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Alcantara DMC, Dos Santos CM, Torres JM, Stutz C, Vieira CA, Moreira RMDS, Rodrigues R, Marcon GEB, Ferreira EDC, Mendes FML, Sarti ECFB, de Oliveira TF, Lemos EF, Andrade UV, Lichs GGDC, Demarchi LHF, Zardin MCSU, Gonçalves CCM, Guilhermino JDF, Fernandez ZDC. Long-term surveillance of SARS-CoV-2 in the school community from Campo Grande, Brazil. BMC Public Health 2024; 24:2057. [PMID: 39085807 PMCID: PMC11290088 DOI: 10.1186/s12889-024-19555-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 07/22/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has significantly impacted education systems worldwide, with Brazil being one of the countries with the longest school closures. Over a million children and teenagers have been affected, leading to increased hunger and nutritional deficiencies. This study aimed to implement long-term surveillance of SARS-CoV-2 infections in public and private schools in Campo Grande, Brazil, after returning to in-person classes. METHODS The study involved testing and genomic surveillance at 23 public and private schools in Campo Grande, Mato Grosso do Sul, Brazil, from October 18, 2021 to November 21, 2022. The participants eligible for enrollment were students aged 6-17 years and staff members from school institutions. At the time of collection, participants were asked if they had symptoms in the last two weeks. Whole-genome sequencing of SARS-CoV-2 was conducted to identify circulating variants and to compare them with those detected in the municipality. The demographic data and clinical history of the participants were described, and a logistic regression model was used to understand how the RT-qPCR results could be related to different characteristics. RESULTS The study included 999 participants, most of whom were women. A total of 85 tests were positive, with an overall positivity rate of 3.2%. The dynamics of case frequency were consistent with those observed in the municipality during the study period. The most common symptoms reported were cough, rhinorrhea, headache, and sore throat. Symptoms were significantly associated with SARS-CoV-2 infection. Eleven lineages were identified in school community samples, with a frequency of occurrence per period similar to that found in the sequences available for the municipality. The most prevalent lineages within the sampling period were BA.2 (59.3%) and BA.5 (29.6%). CONCLUSIONS Our findings demonstrate that schools can play a crucial role in epidemiological surveillance, helping trigger rapid responses to pathogens such as SARS-CoV-2. Long-term surveillance can be used to track outbreaks and assess the role of children and adults in transmission. It can also contribute to pandemic preparedness, enabling a rapid response to emergencies, such as COVID-19.
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Affiliation(s)
| | - Camila Maria Dos Santos
- FIOCRUZ Mato Grosso do Sul, Fundação Oswaldo Cruz (FIOCRUZ), Campo Grande, Mato Grosso do Sul, Brazil
| | - Jaire Marinho Torres
- FIOCRUZ Mato Grosso do Sul, Fundação Oswaldo Cruz (FIOCRUZ), Campo Grande, Mato Grosso do Sul, Brazil
| | - Claudia Stutz
- FIOCRUZ Mato Grosso do Sul, Fundação Oswaldo Cruz (FIOCRUZ), Campo Grande, Mato Grosso do Sul, Brazil
- Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição (FACFAN), Fundação Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, Brazil
| | - Camila Aoyama Vieira
- FIOCRUZ Mato Grosso do Sul, Fundação Oswaldo Cruz (FIOCRUZ), Campo Grande, Mato Grosso do Sul, Brazil
| | - Raissa Mariele Dos Santos Moreira
- Instituto Integrado de Saúde (INISA), Fundação Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, Brazil
| | - Rudielle Rodrigues
- FIOCRUZ Mato Grosso do Sul, Fundação Oswaldo Cruz (FIOCRUZ), Campo Grande, Mato Grosso do Sul, Brazil
| | | | - Eduardo de Castro Ferreira
- FIOCRUZ Mato Grosso do Sul, Fundação Oswaldo Cruz (FIOCRUZ), Campo Grande, Mato Grosso do Sul, Brazil
- Programa de Pós-graduação em Doenças Infecciosas e Parasitárias, Faculdade de Medicina (FAMED), Fundação Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, Brazil
| | - Flavia Maria Lins Mendes
