili Grahit 101, 17003, Girona, Catalonia, Spain.,Universitat de Girona, 17003, Girona, Catalonia, Spain
| | - Antoni Caimari
- Biotechnology Area, Eurecat, Centre Tecnològic de Catalunya, Avinguda Universitat 1, 43204, Reus, Catalonia, Spain
| | - Núria Canela
- Centre for Omic Sciences (COS), Joint Unit Universitat Rovira i Virgili-EURECAT, Unique Scientific and Technical Infrastructures (ICTS), Eurecat, Centre Tecnològic de Catalunya, Avinguda Universitat 1, 43204, Reus, Catalonia, Spain
| | - Albert Carcereny
- Enteric Virus Laboratory, Section of Microbiology, Virology and Biotechnology, Department of Genetics, Microbiology and Statistics, School of Biology, University of Barcelona, 08028, Barcelona, Catalonia, Spain.,Research Institute of Nutrition and Food Safety (INSA), University of Barcelona, 08921, Santa Coloma de Gramenet, Catalonia, Spain
| | - Carme Chacón
- Public Health Agency of Catalonia (ASPCAT), Roc Boronat 81-95, 08005, Barcelona, Catalonia, Spain
| | - Pilar Ciruela
- Public Health Agency of Catalonia (ASPCAT), Roc Boronat 81-95, 08005, Barcelona, Catalonia, Spain
| | - Irene Corbella
- Public Health Agency of Catalonia (ASPCAT), Roc Boronat 81-95, 08005, Barcelona, Catalonia, Spain
| | - Xavier Domingo
- Applied Artificial Intelligence Technological Unit, Eurecat, Centre Tecnològic de Catalunya, Science and Technology Park, H3, 25003, Lleida, Catalonia, Spain
| | - Xavier Escoté
- Technological Unit of Nutrition and Health, Eurecat, Centre Tecnològic de Catalunya, Avinguda Universitat 1, 43204, Reus, Catalonia, Spain
| | - Yaimara Espiñeira
- Applied Artificial Intelligence Technological Unit, Eurecat, Centre Tecnològic de Catalunya, Science and Technology Park, H3, 25003, Lleida, Catalonia, Spain
| | - Eva Forés
- Laboratory of Viruses Contaminants of Water and Food, Department of Genetics, Microbiology and Statistics, School of Biology, University of Barcelona, 08028, Barcelona, Catalonia, Spain
| | | | - David Garcia-Pedemonte
- Enteric Virus Laboratory, Section of Microbiology, Virology and Biotechnology, Department of Genetics, Microbiology and Statistics, School of Biology, University of Barcelona, 08028, Barcelona, Catalonia, Spain.,Research Institute of Nutrition and Food Safety (INSA), University of Barcelona, 08921, Santa Coloma de Gramenet, Catalonia, Spain
| | - Rosina Girones
- Laboratory of Viruses Contaminants of Water and Food, Department of Genetics, Microbiology and Statistics, School of Biology, University of Barcelona, 08028, Barcelona, Catalonia, Spain
| | - Susana Guix
- Enteric Virus Laboratory, Section of Microbiology, Virology and Biotechnology, Department of Genetics, Microbiology and Statistics, School of Biology, University of Barcelona, 08028, Barcelona, Catalonia, Spain.,Research Institute of Nutrition and Food Safety (INSA), University of Barcelona, 08921, Santa Coloma de Gramenet, Catalonia, Spain
| | - Ayalkibet Hundesa
- Laboratory of Viruses Contaminants of Water and Food, Department of Genetics, Microbiology and Statistics, School of Biology, University of Barcelona, 08028, Barcelona, Catalonia, Spain
| | - Marta Itarte
- Laboratory of Viruses Contaminants of Water and Food, Department of Genetics, Microbiology and Statistics, School of Biology, University of Barcelona, 08028, Barcelona, Catalonia, Spain
| | - Roger Mariné-Casadó
- Technological Unit of Nutrition and Health, Eurecat, Centre Tecnològic de Catalunya, Avinguda Universitat 1, 43204, Reus, Catalonia, Spain
| | - Anna Martínez
- Public Health Agency of Catalonia (ASPCAT), Roc Boronat 81-95, 08005, Barcelona, Catalonia, Spain
| | - Sandra Martínez-Puchol
- Laboratory of Viruses Contaminants of Water and Food, Department of Genetics, Microbiology and Statistics, School of Biology, University of Barcelona, 08028, Barcelona, Catalonia, Spain
| | - Anna Mas-Capdevila
- Technological Unit of Nutrition and Health, Eurecat, Centre Tecnològic de Catalunya, Avinguda Universitat 1, 43204, Reus, Catalonia, Spain
| | - Cristina Mejías-Molina
- Laboratory of Viruses Contaminants of Water and Food, Department of Genetics, Microbiology and Statistics, School of Biology, University of Barcelona, 08028, Barcelona, Catalonia, Spain
| | - Marc Moliner I Rafa
- Catalan Water Agency (ACA), Provença, 260, 08008, Barcelona, Catalonia, Spain
| | - Antoni Munné
- Catalan Water Agency (ACA), Provença, 260, 08008, Barcelona, Catalonia, Spain
| | - Rosa Maria Pintó
- Enteric Virus Laboratory, Section of Microbiology, Virology and Biotechnology, Department of Genetics, Microbiology and Statistics, School of Biology, University of Barcelona, 08028, Barcelona, Catalonia, Spain.,Research Institute of Nutrition and Food Safety (INSA), University of Barcelona, 08921, Santa Coloma de Gramenet, Catalonia, Spain
| | - Josep Pueyo-Ros
- Catalan Institute for Water Research (ICRA), Emili Grahit 101, 17003, Girona, Catalonia, Spain.,Universitat de Girona, 17003, Girona, Catalonia, Spain
| | | | - Marta Rusiñol
- Institute of Environmental Assessment & Water Research (IDAEA), CSIC, Barcelona, Catalonia, Spain
| | - Robert Sanfeliu
- Applied Artificial Intelligence Technological Unit, Eurecat, Centre Tecnològic de Catalunya, Science and Technology Park, H3, 25003, Lleida, Catalonia, Spain
| | - Joan Teichenné
- Technological Unit of Nutrition and Health, Eurecat, Centre Tecnològic de Catalunya, Avinguda Universitat 1, 43204, Reus, Catalonia, Spain
| | - Helena Torrell
- Centre for Omic Sciences (COS), Joint Unit Universitat Rovira i Virgili-EURECAT, Unique Scientific and Technical Infrastructures (ICTS), Eurecat, Centre Tecnològic de Catalunya, Avinguda Universitat 1, 43204, Reus, Catalonia, Spain
| | - Lluís Corominas
- Catalan Institute for Water Research (ICRA), Emili Grahit 101, 17003, Girona, Catalonia, Spain.,Universitat de Girona, 17003, Girona, Catalonia, Spain
| | - Carles M Borrego
- Catalan Institute for Water Research (ICRA), Emili Grahit 101, 17003, Girona, Catalonia, Spain. .,Group of Molecular Microbial Ecology, Institute of Aquatic Ecology, University of Girona, 17003, Girona, Catalonia, Spain.
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Wang JX, Wu Z, Wang H, Zhong M, Mao Y, Li Y, Wang M, Yao S. Ventilation reconstruction in bathrooms for restraining hazardous plume: Mitigate COVID-19 and beyond. JOURNAL OF HAZARDOUS MATERIALS 2022; 439:129697. [PMID: 36104926 PMCID: PMC9335364 DOI: 10.1016/j.jhazmat.2022.129697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/11/2022] [Accepted: 07/27/2022] [Indexed: 05/20/2023]
Abstract
Converging evidence reports that the probability of vertical transmission patterns via shared drainage systems, may be responsible for the huge contactless community outbreak in high-rise buildings. Publications indicate that a faulty bathroom exhaust fan system is ineffective in removing lifted hazardous virus-laden aerosols from the toilet bowl space. Common strategies (boosting ventilation capability and applying disinfection tablets) seem unsustainable and remain to date untested. Using combined simulation and experimental approaches, we compared three ventilation schemes in a family bathroom including the traditional ceiling fan, floor fan, and side-wall fan. We found that the traditional ceiling fan was barely functional whereby aerosol particles were not being adequately removed. Conversely, a side-wall fan could function efficiently and an enhanced ventilation capability can have increased performance whereby nearly 80.9% of the lifted aerosol particles were removed. There exists a common, and easily-overlooked mistake in the layout of the bathroom, exposing occupants to a contactless vertical pathogen aerosol transmission route. Corrections and dissemination are thus imperative for the reconstruction of these types of family bathrooms. Our findings provide evidence for the bathroom and smart ventilation system upgrade, promoting indoor public health and human hygiene.
