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Gerrity D, Crank K, Oh EC, Quinones O, Trenholm RA, Vanderford BJ. Wastewater surveillance of high risk substances in Southern Nevada: Sucralose normalization to translate data for potential public health action. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 908:168369. [PMID: 37951274 DOI: 10.1016/j.scitotenv.2023.168369] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/01/2023] [Accepted: 11/04/2023] [Indexed: 11/13/2023]
Abstract
The COVID-19 pandemic highlighted the value of wastewater surveillance in providing unbiased assessments of incidence/prevalence for infectious disease targets, ultimately leading to the development of local, state, and national programs across the United States. To address the growing epidemic of drug abuse, there have been calls to extend these programs to high risk substances (HRS) and metabolites, while leveraging the experience gained during the pandemic and from ongoing efforts in other countries. This study further advances the science of wastewater surveillance for HRS by (1) highlighting analytical and sewer transport considerations, (2) proposing sucralose normalization to adjust for varying human urine/fecal load and confounded population estimates (e.g., high tourism areas), and (3) characterizing temporal and geographic trends in HRS use. This one-year study across eight sewersheds in Southern Nevada (208 total samples) monitored concentrations of 17 pharmaceuticals and personal care products (PPCPs) and 22 HRS and metabolites, including natural, semi-synthetic, and synthetic opioids. The data indicated a ∼200 % increase in heroin and methamphetamine use since 2010, a stark increase in fentanyl consumption beginning in October 2022, and statistically significant differences in HRS consumption patterns between sewersheds and on certain dates. Notably, the latter outcome highlights the potential for wastewater surveillance data to be strategically translated into public health action to reduce and/or more rapidly respond to overdoses.
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Affiliation(s)
- Daniel Gerrity
- Applied Research and Development Center, Southern Nevada Water Authority, P.O. Box 99954, Las Vegas, NV 89193, United States.
| | - Katherine Crank
- Applied Research and Development Center, Southern Nevada Water Authority, P.O. Box 99954, Las Vegas, NV 89193, United States
| | - Edwin C Oh
- Laboratory of Neurogenetics and Precision Medicine, Nevada Institute of Personalized Medicine, Department of Internal Medicine, UNLV School of Medicine, University of Nevada, Las Vegas, Las Vegas, NV 89154, United States
| | - Oscar Quinones
- Applied Research and Development Center, Southern Nevada Water Authority, P.O. Box 99954, Las Vegas, NV 89193, United States
| | - Rebecca A Trenholm
- Applied Research and Development Center, Southern Nevada Water Authority, P.O. Box 99954, Las Vegas, NV 89193, United States
| | - Brett J Vanderford
- Applied Research and Development Center, Southern Nevada Water Authority, P.O. Box 99954, Las Vegas, NV 89193, United States
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Jobling K, Quintela-Baluja M, Hassard F, Adamou P, Blackburn A, Research Team T, McIntyre-Nolan S, O'Mara O, Romalde JL, Di Cesare M, Graham DW. Comparison of gene targets and sampling regimes for SARS-CoV-2 quantification for wastewater epidemiology in UK prisons. JOURNAL OF WATER AND HEALTH 2024; 22:64-76. [PMID: 38295073 PMCID: wh_2023_093 DOI: 10.2166/wh.2023.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Prisons are high-risk settings for infectious disease transmission, due to their enclosed and semi-enclosed environments. The proximity between prisoners and staff, and the diversity of prisons reduces the effectiveness of non-pharmaceutical interventions, such as social distancing. Therefore, alternative health monitoring methods, such as wastewater-based epidemiology (WBE), are needed to track pathogens, including SARS-CoV-2. This pilot study assessed WBE to quantify SARS-CoV-2 prevalence in prison wastewater to determine its utility within a health protection system for residents. The study analysed 266 samples from six prisons in England over a 12-week period for nucleoprotein 1 (N1 gene) and envelope protein (E gene) using quantitative reverse transcriptase-polymerase chain reaction. Both gene assays successfully detected SARS-CoV-2 fragments in wastewater samples, with both genes significantly correlating with COVID-19 case numbers across the prisons (p < 0.01). However, in 25% of the SARS-positive samples, only one gene target was detected, suggesting that both genes be used to reduce false-negative results. No significant differences were observed between 14- and 2-h composite samples, although 2-h samples showed greater signal variance. Population normalisation did not improve correlations between the N1 and E genes and COVID-19 case data. Overall, WBE shows considerable promise for health protection in prison settings.