- FIOCRUZ Mato Grosso do Sul, Fundação Oswaldo Cruz (FIOCRUZ), Campo Grande, Mato Grosso do Sul, Brazil
| | | | | | - Everton Ferreira Lemos
- Universidade Estadual de Mato Grosso do Sul (UEMS), Campo Grande, Mato Grosso do Sul, Brazil
| | | | - Gislene Garcia de Castro Lichs
- Laboratório Central de Saúde Pública do Estado de Mato Grosso do Sul (LACEN/MS), Campo Grande, Mato Grosso do Sul, Brazil
| | - Luiz Henrique Ferraz Demarchi
- Programa de Pós-graduação em Doenças Infecciosas e Parasitárias, Faculdade de Medicina (FAMED), Fundação Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, Brazil
- Laboratório Central de Saúde Pública do Estado de Mato Grosso do Sul (LACEN/MS), Campo Grande, Mato Grosso do Sul, Brazil
| | | | - Crhistinne Cavalheiro Maymone Gonçalves
- Programa de Pós-graduação em Doenças Infecciosas e Parasitárias, Faculdade de Medicina (FAMED), Fundação Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, Brazil
- Secretaria de Estado de Saúde de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
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Folkes M, Castro-Gutierrez V, Lundy L, Bajón-Fernández Y, Soares A, Jeffrey P, Hassard F. Campus source to sink wastewater surveillance of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). CURRENT RESEARCH IN MICROBIAL SCIENCES 2024; 6:100240. [PMID: 38774836 PMCID: PMC11106825 DOI: 10.1016/j.crmicr.2024.100240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2024] Open
Abstract
Wastewater-based surveillance (WBS) offers an aggregate, and cost-effective approach for tracking infectious disease outbreak prevalence within communities, that provides data on community health complementary to individual clinical testing. This study reports on a 16-month WBS initiative on a university campus in England, UK, assessing the presence of SARS-CoV-2 in sewers from large buildings, downstream sewer locations, raw wastewater, partially treated and treated effluents. Key findings include the detection of the Alpha (B.1.1.7) variant in wastewater, with 70 % of confirmed campus cases correlating with positive wastewater samples. Notably, ammonium nitrogen (NH4-N) levels showed a positive correlation (ρ = 0.543, p < 0.01) with virus levels at the large building scale, a relationship not observed at the sewer or wastewater treatment works (WWTW) levels due to dilution. The WWTW was compliant to wastewater standards, but the secondary treatment processes were not efficient for virus removal as SARS-CoV-2 was consistently detected in treated discharges. Tools developed through WBS can also be used to enhance traditional environmental monitoring of aquatic systems. This study provides a detailed source-to-sink evaluation, emphasizing the critical need for the widespread application and improvement of WBS. It showcases WBS utility and reinforces the ongoing challenges posed by viruses to receiving water quality.
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Affiliation(s)
- M. Folkes
- Cranfield University, College Road, Cranfield, Bedfordshire, MK43 0AL, UK
| | - V.M. Castro-Gutierrez
- Center for Research on Environmental Pollution (CICA), Universidad de Costa Rica, Montes de Oca, 11501, Costa Rica
| | - L. Lundy
- Department of Natural Sciences, Middlesex University, NW4 4BT, UK
| | - Y. Bajón-Fernández
- Cranfield University, College Road, Cranfield, Bedfordshire, MK43 0AL, UK
| | - A. Soares
- Cranfield University, College Road, Cranfield, Bedfordshire, MK43 0AL, UK
| | - P. Jeffrey
- Cranfield University, College Road, Cranfield, Bedfordshire, MK43 0AL, UK
| | - F. Hassard
- Cranfield University, College Road, Cranfield, Bedfordshire, MK43 0AL, UK
- Institute for Nanotechnology and Water Sustainability, College of Science, Engineering and Technology, University of South Africa, Johannesburg, South Africa
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Wongprommoon A, Chomkatekaew C, Chewapreecha C. Monitoring pathogens in wastewater. Nat Rev Microbiol 2024; 22:261. [PMID: 38413815 DOI: 10.1038/s41579-024-01033-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Affiliation(s)
| | - Chalita Chomkatekaew
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Claire Chewapreecha
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, UK.