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Affiliation(s)
- Ji-Xiang Wang
- College of Electrical, Energy and Power Engineering, Yangzhou University, Yangzhou 225009, PR China; Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, PR China.
| | - Zhe Wu
- College of Electrical, Energy and Power Engineering, Yangzhou University, Yangzhou 225009, PR China
| | - Hongmei Wang
- College of Electrical, Energy and Power Engineering, Yangzhou University, Yangzhou 225009, PR China
| | - Mingliang Zhong
- Institute of Optics and Electronics, Chinese Academy of Sciences, Chengdu 610209, PR China
| | - Yufeng Mao
- Institute of Optics and Electronics, Chinese Academy of Sciences, Chengdu 610209, PR China
| | - Yunyun Li
- School of Energy and Environment, Southeast University, Nanjing 210096, PR China
| | - Mengxiao Wang
- Department of Traditional Chinese Medicine, Tianjin Medical University General Hospital, Tianjin 300052, PR China
| | - Shuhuai Yao
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, PR China; Department of Chemical and Biological Engineering, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, PR China.
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73
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Kamran A, Salman M, Siddiqui R, Shabbir NZ, Rohail S, Sukaina M. Detection of vaccine-derived poliovirus type 2 amid the burden of infectious diseases in the UK: A cause for alarm. Ann Med Surg (Lond) 2022; 82:104773. [PMID: 36164645 PMCID: PMC9492381 DOI: 10.1016/j.amsu.2022.104773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/19/2022] [Indexed: 11/29/2022] Open
Abstract
The re-emergence of polio in the UK reminds us that the global threat of polio remains. Viruses know no bounds or borders. COVID-19, Monkeypox, and polio are evidence of this. Poliomyelitis was once the leading cause of death and paralysis in the UK and globally. With the introduction of vaccines during the 1950s–1960s, polio was eradicated from most developed countries, including the UK. The last case of wild polio was in 1984, and the UK was polio-free in 2003. The recent detection of vaccine-derived poliovirus type 2 in London sewage samples is alarming. Routine inoculations were adversely affected due to COVID-19, and UK's wastewater monitoring program was suspended due to economic restrictions. The UK faces several challenges with the burden of COVID-19, Monkeypox, and the return of polio could further burden the already pandemic-stricken healthcare system. To prevent further epidemics in the UK, wastewater sampling remains crucial in evaluating, searching, and eradicating the spread of poliovirus. Further epidemiological surveillance in adjacent areas to the Beckton plant is crucial to filling any gaps in understanding the outbreak's extent and guiding the initiation of appropriate and timely public health measures. The importance of vaccination in unvaccinated or incompletely vaccinated individuals cannot be overstated, especially in areas where vaccination rates are low. The risk of polio remains globally until its complete eradication from endemic countries. Until elimination, a global effort should be made to minimize the risk and the consequent spread of poliovirus by maintaining strong population immunity levels through high vaccination coverage.
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74
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Guo Y, Li X, Luby S, Jiang G. Vertical outbreak of COVID-19 in high-rise buildings: The role of sewer stacks and prevention measures. CURRENT OPINION IN ENVIRONMENTAL SCIENCE & HEALTH 2022; 29:100379. [PMID: 35856009 PMCID: PMC9279164 DOI: 10.1016/j.coesh.2022.100379] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 05/25/2023]
Abstract
COVID-19 outbreaks in high-rise buildings suggested the transmission route of fecal-aerosol-inhalation due to the involvement of viral aerosols in sewer stacks. The vertical transmission is likely due to the failure of water traps that allow viral aerosols to spread through sewer stacks. This process can be further facilitated by the chimney effect in vent stack, extract ventilation in bathrooms, or wind-induced air pressure fluctuations. To eliminate the risk of such vertical disease spread, the installation of protective devices is highly encouraged in high-rise buildings. Although the mechanism of vertical pathogen spread through drainage pipeline has been illustrated by tracer gas or microbial experiments and numerical modeling, more research is needed to support the update of regulatory and design standards for sewerage facilities.
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Affiliation(s)
- Ying Guo
- School of Civil, Mining, Environmental and Architectural Engineering, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Xuan Li
- School of Civil, Mining, Environmental and Architectural Engineering, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Stephen Luby
- Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA 94305, USA
| | - Guangming Jiang
- School of Civil, Mining, Environmental and Architectural Engineering, University of Wollongong, Wollongong, NSW 2522, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia
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75
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Joshi M, Kumar M, Srivastava V, Kumar D, Rathore DS, Pandit R, Graham DW, Joshi CG. Genetic sequencing detected the SARS-CoV-2 delta variant in wastewater a month prior to the first COVID-19 case in Ahmedabad (India). ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 310:119757. [PMID: 35853573 PMCID: PMC9287018 DOI: 10.1016/j.envpol.2022.119757] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/22/2022] [Accepted: 07/08/2022] [Indexed: 05/23/2023]
Abstract
Wastewater-based genomic surveillance can identify a huge majority of variants shed by the infected individuals within a population, which goes beyond genomic surveillance based on clinical samples (i.e., symptomatic patients only). We analyzed four samples to detect key mutations in the SARS-CoV-2 genome and track circulating variants in Ahmedabad during the first wave (Sep/Nov 2020) and before the second wave (in Feb 2021) of COVID-19 in India. The analysis identified a total of 34 mutations in the spike protein across samples categorized into 23 types. The spike protein mutations were linked to the VOC-21APR-02; B.1.617.2 lineage (Delta variant) with 57% frequency in wastewater samples of Feb 2021. The key spike protein mutations were T19R, L452R, T478K, D614G, & P681R and deletions at 22029 (6 bp), 28248 (6 bp), & 28271 (1 bp). Interestingly, these mutations were not seen in the samples from Sep/Nov 2020 but did appear before the massive second wave of COVID-19 cases, which in India started in early April 2021. In fact, genetic traces of the Delta variant were found in samples of early Feb 2021, more than a month before the first clinically confirmed case of this in March 2021 in Ahmedabad, Gujarat. The present work describes the circulating of SARS-CoV-2 variants in Ahmedabad and confirms the consequential value of wastewater surveillance for the early detection of variants of concerns (VOCs). Such monitoring must be included as a major component of future health protection systems.
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Affiliation(s)
- Madhvi Joshi
- Gujarat Biotechnology Research Centre (GBRC), Sector- 11, Gandhinagar, Gujarat, 382 011, India
| | - Manish Kumar
- Discipline of Earth Science, Indian Institute of Technology Gandhinagar, Gujarat, 382 355, India; Sustainability Cluster, School of Engineering, University of Petroleum & Energy Studies, Dehradun, Uttarakhand, 248007, India.
| | - Vaibhav Srivastava
- Sustainability Cluster, School of Engineering, University of Petroleum & Energy Studies, Dehradun, Uttarakhand, 248007, India
| | - Dinesh Kumar
- Gujarat Biotechnology Research Centre (GBRC), Sector- 11, Gandhinagar, Gujarat, 382 011, India
| | - Dalip Singh Rathore
- Gujarat Biotechnology Research Centre (GBRC), Sector- 11, Gandhinagar, Gujarat, 382 011, India
| | - Ramesh Pandit
- Gujarat Biotechnology Research Centre (GBRC), Sector- 11, Gandhinagar, Gujarat, 382 011, India
| | - David W Graham
- Newcastle University, School of Engineering, Cassie Building, Newcastle-upon-Tyne, NE1 7RU, UK
| | - Chaitanya G Joshi
- Gujarat Biotechnology Research Centre (GBRC), Sector- 11, Gandhinagar, Gujarat, 382 011, India.