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Affiliation(s)
- Kelly Jobling
- School of Engineering, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; The authors contributed equally to the manuscript. E-mail:
| | - Marcos Quintela-Baluja
- School of Engineering, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; The authors contributed equally to the manuscript
| | - Francis Hassard
- Cranfield Water Science Institute, Cranfield University, Cranfield MK43 0AL, UK
| | - Panagiota Adamou
- School of Engineering, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Adrian Blackburn
- School of Engineering, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | | | | | | | - Jesus L Romalde
- CRETUS, Departamento de Microbiología y Parasitología, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | | | - David W Graham
- School of Engineering, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
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Polanco JA, Schmitz B, Choi S, Safarik J, Prasek S, Plumlee MH. SARS-CoV-2 genetic material is removed during municipal wastewater treatment and is undetectable after advanced treatment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 859:159575. [PMID: 36280060 PMCID: PMC9596176 DOI: 10.1016/j.scitotenv.2022.159575] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/12/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study was to establish whether SARS-CoV-2 genetic material is detectable after municipal wastewater treatment and to verify its expected removal from purified water that is reclaimed for potable reuse. Viral loads of SARS-CoV-2 (N1 and N2 genes) were monitored in raw influent wastewater (sewage) entering a water reclamation facility and in subsequent advanced treatment. Despite the large viral RNA load in raw sewage during peak COVID-19 outbreaks, substantial amounts of SARS-CoV-2 genetic material were removed during the conventional wastewater treatment process. Further, SARS-CoV-2 genetic material was undetectable after advanced purification. This confirms that potable reuse is resilient against high viral loads which are expected results given the advanced degree of wastewater and water treatment. Findings from this study may enhance public perception of the safety of potable water reuse; however, it should also be noted that studies to date worldwide indicate no evidence of SARS-CoV-2 transmission via water, and the CDC does not consider fecal waste or wastewaters as a source of exposure.
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Affiliation(s)
- Julio A Polanco
- Research and Development Department, Orange County Water District, Fountain Valley, CA, United States of America
| | - Bradley Schmitz
- Yuma Center of Excellence for Desert Agriculture (YCEDA), University of Arizona, 6425 W. 8th Street, Yuma, AZ 85364, USA
| | - Samuel Choi
- Environmental Laboratory and Ocean Monitoring, Orange County Sanitation District, Fountain Valley, CA, United States of America
| | - Jana Safarik
- Research and Development Department, Orange County Water District, Fountain Valley, CA, United States of America
| | - Sarah Prasek
- Water & Energy Sustainable Technology (WEST) Center, University of Arizona, 2959 W. Calle Agua Nueva, Tucson, AZ 85745, USA
| | - Megan H Plumlee
- Research and Development Department, Orange County Water District, Fountain Valley, CA, United States of America.