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
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Ensor KB, Schedler JC, Sun T, Schneider R, Mulenga A, Wu J, Stadler LB, Hopkins L. Online trend estimation and detection of trend deviations in sub-sewershed time series of SARS-CoV-2 RNA measured in wastewater. Sci Rep 2024; 14:5575. [PMID: 38448481 PMCID: PMC10918082 DOI: 10.1038/s41598-024-56175-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/03/2024] [Indexed: 03/08/2024] Open
Abstract
Wastewater surveillance has proven a cost-effective key public health tool to understand a wide range of community health diseases and has been a strong source of information on community levels and spread for health departments throughout the SARS- CoV-2 pandemic. Studies spanning the globe demonstrate the strong association between virus levels observed in wastewater and quality clinical case information of the population served by the sewershed. Few of these studies incorporate the temporal dependence present in sampling over time, which can lead to estimation issues which in turn impact conclusions. We contribute to the literature for this important public health science by putting forward time series methods coupled with statistical process control that (1) capture the evolving trend of a disease in the population; (2) separate the uncertainty in the population disease trend from the uncertainty due to sampling and measurement; and (3) support comparison of sub-sewershed population disease dynamics with those of the population represented by the larger downstream treatment plant. Our statistical methods incorporate the fact that measurements are over time, ensuring correct statistical conclusions. We provide a retrospective example of how sub-sewersheds virus levels compare to the upstream wastewater treatment plant virus levels. An on-line algorithm supports real-time statistical assessment of deviations of virus level in a population represented by a sub-sewershed to the virus level in the corresponding larger downstream wastewater treatment plant. This information supports public health decisions by spotlighting segments of the population where outbreaks may be occurring.
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Affiliation(s)
- Katherine B Ensor
- Department of Statistics, Rice University, 6100 Main St., Houston, TX, 77005, USA.
| | - Julia C Schedler
- Department of Statistics, Rice University, 6100 Main St., Houston, TX, 77005, USA
| | - Thomas Sun
- Department of Statistics, Rice University, 6100 Main St., Houston, TX, 77005, USA
| | - Rebecca Schneider
- Houston Health Department, 8000 N. Stadium Dr., Houston, TX, 77054, USA
| | - Anthony Mulenga
- Houston Health Department, 8000 N. Stadium Dr., Houston, TX, 77054, USA
| | - Jingjing Wu
- Department of Civil and Environment Engineering, Rice University, 6100 Main St, Houston, TX, 77005, USA
| | - Lauren B Stadler
- Department of Civil and Environment Engineering, Rice University, 6100 Main St, Houston, TX, 77005, USA
| | - Loren Hopkins
- Houston Health Department and Department of Statistics, Rice University, 6100 Main St., Houston, TX, 77005, USA
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Cobián Güemes AG, Ghatbale P, Blanc AN, Morgan CJ, Garcia A, Leonard J, Huang L, Kovalick G, Proost M, Chiu M, Kuo P, Oh J, Karthikeyan S, Knight R, Pogliano J, Schooley RT, Pride DT. Jumbo phages are active against extensively drug-resistant eyedrop-associated Pseudomonas aeruginosa infections. Antimicrob Agents Chemother 2023; 67:e0065423. [PMID: 37931230 PMCID: PMC10720484 DOI: 10.1128/aac.00654-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 09/08/2023] [Indexed: 11/08/2023] Open
Abstract
Antibiotic-resistant bacteria present an emerging challenge to human health. Their prevalence has been increasing across the globe due in part to the liberal use of antibiotics that has pressured them to develop resistance. Those bacteria that acquire mobile genetic elements are especially concerning because those plasmids may be shared readily with other microbes that can then also become antibiotic resistant. Serious infections have recently been related to the contamination of preservative-free eyedrops with extensively drug-resistant (XDR) isolates of Pseudomonas aeruginosa, already resulting in three deaths. These drug-resistant isolates cannot be managed with most conventional antibiotics. We sought to identify alternatives to conventional antibiotics for the lysis of these XDR isolates and identified multiple bacteriophages (viruses that attack bacteria) that killed them efficiently. We found both jumbo phages (>200 kb in genome size) and non-jumbo phages that were active against these isolates, the former killing more efficiently. Jumbo phages effectively killed the three separate XDR P. aeruginosa isolates both on solid and liquid medium. Given the ongoing nature of the XDR P. aeruginosa eyedrop outbreak, the identification of phages active against them provides physicians with several novel potential alternatives for treatment.