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76
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Kevill JL, Lambert-Slosarska K, Pellett C, Woodhall N, Richardson-O'Neill I, Pântea I, Alex-Sanders N, Farkas K, Jones DL. Assessment of two types of passive sampler for the efficient recovery of SARS-CoV-2 and other viruses from wastewater. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:156580. [PMID: 35690190 PMCID: PMC9181630 DOI: 10.1016/j.scitotenv.2022.156580] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/16/2022] [Accepted: 06/05/2022] [Indexed: 05/26/2023]
Abstract
Wastewater-based epidemiology (WBE) has proven to be a useful surveillance tool during the ongoing SARS-CoV-2 pandemic, and has driven research into evaluating the most reliable and cost-effective techniques for obtaining a representative sample of wastewater. When liquid samples cannot be taken efficiently, passive sampling approaches have been used, however, insufficient data exists on their usefulness for multi-virus capture and recovery. In this study, we compared the virus-binding capacity of two passive samplers (cotton-based tampons and ion exchange filter papers) in two different water types (deionised water and wastewater). Here we focused on the capture of wastewater-associated viruses including Influenza A and B (Flu-A & B), SARS-CoV-2, human adenovirus (AdV), norovirus GII (NoVGII), measles virus (MeV), pepper mild mottle virus (PMMoV), the faecal marker crAssphage and the process control virus Pseudomonas virus phi6. After deployment, we evaluated four different methods to recover viruses from the passive samplers namely, (i) phosphate buffered saline (PBS) elution followed by polyethylene glycol (PEG) precipitation, (ii) beef extract (BE) elution followed by PEG precipitation, (iii) no-elution into PEG precipitation, and (iv) direct extraction. We found that the tampon-based passive samplers had higher viral recoveries in comparison to the filter paper. Overall, the preferred viral recovery method from the tampon passive samplers was the no-elution/PEG precipitation method. Furthermore, we evidenced that non-enveloped viruses had higher percent recoveries from the passive samplers than enveloped viruses. This is the first study of its kind to assess passive sampler and viral recovery methods amongst a plethora of viruses commonly found in wastewater or used as a viral surrogate in wastewater studies.
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Affiliation(s)
- Jessica L Kevill
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK.
| | - Kathryn Lambert-Slosarska
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK
| | - Cameron Pellett
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK
| | - Nick Woodhall
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK
| | - India Richardson-O'Neill
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK
| | - Igor Pântea
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK
| | - Natasha Alex-Sanders
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK
| | - Kata Farkas
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK; School of Ocean Sciences, Bangor University, Menai Bridge, Anglesey LL59 5AB, UK
| | - Davey L Jones
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK; Food Futures Institute, Murdoch University, 90 South Street, Murdoch, WA 6105, Australia
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77
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Robins K, Leonard AFC, Farkas K, Graham DW, Jones DL, Kasprzyk-Hordern B, Bunce JT, Grimsley JMS, Wade MJ, Zealand AM, McIntyre-Nolan S. Research needs for optimising wastewater-based epidemiology monitoring for public health protection. JOURNAL OF WATER AND HEALTH 2022; 20:1284-1313. [PMID: 36170187 DOI: 10.2166/wh.2022.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Wastewater-based epidemiology (WBE) is an unobtrusive method used to observe patterns in illicit drug use, poliovirus, and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The pandemic and need for surveillance measures have led to the rapid acceleration of WBE research and development globally. With the infrastructure available to monitor SARS-CoV-2 from wastewater in 58 countries globally, there is potential to expand targets and applications for public health protection, such as other viral pathogens, antimicrobial resistance (AMR), pharmaceutical consumption, or exposure to chemical pollutants. Some applications have been explored in academic research but are not used to inform public health decision-making. We reflect on the current knowledge of WBE for these applications and identify barriers and opportunities for expanding beyond SARS-CoV-2. This paper critically reviews the applications of WBE for public health and identifies the important research gaps for WBE to be a useful tool in public health. It considers possible uses for pathogenic viruses, AMR, and chemicals. It summarises the current evidence on the following: (1) the presence of markers in stool and urine; (2) environmental factors influencing persistence of markers in wastewater; (3) methods for sample collection and storage; (4) prospective methods for detection and quantification; (5) reducing uncertainties; and (6) further considerations for public health use.
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Affiliation(s)
- Katie Robins
- Environmental Monitoring for Health Protection, UK Health Security Agency, Nobel House, London SW1P 3HX, UK E-mail: ; School of Engineering, Newcastle University, Cassie Building, Newcastle-upon-Tyne NE1 7RU, UK
| | - Anne F C Leonard
- Environmental Monitoring for Health Protection, UK Health Security Agency, Nobel House, London SW1P 3HX, UK E-mail: ; University of Exeter Medical School, European Centre for Environment and Human Health, University of Exeter, Cornwall TR10 9FE, UK
| | - Kata Farkas
- School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK
| | - David W Graham
- School of Engineering, Newcastle University, Cassie Building, Newcastle-upon-Tyne NE1 7RU, UK
| | - David L Jones
- School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK; SoilsWest, Centre for Sustainable Farming Systems, Food Futures Institute, Murdoch University, Murdoch, WA 6105, Australia
| | | | - Joshua T Bunce
- Environmental Monitoring for Health Protection, UK Health Security Agency, Nobel House, London SW1P 3HX, UK E-mail: ; School of Engineering, Newcastle University, Cassie Building, Newcastle-upon-Tyne NE1 7RU, UK
| | - Jasmine M S Grimsley
- Environmental Monitoring for Health Protection, UK Health Security Agency, Nobel House, London SW1P 3HX, UK E-mail:
| | - Matthew J Wade
- Environmental Monitoring for Health Protection, UK Health Security Agency, Nobel House, London SW1P 3HX, UK E-mail: ; School of Engineering, Newcastle University, Cassie Building, Newcastle-upon-Tyne NE1 7RU, UK
| | - Andrew M Zealand
- Environmental Monitoring for Health Protection, UK Health Security Agency, Nobel House, London SW1P 3HX, UK E-mail:
| | - Shannon McIntyre-Nolan
- Environmental Monitoring for Health Protection, UK Health Security Agency, Nobel House, London SW1P 3HX, UK E-mail: ; Her Majesty's Prison and Probation Service, Ministry of Justice, London, SW1H 9AJ, UK
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78
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Mac Mahon J, Criado Monleon AJ, Gill LW, O'Sullivan JJ, Meijer WG. Wastewater-based epidemiology (WBE) for SARS-CoV-2 - A review focussing on the significance of the sewer network using a Dublin city catchment case study. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2022; 86:1402-1425. [PMID: 36178814 DOI: 10.2166/wst.2022.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Wastewater-based epidemiology (WBE) has been employed by many countries globally since the beginning of the COVID-19 pandemic in order to assess the benefits of this surveillance tool in the context of informing public health measures. WBE has been successfully employed to detect SARS-CoV-2 at wastewater treatment plants for community-wide surveillance, as well as in smaller catchments and institutions for targeted surveillance of COVID-19. In addition, WBE has been successfully used to detect new variants, identify areas of high infection levels, as well as to detect new infection outbreaks. However, due to to the large number of inherent uncertainties in the WBE process, including the inherent intricacies of the sewer network, decay of the virus en route to a monitoring point, levels of recovery from sampling and quantification methods, levels of faecal shedding among the infected population, as well as population normalisation methods, the usefulness of wastewater samples as a means of accurately quantifying SARS-CoV-2 infection levels among a population remains less clear. The current WBE programmes in place globally will help to identify new areas of research aimed at reducing the levels of uncertainty in the WBE process, thus improving WBE as a public health monitoring tool for future pandemics. In the meantime, such programmes can provide valuable comparisons to clinical testing data and other public health metrics, as well being an effective early warning tool for new variants and new infection outbreaks. This review includes a case study of sampled wastewater from the sewer network in Dublin, Ireland, during a peak infection period of COVID-19 in the city, which evaluates the different uncertainties in the WBE process.
