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Keenum I, Lin NJ, Logan-Jackson A, Gushgari AJ, D'Souza N, Steele JA, Kaya D, Gushgari LR. Optimizing Wastewater Surveillance: The Necessity of Standardized Reporting and Proficiency for Public Health. Am J Public Health 2024; 114:859-863. [PMID: 39110937 PMCID: PMC11306606 DOI: 10.2105/ajph.2024.307760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2024] [Indexed: 08/11/2024]
Affiliation(s)
- Ishi Keenum
- Ishi Keenum is with the Civil, Environmental, and Geospatial Department, Michigan Technological University, Houghton. Nancy J. Lin and Alshae' Logan-Jackson are with the Biosystems and Biomaterials Division, National Institute of Standards and Technology, Gaithersburg, MD. Adam J. Gushgari is with Eurofins Pandemic Prevention Services, Sacramento, CA. Nishita D'Souza is with Department of Fisheries and Wildlife, Michigan State University, East Lansing. Joshua A. Steele is with the Department of Microbiology, Southern California Coastal Water Research Project, Costa Mesa, CA. Devrim Kaya is with the School of Public Health, San Diego State University, CA. Lydia R. Gushgari is with SPOC Proteomics, Inc., Scottsdale, AZ
| | - Nancy J Lin
- Ishi Keenum is with the Civil, Environmental, and Geospatial Department, Michigan Technological University, Houghton. Nancy J. Lin and Alshae' Logan-Jackson are with the Biosystems and Biomaterials Division, National Institute of Standards and Technology, Gaithersburg, MD. Adam J. Gushgari is with Eurofins Pandemic Prevention Services, Sacramento, CA. Nishita D'Souza is with Department of Fisheries and Wildlife, Michigan State University, East Lansing. Joshua A. Steele is with the Department of Microbiology, Southern California Coastal Water Research Project, Costa Mesa, CA. Devrim Kaya is with the School of Public Health, San Diego State University, CA. Lydia R. Gushgari is with SPOC Proteomics, Inc., Scottsdale, AZ
| | - Alshae' Logan-Jackson
- Ishi Keenum is with the Civil, Environmental, and Geospatial Department, Michigan Technological University, Houghton. Nancy J. Lin and Alshae' Logan-Jackson are with the Biosystems and Biomaterials Division, National Institute of Standards and Technology, Gaithersburg, MD. Adam J. Gushgari is with Eurofins Pandemic Prevention Services, Sacramento, CA. Nishita D'Souza is with Department of Fisheries and Wildlife, Michigan State University, East Lansing. Joshua A. Steele is with the Department of Microbiology, Southern California Coastal Water Research Project, Costa Mesa, CA. Devrim Kaya is with the School of Public Health, San Diego State University, CA. Lydia R. Gushgari is with SPOC Proteomics, Inc., Scottsdale, AZ
| | - Adam J Gushgari
- Ishi Keenum is with the Civil, Environmental, and Geospatial Department, Michigan Technological University, Houghton. Nancy J. Lin and Alshae' Logan-Jackson are with the Biosystems and Biomaterials Division, National Institute of Standards and Technology, Gaithersburg, MD. Adam J. Gushgari is with Eurofins Pandemic Prevention Services, Sacramento, CA. Nishita D'Souza is with Department of Fisheries and Wildlife, Michigan State University, East Lansing. Joshua A. Steele is with the Department of Microbiology, Southern California Coastal Water Research Project, Costa Mesa, CA. Devrim Kaya is with the School of Public Health, San Diego State University, CA. Lydia R. Gushgari is with SPOC Proteomics, Inc., Scottsdale, AZ
| | - Nishita D'Souza
- Ishi Keenum is with the Civil, Environmental, and Geospatial Department, Michigan Technological University, Houghton. Nancy J. Lin and Alshae' Logan-Jackson are with the Biosystems and Biomaterials Division, National Institute of Standards and Technology, Gaithersburg, MD. Adam J. Gushgari is with Eurofins Pandemic Prevention Services, Sacramento, CA. Nishita D'Souza is with Department of Fisheries and Wildlife, Michigan State University, East Lansing. Joshua A. Steele is with the Department of Microbiology, Southern California Coastal Water Research Project, Costa Mesa, CA. Devrim Kaya is with the School of Public Health, San Diego State University, CA. Lydia R. Gushgari is with SPOC Proteomics, Inc., Scottsdale, AZ
| | - Joshua A Steele
- Ishi Keenum is with the Civil, Environmental, and Geospatial Department, Michigan Technological University, Houghton. Nancy J. Lin and Alshae' Logan-Jackson are with the Biosystems and Biomaterials Division, National Institute of Standards and Technology, Gaithersburg, MD. Adam J. Gushgari is with Eurofins Pandemic Prevention Services, Sacramento, CA. Nishita D'Souza is with Department of Fisheries and Wildlife, Michigan State University, East Lansing. Joshua A. Steele is with the Department of Microbiology, Southern California Coastal Water Research Project, Costa Mesa, CA. Devrim Kaya is with the School of Public Health, San Diego State University, CA. Lydia R. Gushgari is with SPOC Proteomics, Inc., Scottsdale, AZ
| | - Devrim Kaya
- Ishi Keenum is with the Civil, Environmental, and Geospatial Department, Michigan Technological University, Houghton. Nancy J. Lin and Alshae' Logan-Jackson are with the Biosystems and Biomaterials Division, National Institute of Standards and Technology, Gaithersburg, MD. Adam J. Gushgari is with Eurofins Pandemic Prevention Services, Sacramento, CA. Nishita D'Souza is with Department of Fisheries and Wildlife, Michigan State University, East Lansing. Joshua A. Steele is with the Department of Microbiology, Southern California Coastal Water Research Project, Costa Mesa, CA. Devrim Kaya is with the School of Public Health, San Diego State University, CA. Lydia R. Gushgari is with SPOC Proteomics, Inc., Scottsdale, AZ
| | - Lydia R Gushgari
- Ishi Keenum is with the Civil, Environmental, and Geospatial Department, Michigan Technological University, Houghton. Nancy J. Lin and Alshae' Logan-Jackson are with the Biosystems and Biomaterials Division, National Institute of Standards and Technology, Gaithersburg, MD. Adam J. Gushgari is with Eurofins Pandemic Prevention Services, Sacramento, CA. Nishita D'Souza is with Department of Fisheries and Wildlife, Michigan State University, East Lansing. Joshua A. Steele is with the Department of Microbiology, Southern California Coastal Water Research Project, Costa Mesa, CA. Devrim Kaya is with the School of Public Health, San Diego State University, CA. Lydia R. Gushgari is with SPOC Proteomics, Inc., Scottsdale, AZ
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Shrestha S, Malla B, Sangsanont J, Sirikanchana K, Ngo HTT, Inson JGM, Enriquez MLD, Alam ZF, Setiyawan AS, Setiadi T, Takeda T, Kitajima M, Haramoto E. Detection of enteroviruses related to hand foot and mouth disease in wastewater of Asian communities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169375. [PMID: 38110101 DOI: 10.1016/j.scitotenv.2023.169375] [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: 10/21/2023] [Revised: 11/25/2023] [Accepted: 12/12/2023] [Indexed: 12/20/2023]
Abstract
Hand, foot, and mouth disease (HFMD) is contagious and predominantly affects children below the age of five. HFMD-associated serotypes of Enterovirus A (EVA) family include EVA71, Coxsackievirus A type 6 (CVA6), 10 (CVA10), and 16 (CVA16). Although prevalent in numerous Asian countries, studies on HFMD-causing agents in wastewater are scarce. This study aimed to conduct wastewater surveillance in various Asian communities to detect and quantify serotypes of EVA associated with HFMD. In total, 77 wastewater samples were collected from Indonesia, the Philippines, Thailand, and Vietnam from March 2022 to February 2023. The detection ratio for CVA6 RNA in samples from Vietnam was 40 % (8/20). The detection ratio for CVA6 and EVA71 RNA each was 25 % (5/20) for the Indonesian samples, indicating the need for clinical surveillance of CVA6, as clinical reports have been limited. For the Philippines, 12 % (2/17) of the samples were positive for CVA6 and EVA71 RNA each, with only one quantifiable sample each. Samples from Thailand had a lower detection ratio (1/20) for CVA6 RNA, and the concentration was unquantifiable. Conversely, CVA10 and CVA16 RNAs were not detected in any of the samples. The minimum and maximum concentrations of CVA6 RNA were 2.7 and 3.9 log10 copies/L and those for EVA71 RNA were 2.5 and 4.9 log10 copies/L, respectively. This study underscores the importance of wastewater surveillance in understanding the epidemiology of HFMD-associated EVA serotypes in Asian communities. Long-term wastewater surveillance is recommended to monitor changes in dominant serotypes, understand seasonality, and develop effective prevention and control strategies for HFMD.