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Affiliation(s)
| | - Pooja Ghatbale
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Alisha N. Blanc
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Chase J. Morgan
- Department of Biology, University of California San Diego, La Jolla, California, USA
| | - Andrew Garcia
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Jesse Leonard
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Lina Huang
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Grace Kovalick
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Marissa Proost
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Megan Chiu
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Peiting Kuo
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Joseph Oh
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Smruthi Karthikeyan
- Department of Environmental Science and Engineering, Division of Engineering and Applied Science, California Institute of Technology, Pasadena, California, USA
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | - Rob Knight
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
- Center for Microbiome Innovation, University of California San Diego, La Jolla, California, USA
- Department of Bioengineering, University of California San Diego, La Jolla, California, USA
- Department of Computer Sciences & Engineering, University of California San Diego, La Jolla, California, USA
| | - Joe Pogliano
- Department of Biology, University of California San Diego, La Jolla, California, USA
- Howard Hughes Medical Institute, University of California San Diego, La Jolla, California, USA
| | - Robert T. Schooley
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - David T. Pride
- Department of Pathology, University of California San Diego, La Jolla, California, USA
- Howard Hughes Medical Institute, University of California San Diego, La Jolla, California, USA
- Department of Medicine, University of California San Diego, La Jolla, California, USA
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Lopez Marin MA, Zdenkova K, Bartackova J, Cermakova E, Dostalkova A, Demnerova K, Vavruskova L, Novakova Z, Sykora P, Rumlova M, Bartacek J. Monitoring COVID-19 spread in selected Prague's schools based on the presence of SARS-CoV-2 RNA in wastewater. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 871:161935. [PMID: 36731569 PMCID: PMC9886433 DOI: 10.1016/j.scitotenv.2023.161935] [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: 07/29/2022] [Revised: 01/13/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic has demanded a broad range of techniques to better monitor its extent. Owing to its consistency, non-invasiveness, and cost effectiveness, wastewater-based epidemiology has emerged as a relevant approach to monitor the pandemic's course. In this work, we analyzed the extent of the COVID-19 pandemic in five primary schools in Prague, the Czech Republic, and how different preventive measures impact the presence of SARS-CoV-2 RNA copy numbers in wastewaters. Copy numbers were measured by reverse transcription-multiplex quantitative real-time PCR. These copy numbers were compared to the number of infected individuals in each school identified through regular clinical tests. Each school had a different monitoring regime and subsequent application of preventive measures to thwart the spread of COVID-19. The schools that constantly identified and swiftly quarantined infected individuals exhibited persistently low amounts of SARS-CoV-2 RNA copies in their wastewaters. In one school, a consistent monitoring of infected individuals, coupled with a delayed action to quarantine, allowed for the estimation of a linear model to predict the number of infected individuals based on the presence of SARS-CoV-2 RNA in the wastewater. The results show the importance of case detection and quarantining to stop the spread of the pandemic and its impact on the presence of SARS-CoV-2 RNA in wastewaters. This work also shows that wastewater-based epidemiological models can be reliably used even in small water catchments, but difficulties arise to fit models due to the nonconstant input of viral particles into the wastewater systems.