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Affiliation(s)
| | | | | | - John J O'Sullivan
- UCD School of Civil Engineering, UCD Dooge Centre for Water Resources Research and UCD Earth Institute, University College Dublin
| | - Wim G Meijer
- UCD School of Biomolecular & Biomedical Science, UCD Earth Institute and UCD Conway Institute, University College Dublin
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79
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Robins PE, Dickson N, Kevill JL, Malham SK, Singer AC, Quilliam RS, Jones DL. Predicting the dispersal of SARS-CoV-2 RNA from the wastewater treatment plant to the coast. Heliyon 2022; 8:e10547. [PMID: 36091966 PMCID: PMC9448708 DOI: 10.1016/j.heliyon.2022.e10547] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/22/2022] [Accepted: 09/01/2022] [Indexed: 11/28/2022] Open
Abstract
Viral pathogens including SARS-CoV-2 RNA have been detected in wastewater treatment effluent, and untreated sewage overflows, that pose an exposure hazard to humans. We assessed whether SARS-CoV-2 RNA was likely to have been present in detectable quantities in UK rivers and estuaries during the first wave of the Covid-19 pandemic. We simulated realistic viral concentrations parameterised on the Camel and Conwy catchments (UK) and their populations, showing detectable SARS-CoV-2 RNA concentrations for untreated but not for treated loading, but also being contingent on viral decay, hydrology, catchment type/shape, and location. Under mean or low river flow conditions, viral RNA concentrated within the estuaries allowing for viral build-up and caused a lag by up to several weeks between the peak in community infections and the viral peak in the environment. There was an increased hazard posed by SARS-CoV-2 RNA with a T90 decay rate >24 h, as the estuarine build-up effect increased. High discharge events transported the viral RNA downstream and offshore, increasing the exposure risk to coastal bathing waters and shellfisheries – although dilution in this case reduced viral concentrations well below detectable levels. Our results highlight the sensitivity of exposure to viral pathogens downstream of wastewater treatment, across a range of viral loadings and catchment characteristics – with implications to environmental surveillance. SARS-CoV-2 RNA from treated sewage unlikely to be detectable in estuaries. SARS-CoV-2 RNA from untreated sewage can be detectable in estuaries. Peak RNA concentration in estuaries can be delayed from peak community infection. RNA concentration is sensitive to viral loading, decay, hydrology, and estuary shape.
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Affiliation(s)
- Peter E. Robins
- School of Ocean Sciences, Bangor University, Menai Bridge, Anglesey LL59 5AB, UK
- Corresponding author.
| | - Neil Dickson
- School of Ocean Sciences, Bangor University, Menai Bridge, Anglesey LL59 5AB, UK
| | - Jessica L. Kevill
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK
| | - Shelagh K. Malham
- School of Ocean Sciences, Bangor University, Menai Bridge, Anglesey LL59 5AB, UK
| | | | - Richard S. Quilliam
- Biological and Environmental Sciences, Faculty of Natural Sciences, University of Stirling, Stirling FK9 4LA, UK
| | - Davey L. Jones
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK
- Food Futures Institute, Murdoch University, 90 South Street, Murdoch, WA 6105, Australia
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80
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Farkas K, Pellett C, Alex-Sanders N, Bridgman MTP, Corbishley A, Grimsley JMS, Kasprzyk-Hordern B, Kevill JL, Pântea I, Richardson-O’Neill IS, Lambert-Slosarska K, Woodhall N, Jones DL. Comparative Assessment of Filtration- and Precipitation-Based Methods for the Concentration of SARS-CoV-2 and Other Viruses from Wastewater. Microbiol Spectr 2022; 10:e0110222. [PMID: 35950856 PMCID: PMC9430619 DOI: 10.1128/spectrum.01102-22] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/19/2022] [Indexed: 12/24/2022] Open
Abstract
Wastewater-based epidemiology (WBE) has been widely used to track levels of SARS-CoV-2 infection in the community during the COVID-19 pandemic. Due to the rapid expansion of WBE, many methods have been used and developed for virus concentration and detection in wastewater. However, very little information is available on the relative performance of these approaches. In this study, we compared the performance of five commonly used wastewater concentration methods for the detection and quantification of pathogenic viruses (SARS-CoV-2, norovirus, rotavirus, influenza, and measles viruses), fecal indicator viruses (crAssphage, adenovirus, pepper mild mottle virus), and process control viruses (murine norovirus and bacteriophage Phi6) in laboratory spiking experiments. The methods evaluated included those based on either ultrafiltration (Amicon centrifugation units and InnovaPrep device) or precipitation (using polyethylene glycol [PEG], beef extract-enhanced PEG, and ammonium sulfate). The two best methods were further tested on 115 unspiked wastewater samples. We found that the volume and composition of the wastewater and the characteristics of the target viruses greatly affected virus recovery, regardless of the method used for concentration. All tested methods are suitable for routine virus concentration; however, the Amicon ultrafiltration method and the beef extract-enhanced PEG precipitation methods yielded the best recoveries. We recommend the use of ultrafiltration-based concentration for low sample volumes with high virus titers and ammonium levels and the use of precipitation-based concentration for rare pathogen detection in high-volume samples. IMPORTANCE As wastewater-based epidemiology is utilized for the surveillance of COVID-19 at the community level in many countries, it is crucial to develop and validate reliable methods for virus detection in sewage. The most important step in viral detection is the efficient concentration of the virus particles and/or their genome for subsequent analysis. In this study, we compared five different methods for the detection and quantification of different viruses in wastewater. We found that dead-end ultrafiltration and beef extract-enhanced polyethylene glycol precipitation were the most reliable approaches. We also discovered that sample volume and physico-chemical properties have a great effect on virus recovery. Hence, wastewater process methods and start volumes should be carefully selected in ongoing and future wastewater-based national surveillance programs for COVID-19 and beyond.
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Affiliation(s)
- Kata Farkas
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd, United Kingdom
- School of Ocean Sciences, Bangor University, Anglesey, United Kingdom
| | - Cameron Pellett
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd, United Kingdom
| | - Natasha Alex-Sanders
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd, United Kingdom
| | - Matthew T. P. Bridgman
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd, United Kingdom
| | - Alexander Corbishley
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Roslin, United Kingdom
| | - Jasmine M. S. Grimsley
- UK Health Security Agency, Environmental Monitoring for Health Protection, London, United Kingdom
| | | | - Jessica L. Kevill
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd, United Kingdom
| | - Igor Pântea
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd, United Kingdom
| | - India S. Richardson-O’Neill
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd, United Kingdom
| | - Kathryn Lambert-Slosarska
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd, United Kingdom
| | - Nick Woodhall
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd, United Kingdom
| | - Davey L. Jones
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd, United Kingdom
- Food Futures Institute, Murdoch University, Murdoch, Western Australia, Australia
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81
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Faraway J, Boxall-Clasby J, Feil EJ, Gibbon MJ, Hatfield O, Kasprzyk-Hordern B, Smith T. Challenges in realising the potential of wastewater-based epidemiology to quantitatively monitor and predict the spread of disease. JOURNAL OF WATER AND HEALTH 2022; 20:1038-1050. [PMID: 35902986 DOI: 10.2166/wh.2022.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Researchers around the world have demonstrated correlations between measurements of SARS-CoV-2 RNA in wastewater (WW) and case rates of COVID-19 derived from direct testing of individuals. This has raised concerns that wastewater-based epidemiology (WBE) methods might be used to quantify the spread of this and other diseases, perhaps faster than direct testing, and with less expense and intrusion. We illustrate, using data from Scotland and the USA, the issues regarding the construction of effective predictive models for disease case rates. We discuss the effects of variation in, and the problem of aligning, public health (PH) reporting and WW measurements. We investigate time-varying effects in PH-reported case rates and their relationship to WW measurements. We show the lack of proportionality of WW measurements to case rates with associated spatial heterogeneity. We illustrate how the precision of predictions is affected by the level of aggregation chosen. We determine whether PH or WW measurements are the leading indicators of disease and how they may be used in conjunction to produce predictive models. The prospects of using WW-based predictive models with or without ongoing PH data are discussed.