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Affiliation(s)
- Sadhana Shrestha
- Interdisciplinary Center for River Basin Environment, University of Yamanashi, 4-3-11 Takeda, Kofu, Yamanashi 400-8511, Japan
| | - Bikash Malla
- Interdisciplinary Center for River Basin Environment, University of Yamanashi, 4-3-11 Takeda, Kofu, Yamanashi 400-8511, Japan
| | - Jatuwat Sangsanont
- Department of Environmental Science, Chulalongkorn University, Phayathai Road, Pathumwan, Bangkok 10330, Thailand; Water Science and Technology for Sustainable Environmental Research Group, Chulalongkorn University, Bangkok 10330, Thailand.
| | - Kwanrawee Sirikanchana
- Research Laboratory of Biotechnology, Chulabhorn Research Institute, 54 Kamphaeng Phet 6 Rd., Talat Bang Khen, Lak Si, Bangkok 10210, Thailand; Center of Excellence on Environmental Health and Toxicology (EHT), OPS, MHESI, Bangkok 10400, Thailand.
| | - Huong Thi Thuy Ngo
- Faculty of Biotechnology, Chemistry and Environmental Engineering, Phenikaa University, Yen Nghia, Ha Dong, Hanoi 12116, Viet Nam; Environmental Chemistry and Ecotoxicology Lab, Phenikaa University, Yen Nghia Ward - Ha Dong District, Hanoi 12116, Viet Nam.
| | - Jessamine Gail M Inson
- Department of Biology, De La Salle University, 2401 Taft Avenue, Manila 1004, Philippines.
| | - Ma Luisa D Enriquez
- Department of Biology, De La Salle University, 2401 Taft Avenue, Manila 1004, Philippines.
| | - Zeba F Alam
- Department of Biology, De La Salle University, 2401 Taft Avenue, Manila 1004, Philippines.
| | - Ahmad Soleh Setiyawan
- Department of Environmental Engineering, Institut Teknologi Bandung, Jl. Ganesha No. 10, Bandung 40132, Indonesia.
| | - Tjandra Setiadi
- Department of Chemical Engineering, Institut Teknologi Bandung, Jl. Ganesa 10, Bandung 40132, Indonesia.
| | - Tomoko Takeda
- Department of Earth and Planetary Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
| | - Masaaki Kitajima
- Division of Environmental Engineering, Hokkaido University, North 13 West 8, Kita-ku, Sapporo, Hokkaido 060-8628, Japan.
| | - Eiji Haramoto
- Interdisciplinary Center for River Basin Environment, University of Yamanashi, 4-3-11 Takeda, Kofu, Yamanashi 400-8511, Japan.
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3
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El Soufi G, Di Jorio L, Gerber Z, Cluzel N, Van Assche J, Delafoy D, Olaso R, Daviaud C, Loustau T, Schwartz C, Trebouet D, Hernalsteens O, Marechal V, Raffestin S, Rousset D, Van Lint C, Deleuze JF, Boni M, Rohr O, Villain-Gambier M, Wallet C. Highly efficient and sensitive membrane-based concentration process allows quantification, surveillance, and sequencing of viruses in large volumes of wastewater. WATER RESEARCH 2024; 249:120959. [PMID: 38070350 DOI: 10.1016/j.watres.2023.120959] [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: 09/28/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024]
Abstract
Wastewater-based epidemiology is experiencing exponential development. Despite undeniable advantages compared to patient-centered approaches (cost, anonymity, survey of large populations without bias, detection of asymptomatic infected peoples…), major technical limitations persist. Among them is the low sensitivity of the current methods used for quantifying and sequencing viral genomes from wastewater. In situations of low viral circulation, during initial stages of viral emergences, or in areas experiencing heavy rains, the extremely low concentrations of viruses in wastewater may fall below the limit of detection of the current methods. The availability during crisis and the cost of the commercial kits, as well as the requirement of expensive materials such as high-speed centrifuge, can also present major blocks to the development of wastewater-based epidemiological survey, specifically in low-income countries. Thereby, highly sensitive, low cost and standardized methods are still needed, to increase the predictability of the viral emergences, to survey low-circulating viruses and to make the results from different labs comparable. Here, we outline and characterize new protocols for concentrating and quantifying SARS-CoV-2 from large volumes (500 mL-1 L) of untreated wastewater. In addition, we report that the methods are applicable for monitoring and sequencing. Our nucleic acid extraction technique (the routine C: 5 mL method) does not require sophisticated equipment such as automatons and is not reliant on commercial kits, making it readily available to a broader range of laboratories for routine epidemiological survey. Furthermore, we demonstrate the efficiency, the repeatability, and the high sensitivity of a new membrane-based concentration method (MBC: 500 mL method) for enveloped (SARS-CoV-2) and non-enveloped (F-specific RNA phages of genogroup II / FRNAPH GGII) viruses. We show that the MBC method allows the quantification and the monitoring of viruses in wastewater with a significantly improved sensitivity compared to the routine C method. In contexts of low viral circulation, we report quantifications of SARS-CoV-2 in wastewater at concentrations as low as 40 genome copies per liter. In highly diluted samples collected in wastewater treatment plants of French Guiana, we confirmed the accuracy of the MBC method compared to the estimations done with the routine C method. Finally, we demonstrate that both the routine C method processing 5 mL and the MBC method processing 500 mL of untreated wastewater are both compatible with SARS-CoV-2 sequencing. We show that the quality of the sequence is correlated with the concentration of the extracted viral genome. Of note, the quality of the sequences obtained with some MBC processed wastewater was improved by dilutions or enzyme substitutions suggesting the presence of specific enzyme inhibitors in some wastewater. To the best of our knowledge, our MBC method is one of the first efficient, sensitive, and repeatable method characterized for SARS-CoV-2 quantification and sequencing from large volumes of wastewater.
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Affiliation(s)
- G El Soufi
- DHPI UR 7292, IUT Louis Pasteur, Université de Strasbourg, Schiltigheim, France; CNRS, IPHC, UMR 7178, Université de Strasbourg, Strasbourg F-67000, France
| | - L Di Jorio
- DHPI UR 7292, IUT Louis Pasteur, Université de Strasbourg, Schiltigheim, France
| | - Z Gerber
- CEA, Centre National de Recherche en Génomique Humaine, Université Paris-Saclay, Evry 91057, France
| | - N Cluzel
- Maison des Modélisations Ingénieries et Technologies (SUMMIT), Sorbonne Université, Paris 75005, France
| | - J Van Assche
- DHPI UR 7292, IUT Louis Pasteur, Université de Strasbourg, Schiltigheim, France
| | - D Delafoy
- CEA, Centre National de Recherche en Génomique Humaine, Université Paris-Saclay, Evry 91057, France
| | - R Olaso
- CEA, Centre National de Recherche en Génomique Humaine, Université Paris-Saclay, Evry 91057, France
| | - C Daviaud
- CEA, Centre National de Recherche en Génomique Humaine, Université Paris-Saclay, Evry 91057, France
| | - T Loustau
- DHPI UR 7292, IUT Louis Pasteur, Université de Strasbourg, Schiltigheim, France
| | - C Schwartz
- DHPI UR 7292, IUT Louis Pasteur, Université de Strasbourg, Schiltigheim, France
| | - D Trebouet
- CNRS, IPHC, UMR 7178, Université de Strasbourg, Strasbourg F-67000, France
| | - O Hernalsteens
- Department of Molecular Biology (DBM), Service of Molecular Virology, Université Libre de Bruxelles (ULB), Gosselies 6041, Belgium
| | - V Marechal
- INSERM, Centre de Recherche Saint-Antoine, Sorbonne Université, Paris 75012, France; OBEPINE Consortium, Paris, France
| | - S Raffestin
- Institut Pasteur de la Guyane, French Guiana, Cayenne 97300, France; OBEPINE Consortium, Paris, France
| | - D Rousset
- Institut Pasteur de la Guyane, French Guiana, Cayenne 97300, France; OBEPINE Consortium, Paris, France
| | - C Van Lint
- Department of Molecular Biology (DBM), Service of Molecular Virology, Université Libre de Bruxelles (ULB), Gosselies 6041, Belgium
| | - J F Deleuze
- CEA, Centre National de Recherche en Génomique Humaine, Université Paris-Saclay, Evry 91057, France
| | - M Boni
- French Armed Forces Biomedical Research Institute, 91220 Brétigny-sur-Orge, France; OBEPINE Consortium, Paris, France
| | - O Rohr
- DHPI UR 7292, IUT Louis Pasteur, Université de Strasbourg, Schiltigheim, France; OBEPINE Consortium, Paris, France.