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Vo V, Tillett RL, Papp K, Shen S, Gu R, Gorzalski A, Siao D, Markland R, Chang CL, Baker H, Chen J, Schiller M, Betancourt WQ, Buttery E, Pandori M, Picker MA, Gerrity D, Oh EC. Use of wastewater surveillance for early detection of Alpha and Epsilon SARS-CoV-2 variants of concern and estimation of overall COVID-19 infection burden. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 835:155410. [PMID: 35469875 PMCID: PMC9026949 DOI: 10.1016/j.scitotenv.2022.155410] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/15/2022] [Accepted: 04/16/2022] [Indexed: 05/14/2023]
Abstract
A decline in diagnostic testing for SARS-CoV-2 is expected to delay the tracking of COVID-19 variants of concern and interest in the United States. We hypothesize that wastewater surveillance programs provide an effective alternative for detecting emerging variants and assessing COVID-19 incidence, particularly when clinical surveillance is limited. Here, we analyzed SARS-CoV-2 RNA in wastewater from eight locations across Southern Nevada between March 2020 and April 2021. Trends in SARS-CoV-2 RNA concentrations (ranging from 4.3 log10 gc/L to 8.7 log10 gc/L) matched trends in confirmed COVID-19 incidence, but wastewater surveillance also highlighted several limitations with the clinical data. Amplicon-based whole genome sequencing (WGS) of 86 wastewater samples identified the B.1.1.7 (Alpha) and B.1.429 (Epsilon) lineages in December 2020, but clinical sequencing failed to identify the variants until January 2021, thereby demonstrating that 'pooled' wastewater samples can sometimes expedite variant detection. Also, by calibrating fecal shedding (11.4 log10 gc/infection) and wastewater surveillance data to reported seroprevalence, we estimate that ~38% of individuals in Southern Nevada had been infected by SARS-CoV-2 as of April 2021, which is significantly higher than the 10% of individuals confirmed through clinical testing. Sewershed-specific ascertainment ratios (i.e., X-fold infection undercounts) ranged from 1.0 to 7.7, potentially due to demographic differences. Our data underscore the growing application of wastewater surveillance in not only the identification and quantification of infectious agents, but also the detection of variants of concern that may be missed when diagnostic testing is limited or unavailable.
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Affiliation(s)
- Van Vo
- Laboratory of Neurogenetics and Precision Medicine, University of Nevada Las Vegas, Las Vegas, NV 89154, USA
| | - Richard L Tillett
- Nevada Institute of Personalized Medicine, University of Nevada Las Vegas, Las Vegas, NV 89154, USA
| | - Katerina Papp
- Southern Nevada Water Authority, P.O. Box 99954, Las Vegas, NV, 89193, USA
| | - Shirley Shen
- Nevada Institute of Personalized Medicine, University of Nevada Las Vegas, Las Vegas, NV 89154, USA
| | - Richard Gu
- Laboratory of Neurogenetics and Precision Medicine, University of Nevada Las Vegas, Las Vegas, NV 89154, USA
| | | | - Danielle Siao
- Nevada State Public Health Laboratory, Reno, NV 89597, USA
| | - Rayma Markland
- Southern Nevada Public Health Laboratory of the Southern Nevada Health District, Las Vegas, NV 89106, USA
| | - Ching-Lan Chang
- Laboratory of Neurogenetics and Precision Medicine, University of Nevada Las Vegas, Las Vegas, NV 89154, USA
| | - Hayley Baker
- Laboratory of Neurogenetics and Precision Medicine, University of Nevada Las Vegas, Las Vegas, NV 89154, USA
| | - Jingchun Chen
- Nevada Institute of Personalized Medicine, University of Nevada Las Vegas, Las Vegas, NV 89154, USA
| | - Martin Schiller
- Nevada Institute of Personalized Medicine, University of Nevada Las Vegas, Las Vegas, NV 89154, USA
| | - Walter Q Betancourt
- Water & Energy Sustainable Technology (WEST) Center, University of Arizona, 2959 W. Calle Agua Nueva, Tucson, AZ 85745, USA
| | - Erin Buttery
- Southern Nevada Public Health Laboratory of the Southern Nevada Health District, Las Vegas, NV 89106, USA
| | - Mark Pandori
- Nevada State Public Health Laboratory, Reno, NV 89597, USA
| | - Michael A Picker
- Southern Nevada Public Health Laboratory of the Southern Nevada Health District, Las Vegas, NV 89106, USA
| | - Daniel Gerrity
- Southern Nevada Water Authority, P.O. Box 99954, Las Vegas, NV, 89193, USA.
| | - Edwin C Oh
- Laboratory of Neurogenetics and Precision Medicine, University of Nevada Las Vegas, Las Vegas, NV 89154, USA; Nevada Institute of Personalized Medicine, University of Nevada Las Vegas, Las Vegas, NV 89154, USA; Department of Internal Medicine, UNLV School of Medicine, University of Nevada Las Vegas, Las Vegas, NV 89154, USA.
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