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Affiliation(s)
- Julian Faraway
- Department of Mathematical Sciences, University of Bath, Bath BA2 7AY, UK E-mail:
| | | | - Edward J Feil
- Department of Biology and Biochemistry, University of Bath, Bath BA2 7AY, UK
| | - Marjorie J Gibbon
- Department of Biology and Biochemistry, University of Bath, Bath BA2 7AY, UK
| | - Oliver Hatfield
- Institute for Mathematical Innovation, University of Bath, Bath BA2 7AY, UK
| | | | - Theresa Smith
- Department of Mathematical Sciences, University of Bath, Bath BA2 7AY, UK E-mail:
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Wu F, Lee WL, Chen H, Gu X, Chandra F, Armas F, Xiao A, Leifels M, Rhode SF, Wuertz S, Thompson J, Alm EJ. Making waves: Wastewater surveillance of SARS-CoV-2 in an endemic future. WATER RESEARCH 2022; 219:118535. [PMID: 35605390 PMCID: PMC9062764 DOI: 10.1016/j.watres.2022.118535] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/29/2022] [Accepted: 04/30/2022] [Indexed: 05/28/2023]
Abstract
Wastewater-based surveillance (WBS) has been widely used as a public health tool to monitor the emergence and spread of SARS-CoV-2 infections in populations during the COVID-19 pandemic. Coincident with the global vaccination efforts, the world is also enduring new waves of SARS-CoV-2 variants. Reinfections and vaccine breakthroughs suggest an endemic future where SARS-CoV-2 continues to persist in the general population. In this treatise, we aim to explore the future roles of wastewater surveillance. Practically, WBS serves as a relatively affordable and non-invasive tool for mass surveillance of SARS-CoV-2 infection while minimizing privacy concerns, attributes that make it extremely suited for its long-term usage. In an endemic future, the utility of WBS will include 1) monitoring the trend of viral loads of targets in wastewater for quantitative estimate of changes in disease incidence; 2) sampling upstream for pinpointing infections in neighborhoods and at the building level; 3) integrating wastewater and clinical surveillance for cost-efficient population surveillance; and 4) genome sequencing wastewater samples to track circulating and emerging variants in the population. We further discuss the challenges and future developments of WBS to reduce inconsistencies in wastewater data worldwide, improve its epidemiological inference, and advance viral tracking and discovery as a preparation for the next viral pandemic.
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Affiliation(s)
- Fuqing Wu
- Center for Infectious Disease, Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health, Houston, TX, USA.
| | - Wei Lin Lee
- Antimicrobial Resistance Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Hongjie Chen
- Antimicrobial Resistance Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Xiaoqiong Gu
- Antimicrobial Resistance Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Franciscus Chandra
- Antimicrobial Resistance Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Federica Armas
- Antimicrobial Resistance Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Amy Xiao
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA; Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Mats Leifels
- Singapore Centre for Environmental Life Sciences Engineering, Nanyang Technological University, Singapore
| | | | - Stefan Wuertz
- Campus for Research Excellence and Technological Enterprise (CREATE), Singapore; Singapore Centre for Environmental Life Sciences Engineering, Nanyang Technological University, Singapore; School of Civil and Environmental Engineering, Nanyang Technological University, Singapore
| | - Janelle Thompson
- Campus for Research Excellence and Technological Enterprise (CREATE), Singapore; Singapore Centre for Environmental Life Sciences Engineering, Nanyang Technological University, Singapore; Asian School of the Environment, Nanyang Technological University, Singapore
| | - Eric J Alm
- Antimicrobial Resistance Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore; Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA; Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology, Cambridge, MA, USA; Broad Institute of MIT and Harvard, Cambridge, MA, USA.
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83
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Castro-Gutierrez V, Hassard F, Vu M, Leitao R, Burczynska B, Wildeboer D, Stanton I, Rahimzadeh S, Baio G, Garelick H, Hofman J, Kasprzyk-Hordern B, Kwiatkowska R, Majeed A, Priest S, Grimsley J, Lundy L, Singer AC, Di Cesare M. Monitoring occurrence of SARS-CoV-2 in school populations: A wastewater-based approach. PLoS One 2022; 17:e0270168. [PMID: 35714109 PMCID: PMC9205509 DOI: 10.1371/journal.pone.0270168] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/03/2022] [Indexed: 01/12/2023] Open
Abstract
Clinical testing of children in schools is challenging, with economic implications limiting its frequent use as a monitoring tool of the risks assumed by children and staff during the COVID-19 pandemic. Here, a wastewater-based epidemiology approach has been used to monitor 16 schools (10 primary, 5 secondary and 1 post-16 and further education) in England. A total of 296 samples over 9 weeks have been analysed for N1 and E genes using qPCR methods. Of the samples returned, 47.3% were positive for one or both genes with a detection frequency in line with the respective local community. WBE offers a low cost, non-invasive approach for supplementing clinical testing and can provide longitudinal insights that are impractical with traditional clinical testing.
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Affiliation(s)
- Victor Castro-Gutierrez
- Cranfield University, Bedfordshire, United Kingdom
- Environmental Pollution Research Center (CICA), University of Costa Rica, Montes de Oca, Costa Rica
| | | | - Milan Vu
- Department of Natural Science, School of Science and Technology, Middlesex University, London, United Kingdom
| | - Rodrigo Leitao
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Beata Burczynska
- Department of Natural Science, School of Science and Technology, Middlesex University, London, United Kingdom
| | - Dirk Wildeboer
- Department of Natural Science, School of Science and Technology, Middlesex University, London, United Kingdom
| | - Isobel Stanton
- UK Centre for Ecology and Hydrology, Wallingford, United Kingdom
| | - Shadi Rahimzadeh
- Department of Natural Science, School of Science and Technology, Middlesex University, London, United Kingdom
| | - Gianluca Baio
- Department of Statistical Science, University College London, London, United Kingdom
| | - Hemda Garelick
- Department of Natural Science, School of Science and Technology, Middlesex University, London, United Kingdom
| | - Jan Hofman
- Water Innovation & Research Centre, Department of Chemical Engineering, University of Bath, Bath, United Kingdom
| | - Barbara Kasprzyk-Hordern
- Water Innovation & Research Centre, Department of Chemistry, University of Bath, Bath, United Kingdom
| | - Rachel Kwiatkowska
- School of Population Health Sciences, University of Bristol, Bristol, United Kingdom
- Field Services, National Infection Service, Public Health England, London, United Kingdom
| | - Azeem Majeed
- Department of Primary Care & Public Health, Imperial College Faculty of Medicine, London, United Kingdom
| | - Sally Priest
- Department of Natural Science, School of Science and Technology, Middlesex University, London, United Kingdom
| | - Jasmine Grimsley
- Joint Biosecurity Centre, Department for Health and Social Care, London, United Kingdom
| | - Lian Lundy
- Department of Natural Science, School of Science and Technology, Middlesex University, London, United Kingdom
| | - Andrew C. Singer
- UK Centre for Ecology and Hydrology, Wallingford, United Kingdom
| | - Mariachiara Di Cesare
- Institute of Public Health and Wellbeing, University of Essex, Colchester, United Kingdom
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84
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Bar-Or I, Indenbaum V, Weil M, Elul M, Levi N, Aguvaev I, Cohen Z, Levy V, Azar R, Mannasse B, Shirazi R, Bucris E, Mor O, Sela Brown A, Sofer D, Zuckerman NS, Mendelson E, Erster O. National Scale Real-Time Surveillance of SARS-CoV-2 Variants Dynamics by Wastewater Monitoring in Israel. Viruses 2022; 14:1229. [PMID: 35746700 PMCID: PMC9227326 DOI: 10.3390/v14061229] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/23/2022] [Accepted: 05/23/2022] [Indexed: 02/04/2023] Open
Abstract
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.