| | - M Villain-Gambier
- CNRS, IPHC, UMR 7178, Université de Strasbourg, Strasbourg F-67000, France
| | - C Wallet
- DHPI UR 7292, IUT Louis Pasteur, Université de Strasbourg, Schiltigheim, France; OBEPINE Consortium, Paris, France
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4
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Rao G, Capone D, Zhu K, Knoble A, Linden Y, Clark R, Lai A, Kim J, Huang CH, Bivins A, Brown J. Simultaneous detection and quantification of multiple pathogen targets in wastewater. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.06.23.23291792. [PMID: 37425908 PMCID: PMC10327253 DOI: 10.1101/2023.06.23.23291792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Wastewater-based epidemiology has emerged as a critical tool for public health surveillance, building on decades of environmental surveillance work for pathogens such as poliovirus. Work to date has been limited to monitoring a single pathogen or small numbers of pathogens in targeted studies; however, few studies consider simultaneous quantitative analysis of a wide variety of pathogens, which could greatly increase the utility of wastewater surveillance. We developed a novel quantitative multi-pathogen surveillance approach (35 pathogen targets including bacteria, viruses, protozoa, and helminths) using TaqMan Array Cards (TAC) and applied the method on concentrated wastewater samples collected at four wastewater treatment plants in Atlanta, GA from February to October of 2020. From sewersheds serving approximately 2 million people, we detected a wide range of targets including many we expected to find in wastewater (e.g., enterotoxigenic E. coli and Giardia in 97% of 29 samples at stable concentrations) as well as unexpected targets including Strongyloides stercoralis (a human threadworm rarely observed in the USA). Other notable detections included SARS-CoV-2, but also several pathogen targets that are not commonly included in wastewater surveillance like Acanthamoeba spp., Balantidium coli, Entamoeba histolytica, astrovirus, norovirus, and sapovirus. Our data suggest broad utility in expanding the scope of enteric pathogen surveillance in wastewaters, with potential for application in a variety of settings where pathogen quantification in fecal waste streams can inform public health surveillance and selection of control measures to limit infections.
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Affiliation(s)
- Gouthami Rao
- Department of Environmental Sciences and Engineering, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Drew Capone
- Department of Environmental and Occupational Health, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Kevin Zhu
- Department of Environmental Sciences and Engineering, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Abigail Knoble
- Department of Environmental Sciences and Engineering, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yarrow Linden
- Department of Environmental Sciences and Engineering, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ryan Clark
- Department of Environmental Sciences and Engineering, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Amanda Lai
- Department of Environmental Sciences and Engineering, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Juhee Kim
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Ching-Hua Huang
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Aaron Bivins
- Department of Civil & Environmental Engineering, Louisiana State University, Baton Rouge, LA, USA
| | - Joe Brown
- Department of Environmental Sciences and Engineering, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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5
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Bowes D, Darling A, Driver EM, Kaya D, Maal-Bared R, Lee LM, Goodman K, Adhikari S, Aggarwal S, Bivins A, Bohrerova Z, Cohen A, Duvallet C, Elnimeiry RA, Hutchison JM, Kapoor V, Keenum I, Ling F, Sills D, Tiwari A, Vikesland P, Ziels R, Mansfeldt C. Structured Ethical Review for Wastewater-Based Testing in Support of Public Health. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:12969-12980. [PMID: 37611169 PMCID: PMC10484207 DOI: 10.1021/acs.est.3c04529] [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: 06/13/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/25/2023]
Abstract
Wastewater-based testing (WBT) for SARS-CoV-2 has rapidly expanded over the past three years due to its ability to provide a comprehensive measurement of disease prevalence independent of clinical testing. The development and simultaneous application of WBT measured biomarkers for research activities and for the pursuit of public health goals, both areas with well-established ethical frameworks. Currently, WBT practitioners do not employ a standardized ethical review process, introducing the potential for adverse outcomes for WBT professionals and community members. To address this deficiency, an interdisciplinary workshop developed a framework for a structured ethical review of WBT. The workshop employed a consensus approach to create this framework as a set of 11 questions derived from primarily public health guidance. This study retrospectively applied these questions to SARS-CoV-2 monitoring programs covering the emergent phase of the pandemic (3/2020-2/2022 (n = 53)). Of note, 43% of answers highlight a lack of reported information to assess. Therefore, a systematic framework would at a minimum structure the communication of ethical considerations for applications of WBT. Consistent application of an ethical review will also assist in developing a practice of updating approaches and techniques to reflect the concerns held by both those practicing and those being monitored by WBT supported programs.
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Affiliation(s)
- Devin
A. Bowes
- Biodesign
Center for Environmental Health Engineering, The Biodesign Institute, Arizona State University, 1001 S. McAllister Ave, Tempe, Arizona 85287, United States
- Center on
Forced Displacement, Boston University, 111 Cummington Mall, Boston, Massachusetts 02215, United States
| | - Amanda Darling
- Department
of Civil and Environmental Engineering, Virginia Tech, 1145 Perry Street, 415 Durham Hall; Blacksburg, Virginia 24061, United States
| | - Erin M. Driver
- Biodesign
Center for Environmental Health Engineering, The Biodesign Institute, Arizona State University, 1001 S. McAllister Ave, Tempe, Arizona 85287, United States
| | - Devrim Kaya
- School of
Chemical, Biological, and Environmental Engineering, Oregon State University, 105 26th St, Corvallis, Oregon 97331, United States
- School of
Public Health, San Diego State University, San Diego and Imperial Valley, California 92182, United States
| | - Rasha Maal-Bared
- Quality
Assurance and Environment, EPCOR Water Services Inc., EPCOR Tower, 2000−10423 101
Street NW, Edmonton, Alberta T5H 0E7, Canada
| | - Lisa M. Lee
- Department
of Population Health Sciences and Division of Scholarly Integrity
and Research Compliance, Virginia Tech, 300 Turner St. NW, Suite 4120 (0497), Blacksburg, Virginia 24061, United States
| | - Kenneth Goodman
- Institute
for Bioethics and Health Policy, Miller School of Medicine, University of Miami, Miami, Florida 33101, United States
| | - Sangeet Adhikari
- Biodesign
Center for Environmental Health Engineering, The Biodesign Institute, Arizona State University, 1001 S. McAllister Ave, Tempe, Arizona 85287, United States
| | - Srijan Aggarwal
- Department
of Civil, Geological, and Environmental Engineering, University of Alaska Fairbanks, 1764 Tanana Loop, Fairbanks, Alaska 99775, United States
| | - Aaron Bivins
- Department
of Civil & Environmental Engineering, Louisiana State University, 3255 Patrick F. Taylor Hall, Baton Rouge, Louisiana 70803, United States
| | - Zuzana Bohrerova
- The Ohio
State University, Department of Civil, Environmental
and Geodetic Engineering, 2070 Neil Avenue, 470 Hitchcock Hall, Columbus, Ohio 43210, United States
| | - Alasdair Cohen
- Department
of Civil and Environmental Engineering, Virginia Tech, 1145 Perry Street, 415 Durham Hall; Blacksburg, Virginia 24061, United States
- Department
of Population Health Sciences, Virginia
Tech, 205 Duck Pond Drive, Blacksburg, Virginia 24061, United States
| | - Claire Duvallet
- Biobot
Analytics, Inc., 501
Massachusetts Avenue; Cambridge, Massachusetts 02139, United States
| | - Rasha A. Elnimeiry
- Public
Health Outbreak Coordination, Informatics, Surveillance (PHOCIS) Office—Surveillance
Section, Division of Disease Control and Health Statistics, Washington State Department of Health, 111 Israel Rd SE, Tumwater, Washington 98501, United States
| | - Justin M. Hutchison
- Department
of Civil, Environmental, and Architectural Engineering, University of Kansas, 1530 W 15th St, Lawrence, Kansas 66045, United States
| | - Vikram Kapoor
- School
of Civil & Environmental Engineering, and Construction Management, University of Texas at San Antonio, 1 UTSA Circle, San Antonio, Texas 78249, United States
| | - Ishi Keenum
- Complex
Microbial Systems Group, National Institute
of Standards and Technology, 100 Bureau Dr, Gaithersburg, Maryland 20899, United States
| | - Fangqiong Ling
- Department
of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, One Brookings Drive, St. Louis, Missouri 63130, United States
| | - Deborah Sills
- Department
of Civil and Environmental Engineering, Bucknell University, Lewisburg, Pennsylvania 17837, United States
| | - Ananda Tiwari
- Department
of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Agnes Sjöberginkatu 2,
P.O. Box 66, FI 00014 Helsinki, Finland
- Expert
Microbiology Unit, Finnish Institute for
Health and Welfare, FI 70600 Kuopio, Finland
| | - Peter Vikesland
- Department
of Civil and Environmental Engineering, Virginia Tech, 1145 Perry Street, 415 Durham Hall; Blacksburg, Virginia 24061, United States
| | - Ryan Ziels