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Affiliation(s)
- Marco A Lopez Marin
- Department of Water Technology and Environmental Engineering, University of Chemistry and Technology Prague, Czechia
| | - K Zdenkova
- Department of Biochemistry and Microbiology, University of Chemistry and Technology Prague, Czechia.
| | - J Bartackova
- Department of Water Technology and Environmental Engineering, University of Chemistry and Technology Prague, Czechia
| | - E Cermakova
- Department of Biochemistry and Microbiology, University of Chemistry and Technology Prague, Czechia
| | - A Dostalkova
- Department of Biotechnology, University of Chemistry and Technology Prague, Czechia
| | - K Demnerova
- Department of Biochemistry and Microbiology, University of Chemistry and Technology Prague, Czechia
| | | | - Z Novakova
- Prazske vodovody a kanalizace, a.s., Czechia
| | - P Sykora
- Prazske vodovody a kanalizace, a.s., Czechia
| | - M Rumlova
- Department of Biotechnology, University of Chemistry and Technology Prague, Czechia
| | - J Bartacek
- Department of Water Technology and Environmental Engineering, University of Chemistry and Technology Prague, Czechia
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7
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Vo AV, Majnoonian A, Ni J, Garfein RS, Wishard Guerra A, Fielding-Miller R. Challenges of COVID-19 Case Investigation and Contact Tracing in School Settings: An Initial Investigation. THE JOURNAL OF SCHOOL HEALTH 2023; 93:353-359. [PMID: 36938803 PMCID: PMC10484113 DOI: 10.1111/josh.13308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 11/17/2022] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Case investigation and contact tracing (CI/CT) are important public health tools to interrupt COVID-19 transmission. Our study aims to understand how parents and school staff perceive COVID-19 CI/CT. METHODS Using a mixed methods approach, we distributed a community survey and conducted 15 focus group discussions (FGDs) in English and Spanish between December 2020 and March 2021 with 20 parents and 22 staff from schools in San Diego County ZIP Codes with COVID-19 rates in the top quintile as of August 2020. RESULTS One in 4 survey respondents reported that they would be reluctant to participate in CI/CT. FGDs revealed themes of mistrust in government authorities, overburdened institutions, unfamiliarity with CI/CT, and uncertainty about its reliability. School community members emphasized that parents trust schools to be involved in CI/CT efforts, but schools are overwhelmed with this added responsibility. CONCLUSIONS Investing in schools as community hubs is necessary so they can become important partners in prevention and mitigation in public health.
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Affiliation(s)
- Anh V Vo
- Qualitative Researcher, Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA; Qualitative Researcher, Center on Gender Equity and Health, School of Medicine, University of California San Diego, San Diego, CA; Scholar (Master Candidate), Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Araz Majnoonian
- Scholar (Ph.D. Candidate), Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA; Qualitative Researcher, Center on Gender Equity and Health, School of Medicine, University of California San Diego, San Diego, CA; Scholar(Ph.D. Candidate), Joint Doctoral Program in Public Health-Global Health, San Diego State University, San Diego, CA
| | - Jessica Ni
- Student Research Assistant, Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA; Scholar(Master Candidate), School of Public Health, University of California Berkeley, Berkeley, CA
| | - Richard S Garfein
- Professor, Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA
| | - Alison Wishard Guerra
- Associate Professor, School of Public Health, University of California Berkeley, Berkeley, CA
| | - Rebecca Fielding-Miller
- Assistant Professor, Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA; Assistant Professor, Center on Gender Equity and Health, School of Medicine, University of California San Diego, San Diego, CA; Assistant Professor, Division of Infectious Disease and Global Public Health, School of Medicine, University of California San Diego, San Diego, CA
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8
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Hassard F, Singh S, Coulon F, Yang Z. Can wastewater monitoring protect public health in schools? LANCET REGIONAL HEALTH. AMERICAS 2023; 20:100475. [PMID: 36945319 PMCID: PMC10018126 DOI: 10.1016/j.lana.2023.100475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 03/03/2023] [Indexed: 03/18/2023]
Affiliation(s)
- Francis Hassard
- Cranfield University, School of Water, Energy and Environment, Cranfield, MK43 0AL, UK
| | - Suniti Singh
- Cranfield University, School of Water, Energy and Environment, Cranfield, MK43 0AL, UK
| | - Frédéric Coulon
- Cranfield University, School of Water, Energy and Environment, Cranfield, MK43 0AL, UK
| | - Zhugen Yang
- Cranfield University, School of Water, Energy and Environment, Cranfield, MK43 0AL, UK
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