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Affiliation(s)
- Itay Bar-Or
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel; (I.B.-O.); (V.I.); (M.W.); (M.E.); (N.L.); (I.A.); (Z.C.); (V.L.); (R.A.); (B.M.); (R.S.); (E.B.); (O.M.); (A.S.B.); (D.S.); (N.S.Z.); (E.M.)
| | - Victoria Indenbaum
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel; (I.B.-O.); (V.I.); (M.W.); (M.E.); (N.L.); (I.A.); (Z.C.); (V.L.); (R.A.); (B.M.); (R.S.); (E.B.); (O.M.); (A.S.B.); (D.S.); (N.S.Z.); (E.M.)
| | - Merav Weil
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel; (I.B.-O.); (V.I.); (M.W.); (M.E.); (N.L.); (I.A.); (Z.C.); (V.L.); (R.A.); (B.M.); (R.S.); (E.B.); (O.M.); (A.S.B.); (D.S.); (N.S.Z.); (E.M.)
| | - Michal Elul
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel; (I.B.-O.); (V.I.); (M.W.); (M.E.); (N.L.); (I.A.); (Z.C.); (V.L.); (R.A.); (B.M.); (R.S.); (E.B.); (O.M.); (A.S.B.); (D.S.); (N.S.Z.); (E.M.)
| | - Nofar Levi
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel; (I.B.-O.); (V.I.); (M.W.); (M.E.); (N.L.); (I.A.); (Z.C.); (V.L.); (R.A.); (B.M.); (R.S.); (E.B.); (O.M.); (A.S.B.); (D.S.); (N.S.Z.); (E.M.)
| | - Irina Aguvaev
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel; (I.B.-O.); (V.I.); (M.W.); (M.E.); (N.L.); (I.A.); (Z.C.); (V.L.); (R.A.); (B.M.); (R.S.); (E.B.); (O.M.); (A.S.B.); (D.S.); (N.S.Z.); (E.M.)
| | - Zvi Cohen
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel; (I.B.-O.); (V.I.); (M.W.); (M.E.); (N.L.); (I.A.); (Z.C.); (V.L.); (R.A.); (B.M.); (R.S.); (E.B.); (O.M.); (A.S.B.); (D.S.); (N.S.Z.); (E.M.)
| | - Virginia Levy
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel; (I.B.-O.); (V.I.); (M.W.); (M.E.); (N.L.); (I.A.); (Z.C.); (V.L.); (R.A.); (B.M.); (R.S.); (E.B.); (O.M.); (A.S.B.); (D.S.); (N.S.Z.); (E.M.)
| | - Roberto Azar
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel; (I.B.-O.); (V.I.); (M.W.); (M.E.); (N.L.); (I.A.); (Z.C.); (V.L.); (R.A.); (B.M.); (R.S.); (E.B.); (O.M.); (A.S.B.); (D.S.); (N.S.Z.); (E.M.)
| | - Batya Mannasse
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel; (I.B.-O.); (V.I.); (M.W.); (M.E.); (N.L.); (I.A.); (Z.C.); (V.L.); (R.A.); (B.M.); (R.S.); (E.B.); (O.M.); (A.S.B.); (D.S.); (N.S.Z.); (E.M.)
| | - Rachel Shirazi
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel; (I.B.-O.); (V.I.); (M.W.); (M.E.); (N.L.); (I.A.); (Z.C.); (V.L.); (R.A.); (B.M.); (R.S.); (E.B.); (O.M.); (A.S.B.); (D.S.); (N.S.Z.); (E.M.)
| | - Efrat Bucris
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel; (I.B.-O.); (V.I.); (M.W.); (M.E.); (N.L.); (I.A.); (Z.C.); (V.L.); (R.A.); (B.M.); (R.S.); (E.B.); (O.M.); (A.S.B.); (D.S.); (N.S.Z.); (E.M.)
| | - Orna Mor
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel; (I.B.-O.); (V.I.); (M.W.); (M.E.); (N.L.); (I.A.); (Z.C.); (V.L.); (R.A.); (B.M.); (R.S.); (E.B.); (O.M.); (A.S.B.); (D.S.); (N.S.Z.); (E.M.)
- Sackler Faculty of Medicine, School of Public Health, Tel-Aviv University, Tel-Aviv 69978, Israel
| | - Alin Sela Brown
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel; (I.B.-O.); (V.I.); (M.W.); (M.E.); (N.L.); (I.A.); (Z.C.); (V.L.); (R.A.); (B.M.); (R.S.); (E.B.); (O.M.); (A.S.B.); (D.S.); (N.S.Z.); (E.M.)
| | - Danit Sofer
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel; (I.B.-O.); (V.I.); (M.W.); (M.E.); (N.L.); (I.A.); (Z.C.); (V.L.); (R.A.); (B.M.); (R.S.); (E.B.); (O.M.); (A.S.B.); (D.S.); (N.S.Z.); (E.M.)
| | - Neta S. Zuckerman
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel; (I.B.-O.); (V.I.); (M.W.); (M.E.); (N.L.); (I.A.); (Z.C.); (V.L.); (R.A.); (B.M.); (R.S.); (E.B.); (O.M.); (A.S.B.); (D.S.); (N.S.Z.); (E.M.)
| | - Ella Mendelson
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel; (I.B.-O.); (V.I.); (M.W.); (M.E.); (N.L.); (I.A.); (Z.C.); (V.L.); (R.A.); (B.M.); (R.S.); (E.B.); (O.M.); (A.S.B.); (D.S.); (N.S.Z.); (E.M.)
- Sackler Faculty of Medicine, School of Public Health, Tel-Aviv University, Tel-Aviv 69978, Israel
| | - Oran Erster
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel; (I.B.-O.); (V.I.); (M.W.); (M.E.); (N.L.); (I.A.); (Z.C.); (V.L.); (R.A.); (B.M.); (R.S.); (E.B.); (O.M.); (A.S.B.); (D.S.); (N.S.Z.); (E.M.)
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85
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Hassard F, Smith TR, Boehm AB, Nolan S, O'Mara O, Di Cesare M, Graham D. Wastewater surveillance for rapid identification of infectious diseases in prisons. THE LANCET MICROBE 2022; 3:e556-e557. [PMID: 35688168 PMCID: PMC9173719 DOI: 10.1016/s2666-5247(22)00154-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 05/23/2022] [Indexed: 12/04/2022] Open
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86
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Marion G, Hadley L, Isham V, Mollison D, Panovska-Griffiths J, Pellis L, Tomba GS, Scarabel F, Swallow B, Trapman P, Villela D. Modelling: Understanding pandemics and how to control them. Epidemics 2022; 39:100588. [PMID: 35679714 DOI: 10.1016/j.epidem.2022.100588] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 03/22/2022] [Accepted: 05/26/2022] [Indexed: 12/11/2022] Open
Abstract
New disease challenges, societal demands and better or novel types of data, drive innovations in the structure, formulation and analysis of epidemic models. Innovations in modelling can lead to new insights into epidemic processes and better use of available data, yielding improved disease control and stimulating collection of better data and new data types. Here we identify key challenges for the structure, formulation, analysis and use of mathematical models of pathogen transmission relevant to current and future pandemics.
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Affiliation(s)
- Glenn Marion
- Biomathematics and Statistics Scotland, Edinburgh, UK; Scottish COVID-19 Response Consortium, UK.