- Department
of Civil Engineering, The University of
British Columbia, 6250
Applied Science Ln #2002, Vancouver, BC V6T 1Z4, Canada
| | - Cresten Mansfeldt
- Department
of Civil, Environmental, and Architectural Engineering, University of Colorado Boulder, UCB 428, Boulder, Colorado 80309, United States
- Environmental
Engineering Program, University of Colorado
Boulder, UCB 607, Boulder, Colorado 80309, United States
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6
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Bowes DA, Darling A, Driver EM, Kaya D, Maal-Bared R, Lee LM, Goodman K, Adhikari S, Aggarwal S, Bivins A, Bohrerova Z, Cohen A, Duvallet C, Elnimeiry RA, Hutchison JM, Kapoor V, Keenum I, Ling F, Sills D, Tiwari A, Vikesland P, Ziels R, Mansfeldt C. Structured Ethical Review for Wastewater-Based Testing. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.06.12.23291231. [PMID: 37398480 PMCID: PMC10312843 DOI: 10.1101/2023.06.12.23291231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Wastewater-based testing (WBT) for SARS-CoV-2 has rapidly expanded over the past three years due to its ability to provide a comprehensive measurement of disease prevalence independent of clinical testing. The development and simultaneous application of the field blurred the boundary between measuring biomarkers for research activities and for pursuit of public health goals, both areas with well-established ethical frameworks. Currently, WBT practitioners do not employ a standardized ethical review process (or associated data management safeguards), introducing the potential for adverse outcomes for WBT professionals and community members. To address this deficiency, an interdisciplinary group developed a framework for a structured ethical review of WBT. The workshop employed a consensus approach to create this framework as a set of 11-questions derived from primarily public health guidance because of the common exemption of wastewater samples to human subject research considerations. This study retrospectively applied the set of questions to peer- reviewed published reports on SARS-CoV-2 monitoring campaigns covering the emergent phase of the pandemic from March 2020 to February 2022 (n=53). Overall, 43% of the responses to the questions were unable to be assessed because of lack of reported information. It is therefore hypothesized that a systematic framework would at a minimum improve the communication of key ethical considerations for the application of WBT. Consistent application of a standardized ethical review will also assist in developing an engaged practice of critically applying and updating approaches and techniques to reflect the concerns held by both those practicing and being monitored by WBT supported campaigns. Abstract Figure Synopsis Development of a structured ethical review facilitates retrospective analysis of published studies and drafted scenarios in the context of wastewater-based testing.
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Affiliation(s)
- Devin A. Bowes
- Biodesign Center for Environmental Health Engineering, The Biodesign Institute, Arizona State University, 1001 S. McAllister Ave, Tempe, AZ, 85287
- Center on Forced Displacement, Boston University, 111 Cummington Mall, Boston, MA, 02215
| | - Amanda Darling
- Department of Civil and Environmental Engineering, Virginia Tech, 1145 Perry Street; 415 Durham Hall; Blacksburg, VA 24061
| | - Erin M. Driver
- Biodesign Center for Environmental Health Engineering, The Biodesign Institute, Arizona State University, 1001 S. McAllister Ave, Tempe, AZ, 85287
| | - Devrim Kaya
- School of Chemical, Biological, and Environmental Engineering, Oregon State University, 105 26th St, Corvallis, Oregon 97331
- School of Public Health, San Diego State University, San Diego and Imperial Valley, CA
| | - Rasha Maal-Bared
- Quality Assurance and Environment, EPCOR Water Services Inc., EPCOR Tower, 2000–10423 101 Street NW, Edmonton, Alberta, CA
| | - Lisa M. Lee
- Department of Population Health Sciences and Division of Scholarly Integrity and Research Compliance, Virginia Tech, 300 Turner St. NW, Suite 4120 (0497), Blacksburg, VA 24061
| | - Kenneth Goodman
- Institute for Bioethics and Health Policy, Miller School of Medicine, University of Miami, Miami, Florida
| | - Sangeet Adhikari
- Biodesign Center for Environmental Health Engineering, The Biodesign Institute, Arizona State University, 1001 S. McAllister Ave, Tempe, AZ, 85287
| | - Srijan Aggarwal
- Department of Civil, Geological, and Environmental Engineering, University of Alaska Fairbanks, 1764 Tanana Loop, Fairbanks, AK 99775
| | - Aaron Bivins
- Department of Civil & Environmental Engineering, Louisiana State University, 3255 Patrick F. Taylor Hall, Baton Rouge, LA 70803
| | - Zuzana Bohrerova
- The Ohio State University, Department of Civil, Environmental and Geodetic Engineering, 2070 Neil Avenue, 470 Hitchcock Hall, Columbus, OH 43210
| | - Alasdair Cohen
- Department of Civil and Environmental Engineering, Virginia Tech, 1145 Perry Street; 415 Durham Hall; Blacksburg, VA 24061
- Department of Population Health Sciences, Virginia Tech, 205 Duck Pond Drive, Blacksburg, VA 24061
| | - Claire Duvallet
- Biobot Analytics, Inc., 501 Massachusetts Avenue; Cambridge, MA; 02139
| | - Rasha A. Elnimeiry
- Public Health Outbreak Coordination, Informatics, Surveillance (PHOCIS) Office – Surveillance Section, Division of Disease Control and Health Statistics, Washington State Department of Health, 111 Israel Rd SE, Tumwater, WA 98501
| | - Justin M. Hutchison
- Department of Civil, Environmental, and Architectural Engineering, University of Kansas, 1530 W 15th St, Lawrence, KS 66045
| | - Vikram Kapoor
- School of Civil & Environmental Engineering, and Construction Management, University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX 78249
| | - Ishi Keenum
- Complex Microbial Systems Group, National Institute of Standards and Technology, 100 Bureau Dr, Gaithersburg, MD 20899
| | - Fangqiong Ling
- Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130
| | - Deborah Sills
- Department of Civil and Environmental Engineering, Bucknell University, Lewisburg, PA, 17837
| | - Ananda Tiwari
- Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Agnes Sjöberginkatu 2 P.O. Box 66 FI 00014 Helsinki, Finland
- Expert Microbiology Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Peter Vikesland
- Department of Civil and Environmental Engineering, Virginia Tech, 1145 Perry Street; 415 Durham Hall; Blacksburg, VA 24061
| | - Ryan Ziels
- Department of Civil Engineering, the University of British Columbia, 6250 Applied Science Ln #2002, Vancouver, BC V6T 1Z4
| | - Cresten Mansfeldt
- Department of Civil, Environmental, and Architectural Engineering, University of Colorado Boulder, UCB 428, Boulder, CO 80309
- Environmental Engineering Program, University of Colorado Boulder, UCB 607, Boulder, CO 80309
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7
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Gentry Z, Zhao L, Faust RA, David RE, Norton J, Xagoraraki I. Wastewater surveillance beyond COVID-19: a ranking system for communicable disease testing in the tri-county Detroit area, Michigan, USA. Front Public Health 2023; 11:1178515. [PMID: 37333521 PMCID: PMC10272568 DOI: 10.3389/fpubh.2023.1178515] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/12/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction Throughout the coronavirus disease 2019 (COVID-19) pandemic, wastewater surveillance has been utilized to monitor the disease in the United States through routine national, statewide, and regional monitoring projects. A significant canon of evidence was produced showing that wastewater surveillance is a credible and effective tool for disease monitoring. Hence, the application of wastewater surveillance can extend beyond monitoring SARS-CoV-2 to encompass a diverse range of emerging diseases. This article proposed a ranking system for prioritizing reportable communicable diseases (CDs) in the Tri-County Detroit Area (TCDA), Michigan, for future wastewater surveillance applications at the Great Lakes Water Authority's Water Reclamation Plant (GLWA's WRP). Methods The comprehensive CD wastewater surveillance ranking system (CDWSRank) was developed based on 6 binary and 6 quantitative parameters. The final ranking scores of CDs were computed by summing the multiplication products of weighting factors for each parameter, and then were sorted based on decreasing priority. Disease incidence data from 2014 to 2021 were collected for the TCDA. Disease incidence trends in the TCDA were endowed with higher weights, prioritizing the TCDA over the state of Michigan. Results Disparities in incidences of CDs were identified between the TCDA and state of Michigan, indicating epidemiological differences. Among 96 ranked CDs, some top ranked CDs did not present relatively high incidences but were prioritized, suggesting that such CDs require significant attention by wastewater surveillance practitioners, despite their relatively low incidences in the geographic area of interest. Appropriate wastewater sample concentration methods are summarized for the application of wastewater surveillance as per viral, bacterial, parasitic, and fungal pathogens. Discussion The CDWSRank system is one of the first of its kind to provide an empirical approach to prioritize CDs for wastewater surveillance, specifically in geographies served by centralized wastewater collection in the area of interest. The CDWSRank system provides a methodological tool and critical information that can help public health officials and policymakers allocate resources. It can be used to prioritize disease surveillance efforts and ensure that public health interventions are targeted at the most potentially urgent threats. The CDWSRank system can be easily adopted to geographical locations beyond the TCDA.