| | - Liza Hadley
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, UK
| | - Valerie Isham
- Department of Statistical Science, University College London, UK
| | - Denis Mollison
- Department of Actuarial Mathematics and Statistics, Heriot-Watt University, UK
| | - Jasmina Panovska-Griffiths
- The Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK; The Queen's College, Oxford University, UK
| | - Lorenzo Pellis
- Department of Mathematics, University of Manchester, UK; The Alan Turing Institute, London, UK; Joint UNIversities Pandemic and Epidemiological Research, UK
| | | | - Francesca Scarabel
- Department of Mathematics, University of Manchester, UK; Joint UNIversities Pandemic and Epidemiological Research, UK; CDLab - Computational Dynamics Laboratory, Department of Mathematics, Computer Science and Physics, University of Udine, Italy
| | - Ben Swallow
- Scottish COVID-19 Response Consortium, UK; School of Mathematics and Statistics, University of Glasgow, UK
| | - Pieter Trapman
- Department of Mathematics, Stockholm University, Stockholm, Sweden
| | - Daniel Villela
- Program of Scientific Computing, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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87
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Dzinamarira T, Pierre G, Iradukunda PG, Tungwarara N, Mukwenha S, Mpabuka E, Mataruka K, Chitungo I, Musuka G, Murewanhema G. Epidemiological surveillance of enteric viral diseases using wastewater in Africa - A rapid review. J Infect Public Health 2022; 15:703-707. [PMID: 35661916 DOI: 10.1016/j.jiph.2022.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/27/2022] [Accepted: 05/19/2022] [Indexed: 12/24/2022] Open
Abstract
Viral enteric pathogens remain an important cause of diarrhoeal outbreaks among children in sub-Saharan Africa (SSA). Consequently, diarrhoeal illness remains a significant cause of morbidity and mortality in the under-fives in SSA. These outbreaks associated with viral pathogens tend to be seasonal and early warning systems for impending outbreaks could be very crucial for triggering preventive public health response and building public health resilience to deal with increased demand for medical services. Wastewater surveillance for pathogens is an important epidemiological component that could inform early warning systems. The objective of this rapid review was to evaluate the use of wastewater for epidemiology surveillance of enteric viral pathogens. Nine studies met the inclusion criteria. Eight viral pathogens were reviewed and analysed from 6 countries that performed wastewater analysis. Six studies explored the epidemiologic significance of viral pathogens in wastewater. The findings of this review revealed that monitoring of wastewater can provide an additional tool to determine the epidemiology of viral pathogens circulating in the community thereby providing early warning of potential outbreaks using wastewater-based epidemiology methods. Five of the included studies revealed the occurrence of viral pathogens in raw sewage and treated wastewater as an indication of inefficient elimination of viruses leading to potential release into water sources which presents a public health risk, increasing the risk of inducing gastroenteritis in the population. Six studies revealed the need for public health authorities to realise the potential benefit of environmental surveillance (ES) as an additional tool to determine the epidemiology of viral pathogens circulating in each community. Despite the significant public health challenge associated with enteric viral pathogens in sub-Saharan Africa, there remains remarkable underinvestment in potentially epidemiologically beneficial research, including wastewater-based epidemiology for these infections.
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Affiliation(s)
- Tafadzwa Dzinamarira
- School of Health Systems & Public Health, University of Pretoria, Pretoria 0002, South Africa; ICAP at Columbia University, Kigali, Rwanda.
| | - Gashema Pierre
- College of Medicine and Veterinary Medicine, University of Edinburgh, UK
| | | | - Nigel Tungwarara
- Department of Health Studies, University of South Africa, South Africa
| | | | | | - Kidson Mataruka
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Itai Chitungo
- College of Medicine and Health Sciences, Faculty of Medicine, University of Zimbabwe, Harare, Zimbabwe
| | | | - Grant Murewanhema
- College of Medicine and Health Sciences, Faculty of Medicine, University of Zimbabwe, Harare, Zimbabwe
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88
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Sweetapple C, Melville-Shreeve P, Chen AS, Grimsley JMS, Bunce JT, Gaze W, Fielding S, Wade MJ. Building knowledge of university campus population dynamics to enhance near-to-source sewage surveillance for SARS-CoV-2 detection. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 806:150406. [PMID: 34571237 PMCID: PMC8450208 DOI: 10.1016/j.scitotenv.2021.150406] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/11/2021] [Accepted: 09/13/2021] [Indexed: 05/05/2023]
Abstract
Wastewater surveillance has been widely implemented for monitoring of SARS-CoV-2 during the global COVID-19 pandemic, and near-to-source monitoring is of particular interest for outbreak management in discrete populations. However, variation in population size poses a challenge to the triggering of public health interventions using wastewater SARS-CoV-2 concentrations. This is especially important for near-to-source sites that are subject to significant daily variability in upstream populations. Focusing on a university campus in England, this study investigates methods to account for variation in upstream populations at a site with highly transient footfall and provides a better understanding of the impact of variable populations on the SARS-CoV-2 trends provided by wastewater-based epidemiology. The potential for complementary data to help direct response activities within the near-to-source population is also explored, and potential concerns arising due to the presence of heavily diluted samples during wet weather are addressed. Using wastewater biomarkers, it is demonstrated that population normalisation can reveal significant differences between days where SARS-CoV-2 concentrations are very similar. Confidence in the trends identified is strongest when samples are collected during dry weather periods; however, wet weather samples can still provide valuable information. It is also shown that building-level occupancy estimates based on complementary data aid identification of potential sources of SARS-CoV-2 and can enable targeted actions to be taken to identify and manage potential sources of pathogen transmission in localised communities.
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Affiliation(s)
- Chris Sweetapple
- Joint Biosecurity Centre, Department of Health and Social Care, Windsor House, Victoria Street, London SW1H 0TL, United Kingdom; Centre for Water Systems, College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter EX4 4QF, United Kingdom
| | - Peter Melville-Shreeve
- Centre for Water Systems, College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter EX4 4QF, United Kingdom
| | - Albert S Chen
- Centre for Water Systems, College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter EX4 4QF, United Kingdom
| | - Jasmine M S Grimsley
- Joint Biosecurity Centre, Department of Health and Social Care, Windsor House, Victoria Street, London SW1H 0TL, United Kingdom
| | - Joshua T Bunce
- Joint Biosecurity Centre, Department of Health and Social Care, Windsor House, Victoria Street, London SW1H 0TL, United Kingdom; Department for Environment, Food and Rural Affairs, Seacole Building, London SW1P 4DF, United Kingdom; School of Engineering, Newcastle University, Newcastle-upon-Tyne NE1 7RU, United Kingdom
| | - William Gaze
- Environment and Sustainability Institute, University of Exeter, Penryn Campus, Penryn, Cornwall TR10 9FE, United Kingdom
| | - Sean Fielding
- Innovation Centre, University of Exeter, Exeter EX4 4RN, United Kingdom
| | - Matthew J Wade
- Joint Biosecurity Centre, Department of Health and Social Care, Windsor House, Victoria Street, London SW1H 0TL, United Kingdom; School of Engineering, Newcastle University, Newcastle-upon-Tyne NE1 7RU, United Kingdom.
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89
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Dzinamarira T, Murewanhema G, Iradukunda PG, Madziva R, Herrera H, Cuadros DF, Tungwarara N, Chitungo I, Musuka G. Utilization of SARS-CoV-2 Wastewater Surveillance in Africa-A Rapid Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:969. [PMID: 35055789 PMCID: PMC8775514 DOI: 10.3390/ijerph19020969] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/04/2022] [Accepted: 01/13/2022] [Indexed: 02/06/2023]
Abstract
Wastewater-based epidemiology for SARS-CoV-2 RNA detection in wastewater is desirable for understanding COVID-19 in settings where financial resources and diagnostic facilities for mass individual testing are severely limited. We conducted a rapid review to map research evidence on the utilization of SARS-CoV-2 wastewater surveillance in Africa. We searched PubMed, Google Scholar, and the World Health Organization library databases for relevant reports, reviews, and primary observational studies. Eight studies met the inclusion criteria. Narrative synthesis of the findings from included primary studies revealed the testing methodologies utilized and that detected amount of SARS-CoV-2 viral RNA correlated with the number of new cases in the studied areas. The included reviews revealed the epidemiological significance and environmental risks of SARS-CoV-2 wastewater. Wastewater surveillance data at the community level can be leveraged for the rapid assessment of emerging threats and aid pandemic preparedness. Our rapid review revealed a glaring gap in the primary literature on SARS-CoV-2 wastewater surveillance on the continent, and accelerated and adequate investment into research is urgently needed to address this gap.
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Affiliation(s)
- Tafadzwa Dzinamarira
- School of Health Systems & Public Health, University of Pretoria, Pretoria 0002, South Africa
- ICAP at Columbia University, Harare, Zimbabwe;
| | - Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe;
| | - Patrick Gad Iradukunda
- London School of Hygiene and Tropical Medicine, University of London, London WC1E 7HU, UK;
| | - Roda Madziva
- School of Sociology and Social Policy, University of Nottingham, Nottingham NG7 2RD, UK;
| | - Helena Herrera
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth PO1 2UP, UK;
| | - Diego F. Cuadros
- Department of Geography and Geographic Information Science, University of Cincinnati, Cincinnati, OH 45221, USA;
| | - Nigel Tungwarara
- Department of Health Studies, University of South Africa, Pretoria 0002, South Africa;
| | - Itai Chitungo
- Chemical Pathology Unit, Department of Laboratory Diagnostic and Investigative Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe;
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90
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Castro-Gutierrez V, Hassard F, Vu M, Leitao R, Burczynska B, Wildeboer D, Stanton I, Rahimzadeh S, Baio G, Garelick H, Hofman J, Kasprzyk-Hordern B, Kwiatkowska R, Majeed A, Priest S, Grimsley J, Lundy L, Singer AC, Di Cesare M. Monitoring occurrence of SARS-CoV-2 in school populations: A wastewater-based approach. PLoS One 2022. [PMID: 35714109 DOI: 10.1101/2021.03.25.21254231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
Abstract
Clinical testing of children in schools is challenging, with economic implications limiting its frequent use as a monitoring tool of the risks assumed by children and staff during the COVID-19 pandemic. Here, a wastewater-based epidemiology approach has been used to monitor 16 schools (10 primary, 5 secondary and 1 post-16 and further education) in England. A total of 296 samples over 9 weeks have been analysed for N1 and E genes using qPCR methods. Of the samples returned, 47.3% were positive for one or both genes with a detection frequency in line with the respective local community. WBE offers a low cost, non-invasive approach for supplementing clinical testing and can provide longitudinal insights that are impractical with traditional clinical testing.
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Affiliation(s)
- Victor Castro-Gutierrez
- Cranfield University, Bedfordshire, United Kingdom
- Environmental Pollution Research Center (CICA), University of Costa Rica, Montes de Oca, Costa Rica
| | | | - Milan Vu
- Department of Natural Science, School of Science and Technology, Middlesex University, London, United Kingdom
| | - Rodrigo Leitao
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Beata Burczynska
- Department of Natural Science, School of Science and Technology, Middlesex University, London, United Kingdom
| | - Dirk Wildeboer
- Department of Natural Science, School of Science and Technology, Middlesex University, London, United Kingdom
| | - Isobel Stanton
- UK Centre for Ecology and Hydrology, Wallingford, United Kingdom
| | - Shadi Rahimzadeh
- Department of Natural Science, School of Science and Technology, Middlesex University, London, United Kingdom
| | - Gianluca Baio
- Department of Statistical Science, University College London, London, United Kingdom
| | - Hemda Garelick
- Department of Natural Science, School of Science and Technology, Middlesex University, London, United Kingdom
| | - Jan Hofman
- Water Innovation & Research Centre, Department of Chemical Engineering, University of Bath, Bath, United Kingdom
| | - Barbara Kasprzyk-Hordern
- Water Innovation & Research Centre, Department of Chemistry, University of Bath, Bath, United Kingdom
| | - Rachel Kwiatkowska
- School of Population Health Sciences, University of Bristol, Bristol, United Kingdom
- Field Services, National Infection Service, Public Health England, London, United Kingdom
| | - Azeem Majeed
- Department of Primary Care & Public Health, Imperial College Faculty of Medicine, London, United Kingdom
| | - Sally Priest
- Department of Natural Science, School of Science and Technology, Middlesex University, London, United Kingdom
| | - Jasmine Grimsley
- Joint Biosecurity Centre, Department for Health and Social Care, London, United Kingdom
| | - Lian Lundy
- Department of Natural Science, School of Science and Technology, Middlesex University, London, United Kingdom
| | - Andrew C Singer
- UK Centre for Ecology and Hydrology, Wallingford, United Kingdom
| | - Mariachiara Di Cesare
- Institute of Public Health and Wellbeing, University of Essex, Colchester, United Kingdom
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91
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Cluzel N, Courbariaux M, Wang S, Moulin L, Wurtzer S, Bertrand I, Laurent K, Monfort P, Gantzer C, Guyader SL, Boni M, Mouchel JM, Maréchal V, Nuel G, Maday Y. A nationwide indicator to smooth and normalize heterogeneous SARS-CoV-2 RNA data in wastewater. ENVIRONMENT INTERNATIONAL 2022; 158:106998. [PMID: 34991258 PMCID: PMC8608586 DOI: 10.1016/j.envint.2021.106998] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/20/2021] [Accepted: 11/21/2021] [Indexed: 05/18/2023]
Abstract
Since many infected people experience no or few symptoms, the SARS-CoV-2 epidemic is frequently monitored through massive virus testing of the population, an approach that may be biased and may be difficult to sustain in low-income countries. Since SARS-CoV-2 RNA can be detected in stool samples, quantifying SARS-CoV-2 genome by RT-qPCR in wastewater treatment plants (WWTPs) has been carried out as a complementary tool to monitor virus circulation among human populations. However, measuring SARS-CoV-2 viral load in WWTPs can be affected by many experimental and environmental factors. To circumvent these limits, we propose here a novel indicator, the wastewater indicator (WWI), that partly reduces and corrects the noise associated with the SARS-CoV-2 genome quantification in wastewater (average noise reduction of 19%). All data processing results in an average correlation gain of 18% with the incidence rate. The WWI can take into account the censorship linked to the limit of quantification (LOQ), allows the automatic detection of outliers to be integrated into the smoothing algorithm, estimates the average measurement error committed on the samples and proposes a solution for inter-laboratory normalization in the absence of inter-laboratory assays (ILA). This method has been successfully applied in the context of Obépine, a French national network that has been quantifying SARS-CoV-2 genome in a representative sample of French WWTPs since March 5th 2020. By August 26th, 2021, 168 WWTPs were monitored in the French metropolitan and overseas territories of France. We detail the process of elaboration of this indicator, show that it is strongly correlated to the incidence rate and that the optimal time lag between these two signals is only a few days, making our indicator an efficient complement to the incidence rate. This alternative approach may be especially important to evaluate SARS-CoV-2 dynamics in human populations when the testing rate is low.
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Affiliation(s)
- Nicolas Cluzel
- Sorbonne Université, Maison des Modélisations Ingénieries et Technologies (SUMMIT), 75005 Paris, France.
| | - Marie Courbariaux
- Sorbonne Université, Maison des Modélisations Ingénieries et Technologies (SUMMIT), 75005 Paris, France
| | - Siyun Wang
- Sorbonne Université, Maison des Modélisations Ingénieries et Technologies (SUMMIT), 75005 Paris, France
| | - Laurent Moulin
- Eau de Paris, Département de Recherche, Développement et Qualité de l'Eau, 33 avenue Jean Jaurès, F-94200 Ivry sur Seine, France
| | - Sébastien Wurtzer
- Eau de Paris, Département de Recherche, Développement et Qualité de l'Eau, 33 avenue Jean Jaurès, F-94200 Ivry sur Seine, France
| | | | - Karine Laurent
- Sorbonne Université, Maison des Modélisations Ingénieries et Technologies (SUMMIT), 75005 Paris, France
| | - Patrick Monfort
- HydroSciences Montpellier, UMR 5151, Université de Montpellier, CNRS, IRD, F-34093 Montpellier, France
| | | | - Soizick Le Guyader
- Ifremer, laboratoire de Microbiologie, SG2M/LSEM, BP 21105, 44311 Nantes, France
| | - Mickaël Boni
- Institut de Recherche Biomédicale des Armées, 1 place Valérie André, F-91220 Brétigny-sur-Orge, France
| | - Jean-Marie Mouchel
- Sorbonne Université, CNRS, EPHE, UMR 7619 Metis, e-LTER Zone Atelier Seine, F-75005 Paris, France
| | - Vincent Maréchal
- Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, F-75012 Paris, France
| | - Grégory Nuel
- Stochastics and Biology Group, Probability and Statistics (LPSM, CNRS 8001), Sorbonne University, Campus Pierre et Marie Curie, 4 Place Jussieu, 75005 Paris, France
| | - Yvon Maday
- Sorbonne Université, CNRS, Université de Paris, Laboratoire Jacques-Louis Lions (LJLL), F-75005 Paris, France; Institut Universaire de France, France.
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92
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Wastewater is a robust proxy for monitoring circulating SARS-CoV-2 variants. Nat Biotechnol 2022; 40:1768-1769. [PMID: 35864171 PMCID: PMC9302220 DOI: 10.1038/s41587-022-01388-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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