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Affiliation(s)
- Zachary Gentry
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, United States
| | - Liang Zhao
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, United States
| | | | - Randy E. David
- Wayne State University School of Medicine, Detroit, MI, United States
| | - John Norton
- Great Lakes Water Authority, Detroit, MI, United States
| | - Irene Xagoraraki
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, United States
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Napit R, Manandhar P, Chaudhary A, Shrestha B, Poudel A, Raut R, Pradhan S, Raut S, Rajbhandari PG, Gurung A, Rajbhandari RM, Dixit SM, Schwind JS, Johnson CK, Mazet JK, Karmacharya DB. Rapid genomic surveillance of SARS-CoV-2 in a dense urban community of Kathmandu Valley using sewage samples. PLoS One 2023; 18:e0283664. [PMID: 36996055 PMCID: PMC10062583 DOI: 10.1371/journal.pone.0283664] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 03/14/2023] [Indexed: 03/31/2023] Open
Abstract
Understanding disease burden and transmission dynamics in resource-limited, low-income countries like Nepal are often challenging due to inadequate surveillance systems. These issues are exacerbated by limited access to diagnostic and research facilities throughout the country. Nepal has one of the highest COVID-19 case rates (915 cases per 100,000 people) in South Asia, with densely-populated Kathmandu experiencing the highest number of cases. Swiftly identifying case clusters (hotspots) and introducing effective intervention programs is crucial to mounting an effective containment strategy. The rapid identification of circulating SARS-CoV-2 variants can also provide important information on viral evolution and epidemiology. Genomic-based environmental surveillance can help in the early detection of outbreaks before clinical cases are recognized and identify viral micro-diversity that can be used for designing real-time risk-based interventions. This research aimed to develop a genomic-based environmental surveillance system by detecting and characterizing SARS-CoV-2 in sewage samples of Kathmandu using portable next-generation DNA sequencing devices. Out of 22 sites in the Kathmandu Valley from June to August 2020, sewage samples from 16 (80%) sites had detectable SARS-CoV-2. A heatmap was created to visualize the presence of SARS-CoV-2 infection in the community based on viral load intensity and corresponding geospatial data. Further, 47 mutations were observed in the SARS-CoV-2 genome. Some detected mutations (n = 9, 22%) were novel at the time of data analysis and yet to be reported in the global database, with one indicating a frameshift deletion in the spike gene. SNP analysis revealed possibility of assessing circulating major/minor variant diversity on environmental samples based on key mutations. Our study demonstrated the feasibility of rapidly obtaining vital information on community transmission and disease dynamics of SARS-CoV-2 using genomic-based environmental surveillance.
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Affiliation(s)
- Rajindra Napit
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
- Virology Division, BIOVAC Nepal Pvt. Ltd., Nala, Banepa, Nepal
| | - Prajwol Manandhar
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
- Virology Division, BIOVAC Nepal Pvt. Ltd., Nala, Banepa, Nepal
| | - Ashok Chaudhary
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
| | - Bishwo Shrestha
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
| | - Ajit Poudel
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
- Virology Division, BIOVAC Nepal Pvt. Ltd., Nala, Banepa, Nepal
| | - Roji Raut
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
| | - Saman Pradhan
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
- Virology Division, BIOVAC Nepal Pvt. Ltd., Nala, Banepa, Nepal
| | - Samita Raut
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
| | - Pragun G. Rajbhandari
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
| | - Anupama Gurung
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
| | - Rajesh M. Rajbhandari
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
- Virology Division, BIOVAC Nepal Pvt. Ltd., Nala, Banepa, Nepal
| | - Sameer M. Dixit
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
| | - Jessica S. Schwind
- Institute for Health Logistics & Analytics, Georgia Southern University, Statesboro, GA, United States of America
| | - Christine K. Johnson
- One Health Institute, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States of America
| | - Jonna K. Mazet
- One Health Institute, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States of America
| | - Dibesh B. Karmacharya
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
- Virology Division, BIOVAC Nepal Pvt. Ltd., Nala, Banepa, Nepal
- The School of Biological Sciences, University of Queensland, Brisbane, Australia
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9
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Spurbeck RR, Catlin LA, Mukherjee C, Smith AK, Minard-Smith A. Analysis of metatranscriptomic methods to enable wastewater-based biosurveillance of all infectious diseases. Front Public Health 2023; 11:1145275. [PMID: 37033057 PMCID: PMC10073511 DOI: 10.3389/fpubh.2023.1145275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/27/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction Wastewater-based surveillance emerged during the COVID-19 pandemic as an efficient way to quickly screen large populations, monitor infectious disease transmission over time, and identify whether more virulent strains are becoming more prevalent in the region without burdening the health care system with individualized testing. Ohio was one of the first states to implement wastewater monitoring through its Ohio Coronavirus Wastewater Monitoring Network (OCWMN), originally tracking the prevalence of COVID-19 by quantitative qPCR from over 67 sites across the state. The OCWMN evolved along with the pandemic to include sequencing the SARS-CoV-2 genome to assess variants of concern circulating within the population. As the pandemic wanes, networks such as OCWMN can be expanded to monitor other infectious diseases and outbreaks of interest to the health department to reduce the burden of communicable diseases. However, most surveillance still utilizes qPCR based diagnostic tests for individual pathogens, which is hard to scale for surveillance of multiple pathogens. Methods Here we have tested several genomic methods, both targeted and untargeted, for wastewater-based biosurveillance to find the most efficient procedure to detect and track trends in reportable infectious diseases and outbreaks of known pathogens as well as potentially novel pathogens or variants on the rise in our communities. RNA extracts from the OCWMN were provided weekly from 10 sites for 6 weeks. Total RNA was sequenced from the samples on the Illumina NextSeq and on the MinION to identify pathogens present. The MinION long read platform was also used to sequence SARS-CoV-2 with the goal of reducing the complexity of variant calling in mixed populations as occurs with short Illumina reads. Finally, a targeted hybridization approach was tested for compatibility with wastewater RNA samples. Results and discussion The data analyzed here provides a baseline assessment that demonstrates that wastewater is a rich resource for infectious disease epidemiology and identifies technology gaps and potential solutions to enable this resource to be used by public health laboratories to monitor the infectious disease landscape of the regions they serve.
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Affiliation(s)
- Rachel R. Spurbeck
- Health Business Unit, Drug Development and Precision Diagnostics Division, Life Sciences Research Business Line, Battelle Memorial Institute, Columbus, OH, United States
| | - Lindsay A. Catlin
- National Security Business Unit, Bioscience Center, CBRNE Business Line, Battelle Memorial Institute, Columbus, OH, United States
| | - Chiranjit Mukherjee
- Health Business Unit, Health Analytics Division, Health Outcomes and Biotechnology Solutions Business Line, Battelle Memorial Institute, Columbus, OH, United States
| | - Anthony K. Smith
- National Security Business Unit, Bioscience Center, CBRNE Business Line, Battelle Memorial Institute, Columbus, OH, United States
| | - Angela Minard-Smith
- Health Business Unit, Health Analytics Division, Health Outcomes and Biotechnology Solutions Business Line, Battelle Memorial Institute, Columbus, OH, United States
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Brooks YM, Gryskwicz B, Sidaway E, Shelley B, Coroi L, Downing M, Downing T, McDonnell S, Ostrye D, Hoop K, Parrish G. A case study of a community-organized wastewater surveillance in a small community: correlating weekly reported COVID-19 cases with SARS-CoV-2 RNA concentrations during fall 2020 to summer 2021 in Yarmouth, ME. JOURNAL OF WATER AND HEALTH 2023; 21:329-342. [PMID: 37338313 PMCID: wh_2023_238 DOI: 10.2166/wh.2023.238] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Wastewater surveillance offers a rapid evaluation of SARS-CoV-2 transmission in a community. We describe how a community group, the Yarmouth Wastewater Testing Team (YWTT), in Yarmouth, Maine, (population 8,990) utilized an asset-based community design framework to organize and manage a program to monitor SARS-CoV-2 RNA concentrations. From September 22, 2020 through June 8, 2021, the YWTT disseminated weekly reports of the wastewater results and reported COVID-19 cases within the Yarmouth postal code. After high and increasing SARS-CoV-2 RNA concentrations, the YWTT issued two community advisories to encourage extra care to reduce exposure. Correlations between SARS-CoV-2 RNA concentrations and COVID-19 cases were stronger the week after sampling, and the average of the COVID-19 cases during the week of sampling and the following week, indicating that surveillance provided advance notice of cases. A 10% increase in SARS-CoV-2 RNA concentrations was associated with a 13.29% increase in the average number of weekly reported cases of COVID-19 during the week of sampling and the following week (R2 = 0.42; p < 0.001). Adjusting for viral recovery (December 21, 2020 through June 8, 2021), improved R2 from 0.60 to 0.68. Wastewater surveillance was an effective tool for the YWTT to quickly respond to viral transmission.
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Affiliation(s)
- Yolanda M Brooks
- Department of Sciences, St. Joseph's College of Maine, 278 White's Bridge Rd, Standish, ME 04084, USA E-mail: ;
| | - Bailey Gryskwicz
- Department of Sciences, St. Joseph's College of Maine, 278 White's Bridge Rd, Standish, ME 04084, USA E-mail: ;
| | - Eilidh Sidaway
- Department of Sciences, St. Joseph's College of Maine, 278 White's Bridge Rd, Standish, ME 04084, USA E-mail: ;
| | - Brianna Shelley
- Department of Sciences, St. Joseph's College of Maine, 278 White's Bridge Rd, Standish, ME 04084, USA E-mail: ;
| | - Laura Coroi
- Wastewater Testing Team, Yarmouth Community Coronavirus Task Force, C/O Yarmouth Town Hall, 200 Main St., Yarmouth, ME 04096, USA
| | - Margaret Downing
- Wastewater Testing Team, Yarmouth Community Coronavirus Task Force, C/O Yarmouth Town Hall, 200 Main St., Yarmouth, ME 04096, USA
| | - Tom Downing
- Wastewater Testing Team, Yarmouth Community Coronavirus Task Force, C/O Yarmouth Town Hall, 200 Main St., Yarmouth, ME 04096, USA
| | - Sharon McDonnell
- Wastewater Testing Team, Yarmouth Community Coronavirus Task Force, C/O Yarmouth Town Hall, 200 Main St., Yarmouth, ME 04096, USA
| | - Dan Ostrye
- Wastewater Testing Team, Yarmouth Community Coronavirus Task Force, C/O Yarmouth Town Hall, 200 Main St., Yarmouth, ME 04096, USA
| | - Katrina Hoop
- Department of Social Sciences, University of Maine at Augusta, 46 University Drive, Augusta, ME 04330, USA
| | - Gib Parrish
- Wastewater Testing Team, Yarmouth Community Coronavirus Task Force, C/O Yarmouth Town Hall, 200 Main St., Yarmouth, ME 04096, USA
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11
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Amin V, Bowes DA, Halden RU. Systematic scoping review evaluating the potential of wastewater-based epidemiology for monitoring cardiovascular disease and cancer. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 858:160103. [PMID: 36370774 PMCID: PMC9643312 DOI: 10.1016/j.scitotenv.2022.160103] [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: 08/15/2022] [Revised: 11/05/2022] [Accepted: 11/06/2022] [Indexed: 06/16/2023]
Abstract
Cardiovascular disease (CVD) and cancer are collectively responsible for tens of millions of global deaths each year. These rates are projected to intensify as the COVID-19 pandemic has caused delays in individualized diagnostics, or exacerbated prevalence due to Post Acute Coronavirus (COVID-19) Syndrome. Wastewater-based epidemiology (WBE) has successfully been employed as a useful tool for generating population-level health assessments, and was examined here in this systematic scoping literature review to (i) identify endogenous human biomarkers reported to indicate CVD or cancer in clinical practice, (ii) assess specificity to the indicated diseases, (iii) evaluate the utility for estimating population-level disease prevalence in community wastewater, and (iv) contextualize the obtained information for monitoring CVD and cancer presence via WBE. A total of 48 peer-reviewed papers were critically examined identifying five urinary protein biomarkers: cardiac troponin I (cTnI) (heart attack/heart failure), cystatin C (atherosclerosis), normetanephrine (tumor presence), α-fetoprotein (prostate and liver cancer), and microtubule assisted serine/threonine kinase 4 (MAST4) (breast cancer). Next, urinary excretion information was utilized to predict biomarker concentrations extant in community wastewater, resulting in average healthy concentrations ranging from 0.02 to 1159 ng/L, and disease-indicating thresholds from 0.16 to 3041 ng/L. Finally, estimating prevalence-adjusted wastewater measurements was explored in order to assess community-level CVD and cancer presence utilizing U.S. reported prevalence rates. Results obtained suggest that WBE can serve as a viable tool in support of current methods for CVD and cancer assessment to reduce morbidities and mortalities worldwide.
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Affiliation(s)
- Vivek Amin
- The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, 1001 S. McAllister Ave, AZ 85287-8101, USA
| | - Devin A Bowes
- The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, 1001 S. McAllister Ave, AZ 85287-8101, USA
| | - Rolf U Halden
- The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, 1001 S. McAllister Ave, AZ 85287-8101, USA; School for Sustainable Engineering and the Built Environment, Arizona State University, 1001 S. McAllister Ave, AZ 85287-8101, USA; OneWaterOneHealth, The Arizona State University Foundation, The Biodesign Institute, Arizona State University, 1001 S. McAllister Ave, Tempe, AZ 85281, USA; Global Futures Laboratory, Arizona State University, 800 S. Cady Mall, Tempe, AZ 85281, USA.
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12
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Armas F, Chandra F, Lee WL, Gu X, Chen H, Xiao A, Leifels M, Wuertz S, Alm EJ, Thompson J. Contextualizing Wastewater-Based surveillance in the COVID-19 vaccination era. ENVIRONMENT INTERNATIONAL 2023; 171:107718. [PMID: 36584425 PMCID: PMC9783150 DOI: 10.1016/j.envint.2022.107718] [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: 03/31/2022] [Revised: 12/16/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
SARS-CoV-2 wastewater-based surveillance (WBS) offers a tool for cost-effective oversight of a population's infections. In the past two years, WBS has proven to be crucial for managing the pandemic across different geographical regions. However, the changing context of the pandemic due to high levels of COVID-19 vaccination warrants a closer examination of its implication towards SARS-CoV-2 WBS. Two main questions were raised: 1) Does vaccination cause shedding of viral signatures without infection? 2) Does vaccination affect the relationship between wastewater and clinical data? To answer, we review historical reports of shedding from viral vaccines in use prior to the COVID-19 pandemic including for polio, rotavirus, influenza and measles infection and provide a perspective on the implications of different COVID-19 vaccination strategies with regard to the potential shedding of viral signatures into the sewershed. Additionally, we reviewed studies that looked into the relationship between wastewater and clinical data and how vaccination campaigns could have affected the relationship. Finally, analyzing wastewater and clinical data from the Netherlands, we observed changes in the relationship concomitant with increasing vaccination coverage and switches in dominant variants of concern. First, that no vaccine-derived shedding is expected from the current commercial pipeline of COVID-19 vaccines that may confound interpretation of WBS data. Secondly, that breakthrough infections from vaccinated individuals contribute significantly to wastewater signals and must be interpreted in light of the changing dynamics of shedding from new variants of concern.
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Affiliation(s)
- Federica Armas
- 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
| | - 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
| | - Xiaoqiong Gu
- 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
| | - Amy Xiao
- Department of Biological Engineering, Massachusetts Institute of Technology, USA; Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology
| | - Mats Leifels
- Singapore Centre for Environmental Life Sciences Engineering, Nanyang Technological University, Singapore
| | - Stefan Wuertz
- Singapore Centre for Environmental Life Sciences Engineering, Nanyang Technological University, Singapore; School of Civil and Environmental Engineering, 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, USA; Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology; Broad Institute of MIT and Harvard, Cambridge, MA, USA.
| | - 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.
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13
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Standards to support an enduring capability in wastewater surveillance for public health: Where are we? CASE STUDIES IN CHEMICAL AND ENVIRONMENTAL ENGINEERING 2022; 6:100247. [PMID: 37520917 PMCID: PMC9376981 DOI: 10.1016/j.cscee.2022.100247] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 06/02/2023]
Abstract
The COVID-19 pandemic highlighted a wide range of public health system challenges for infectious disease surveillance. The discovery that the SARS-CoV-2 virus was shed in feces and can be characterized using PCR-based testing of sewage samples offers new possibilities and challenges for wastewater surveillance (WWS). However, WWS standardization of practices is needed to provide actionable data for a public health response. A workshop was convened consisting of academic, federal government, and industry stakeholders. The objective was to review WWS sampling protocols, testing methods, analyses, and data interpretation approaches for WWS employed nationally and identify opportunities for standardizing practices, including the development of documentary standards or reference materials in the case of SARS-CoV-2 surveillance. Other WWS potential future threats to public health were also discussed. Several aspects of WWS were considered and each offers the opportunity for standards development. These areas included sampling strategies, analytical methods, and data reporting practices. Each of these areas converged on a common theme, the challenge of results comparability across facilities and jurisdictions. For sampling, the consensus solution was the development of documentary standards to guide appropriate sampling practices. In contrast, the predominant opportunity for analytical methods was reference material development, such as PCR-based standards and surrogate recovery controls. For data reporting practices, the need for establishing the minimal required metadata, a metadata vocabulary, and standardizing data units of measure including measurement threshold definitions was discussed. Beyond SARS-CoV-2 testing, there was general agreement that the WWS platform will continue to be a valuable tool for a wide range of public health threats and that future cross-sector engagements are needed to guide an enduring WWS capability.
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Yu L, Tian Z, Joshi DR, Yuan L, Tuladhar R, Zhang Y, Yang M. Detection of SARS-CoV-2 and Other Viruses in Wastewater: Optimization and Automation of an Aluminum Hydroxide Adsorption-Precipitation Method for Virus Concentration. ACS ES&T WATER 2022; 2:2175-2184. [PMID: 37552732 PMCID: PMC9115887 DOI: 10.1021/acsestwater.2c00079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 06/18/2023]
Abstract
This study aimed to provide a low-cost technique for virus detection in wastewater by improving an aluminum hydroxide adsorption-precipitation method. The releasing efficiency of viruses trapped by the aluminum hydroxide precipitates was improved by adding ethylenediaminetetraacetic acid disodium salt (EDTA-2Na) to dissolve the precipitates at a Na2EDTA·2H2O:AlCl3 molar ratio of 1.8-3.6. The recovery rates of the improved method for seven viruses, including SARS-CoV-2-abEN pseudovirus and six animal viruses, were 5.9-22.3% in tap water and 4.9-35.1% in wastewater. Rotavirus A (9.0-4.5 × 103 copies/mL), porcine circovirus type 2 (5.8-6.4 × 105 copies/mL), and porcine parvovirus (5.6-2.7 × 104 copies/mL) were detected in China's pig farm wastewater, while rotavirus A (2.0 × 103 copies/mL) was detected in hospital wastewater. SARS-CoV-2 was detected in hospital wastewater (8.4 × 102 to 1.4 × 104 copies/mL), sewage (6.4 × 10 to 2.3 × 103 copies/mL), and river water (6.6 × 10 to 9.3 × 10 copies/mL) in Nepal. The method was automized, with a rate of recovery of 4.8 ± 1.4% at a virus concentration of 102 copies/mL. Thus, the established method could be used for wastewater-based epidemiology with sufficient sensitivity in coping with the COVID-19 epidemic and other virus epidemics.
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Affiliation(s)
- Lina Yu
- State Key Laboratory of Environmental Aquatic
Chemistry, Research Center for Eco-Environmental Sciences, Chinese Academy of
Sciences, Beijing 100085, China
- Sino-Danish College, University of
Chinese Academy of Sciences, Beijing 100190,
China
- University of Chinese Academy of
Sciences, Beijing 100049, China
| | - Zhe Tian
- State Key Laboratory of Environmental Aquatic
Chemistry, Research Center for Eco-Environmental Sciences, Chinese Academy of
Sciences, Beijing 100085, China
| | - Dev Raj Joshi
- Central Department of Microbiology,
Tribhuvan University, GPO 44613 Kirtipur, Kathmandu,
Nepal
| | - Lin Yuan
- Beijing Sino-science Gene Technology
Company, Ltd., Beijing 102629, China
| | - Reshma Tuladhar
- Central Department of Microbiology,
Tribhuvan University, GPO 44613 Kirtipur, Kathmandu,
Nepal
| | - Yu Zhang
- State Key Laboratory of Environmental Aquatic
Chemistry, Research Center for Eco-Environmental Sciences, Chinese Academy of
Sciences, Beijing 100085, China
- Sino-Danish College, University of
Chinese Academy of Sciences, Beijing 100190,
China
- University of Chinese Academy of
Sciences, Beijing 100049, China
| | - Min Yang
- Sino-Danish College, University of
Chinese Academy of Sciences, Beijing 100190,
China
- University of Chinese Academy of
Sciences, Beijing 100049, China
- Key Laboratory of Drinking Water Science and Technology,
Research Center for Eco-Environmental Sciences, Chinese Academy of
Sciences, Beijing 100085, China
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15
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Cohen A, Maile-Moskowitz A, Grubb C, Gonzalez RA, Ceci A, Darling A, Hungerford L, Fricker R, Finkielstein CV, Pruden A, Vikesland PJ. Subsewershed SARS-CoV-2 Wastewater Surveillance and COVID-19 Epidemiology Using Building-Specific Occupancy and Case Data. ACS ES&T WATER 2022; 2:2047-2059. [PMID: 37552724 PMCID: PMC9128018 DOI: 10.1021/acsestwater.2c00059] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 08/10/2023]
Abstract
To evaluate the use of wastewater-based surveillance and epidemiology to monitor and predict SARS-CoV-2 virus trends, over the 2020-2021 academic year we collected wastewater samples twice weekly from 17 manholes across Virginia Tech's main campus. We used data from external door swipe card readers and student isolation/quarantine status to estimate building-specific occupancy and COVID-19 case counts at a daily resolution. After analyzing 673 wastewater samples using reverse transcription quantitative polymerase chain reaction (RT-qPCR), we reanalyzed 329 samples from isolation and nonisolation dormitories and the campus sewage outflow using reverse transcription digital droplet polymerase chain reaction (RT-ddPCR). Population-adjusted viral copy means from isolation dormitory wastewater were 48% and 66% higher than unadjusted viral copy means for N and E genes (1846/100 mL to 2733/100 mL/100 people and 2312/100 mL to 3828/100 mL/100 people, respectively; n = 46). Prespecified analyses with random-effects Poisson regression and dormitory/cluster-robust standard errors showed that the detection of N and E genes were associated with increases of 85% and 99% in the likelihood of COVID-19 cases 8 days later (incident-rate ratio (IRR) = 1.845, p = 0.013 and IRR = 1.994, p = 0.007, respectively; n = 215), and one-log increases in swipe card normalized viral copies (copies/100 mL/100 people) for N and E were associated with increases of 21% and 27% in the likelihood of observing COVID-19 cases 8 days following sample collection (IRR = 1.206, p < 0.001, n = 211 for N; IRR = 1.265, p < 0.001, n = 211 for E). One-log increases in swipe normalized copies were also associated with 40% and 43% increases in the likelihood of observing COVID-19 cases 5 days after sample collection (IRR = 1.403, p = 0.002, n = 212 for N; IRR = 1.426, p < 0.001, n = 212 for E). Our findings highlight the use of building-specific occupancy data and add to the evidence for the potential of wastewater-based epidemiology to predict COVID-19 trends at subsewershed scales.
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Affiliation(s)
- Alasdair Cohen
- Department of Population Health Sciences,
Virginia Tech, Blacksburg, Virginia 24061, United
States
- Department of Civil and Environmental Engineering,
Virginia Tech, Blacksburg, Virginia 24061, United
States
| | - Ayella Maile-Moskowitz
- Department of Civil and Environmental Engineering,
Virginia Tech, Blacksburg, Virginia 24061, United
States
| | - Christopher Grubb
- Department of Statistics, Virginia
Tech, Blacksburg, Virginia 24061, United States
| | - Raul A. Gonzalez
- Hampton Roads Sanitation
District, Virginia Beach, Virginia 23455, United
States
| | - Alessandro Ceci
- Molecular Diagnostics Laboratory, Fralin Biomedical
Research Institute, Virginia Tech, Roanoke, Virginia 24016,
United States
| | - Amanda Darling
- Department of Population Health Sciences,
Virginia Tech, Blacksburg, Virginia 24061, United
States
- Department of Civil and Environmental Engineering,
Virginia Tech, Blacksburg, Virginia 24061, United
States
| | - Laura Hungerford
- Department of Population Health Sciences,
Virginia Tech, Blacksburg, Virginia 24061, United
States
| | - Ronald
D. Fricker
- Department of Statistics, Virginia
Tech, Blacksburg, Virginia 24061, United States
| | - Carla V. Finkielstein
- Molecular Diagnostics Laboratory, Fralin Biomedical
Research Institute, Virginia Tech, Roanoke, Virginia 24016,
United States
- Integrated Cellular Responses Laboratory, Fralin
Biomedical Research Institute at VTC, Roanoke, Virginia 24016,
United States
- Department of Biological Sciences,
Virginia Tech, Blacksburg, Virginia 24061, United
States
| | - Amy Pruden
- Department of Civil and Environmental Engineering,
Virginia Tech, Blacksburg, Virginia 24061, United
States
| | - Peter J. Vikesland
- Department of Civil and Environmental Engineering,
Virginia Tech, Blacksburg, Virginia 24061, United
States
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16
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Kilaru P, Hill D, Anderson K, Collins MB, Green H, Kmush BL, Larsen DA. Wastewater Surveillance for Infectious Disease: A Systematic Review. Am J Epidemiol 2022; 192:305-322. [PMID: 36227259 PMCID: PMC9620728 DOI: 10.1093/aje/kwac175] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 08/25/2022] [Accepted: 10/05/2022] [Indexed: 02/07/2023] Open
Abstract
Wastewater surveillance for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been shown to be a valuable source of information regarding SARS-CoV-2 transmission and coronavirus disease 2019 (COVID-19) cases. Although the method has been used for several decades to track other infectious diseases, there has not been a comprehensive review outlining all of the pathogens that have been surveilled through wastewater. Herein we identify the infectious diseases that have been previously studied via wastewater surveillance prior to the COVID-19 pandemic. Infectious diseases and pathogens were identified in 100 studies of wastewater surveillance across 38 countries, as were themes of how wastewater surveillance and other measures of disease transmission were linked. Twenty-five separate pathogen families were identified in the included studies, with the majority of studies examining pathogens from the family Picornaviridae, including polio and nonpolio enteroviruses. Most studies of wastewater surveillance did not link what was found in the wastewater to other measures of disease transmission. Among those studies that did, the value reported varied by study. Wastewater surveillance should be considered as a potential public health tool for many infectious diseases. Wastewater surveillance studies can be improved by incorporating other measures of disease transmission at the population-level including disease incidence and hospitalizations.
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Affiliation(s)
- Pruthvi Kilaru
- Department of Public Health, Syracuse University, Syracuse, New York, United States,Des Moines University College of Osteopathic Medicine, Des Moines, Iowa, United States
| | - Dustin Hill
- Department of Public Health, Syracuse University, Syracuse, New York, United States,Graduate Program in Environmental Science, State University of New York College of Environmental Science and Forestry, Syracuse, New York, United States
| | - Kathryn Anderson
- Department of Medicine, State University of New York Upstate Medical University, Syracuse, New York, United States
| | - Mary B Collins
- Department of Environmental Studies, State University of New York College of Environmental Science, Syracuse, New York, United States
| | - Hyatt Green
- Department of Environmental Biology, State University of New York College of Environmental Science, Syracuse, New York, United States
| | - Brittany L Kmush
- Department of Public Health, Syracuse University, Syracuse, New York, United States
| | - David A Larsen
- Correspondence to Dr. Dave Larsen, Department of Public Health, Syracuse University, 430C White Hall, Syracuse, NY 13244 ()
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17
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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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18
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Zarza E, Diego-García E, García LV, Castro R, Mejía G, Herrera D, Cuevas R, Palomeque Á, Iša P, Guillén K. Monitoring SARS-CoV-2 in the Wastewater and Rivers of Tapachula, a Migratory Hub in Southern Mexico. FOOD AND ENVIRONMENTAL VIROLOGY 2022; 14:199-211. [PMID: 35508751 PMCID: PMC9067545 DOI: 10.1007/s12560-022-09523-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/20/2022] [Indexed: 05/11/2023]
Abstract
The COVID-19 pandemic has been monitored by applying different strategies, including SARS-CoV-2 detection with clinical testing or through wastewater-based epidemiology (WBE). We used the latter approach to follow SARS-CoV-2 dispersion in Tapachula city, located in Mexico's tropical southern border region. Tapachula is a dynamic entry point for people seeking asylum in Mexico or traveling to the USA. Clinical testing facilities for SARS-CoV-2 monitoring are limited in the city. A total of eighty water samples were collected from urban and suburban rivers and sewage and a wastewater treatment plant over 4 months in Tapachula. We concentrated viral particles with a PEG-8000-based method, performed RNA extraction, and detected SARS-CoV-2 particles through RT-PCR. We considered the pepper mild mottle virus as a fecal water pollution biomarker and analytical control. SARS-CoV-2 viral loads (N1 and N2 markers) were quantified and correlated with official regional statistics of COVID-19 bed occupancy and confirmed cases (r > 91%). Our results concluded that WBE proved a valuable tool for tracing and tracking the COVID-19 pandemic in tropical countries with similar water temperatures (21-29 °C). Monitoring SARS-CoV-2 through urban and suburban river water sampling would be helpful in places lacking a wastewater treatment plant or water bodies with sewage discharges.
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Affiliation(s)
- Eugenia Zarza
- El Colegio de la Frontera Sur (ECOSUR), Grupo Académico de Biotecnología Ambiental, Carretera Antiguo Aeropuerto Km 2.5, 30700, Tapachula, Chiapas, Mexico
- Investigadoras CONACyT- El Colegio de la Frontera Sur, Av. Insurgentes Sur 1582, Col. Crédito Constructor, Benito Juárez, 03940, Mexico City, Mexico
| | - Elia Diego-García
- El Colegio de la Frontera Sur (ECOSUR), Grupo Académico de Biotecnología Ambiental, Carretera Antiguo Aeropuerto Km 2.5, 30700, Tapachula, Chiapas, Mexico
- Investigadoras CONACyT- El Colegio de la Frontera Sur, Av. Insurgentes Sur 1582, Col. Crédito Constructor, Benito Juárez, 03940, Mexico City, Mexico
| | - Luz Verónica García
- El Colegio de la Frontera Sur (ECOSUR), Grupo Académico de Biotecnología Ambiental, Carretera Antiguo Aeropuerto Km 2.5, 30700, Tapachula, Chiapas, Mexico
| | - Ricardo Castro
- El Colegio de la Frontera Sur (ECOSUR), Grupo Académico de Biotecnología Ambiental, Carretera Antiguo Aeropuerto Km 2.5, 30700, Tapachula, Chiapas, Mexico
| | - Gamaliel Mejía
- El Colegio de la Frontera Sur (ECOSUR), Grupo Académico de Biotecnología Ambiental, Carretera Antiguo Aeropuerto Km 2.5, 30700, Tapachula, Chiapas, Mexico
| | - David Herrera
- El Colegio de la Frontera Sur (ECOSUR), Grupo Académico de Biotecnología Ambiental, Carretera Antiguo Aeropuerto Km 2.5, 30700, Tapachula, Chiapas, Mexico
| | - Raúl Cuevas
- El Colegio de la Frontera Sur (ECOSUR), Grupo Académico de Biotecnología Ambiental, Carretera Antiguo Aeropuerto Km 2.5, 30700, Tapachula, Chiapas, Mexico
| | - Ángeles Palomeque
- El Colegio de la Frontera Sur (ECOSUR), Grupo Académico de Biotecnología Ambiental, Carretera Antiguo Aeropuerto Km 2.5, 30700, Tapachula, Chiapas, Mexico
| | - Pavel Iša
- Instituto de Biotecnología, Universidad Nacional Autónoma de México, Av. Universidad 2001, 62210, Cuernavaca, Morelos, Mexico
| | - Karina Guillén
- El Colegio de la Frontera Sur (ECOSUR), Grupo Académico de Biotecnología Ambiental, Carretera Antiguo Aeropuerto Km 2.5, 30700, Tapachula, Chiapas, Mexico.
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19
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Dharmadhikari T, Rajput V, Yadav R, Boargaonkar R, Patil D, Kale S, Kamble SP, Dastager SG, Dharne MS. High throughput sequencing based direct detection of SARS-CoV-2 fragments in wastewater of Pune, West India. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 807:151038. [PMID: 34688738 PMCID: PMC8530769 DOI: 10.1016/j.scitotenv.2021.151038] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/28/2021] [Accepted: 10/13/2021] [Indexed: 05/20/2023]
Abstract
Given a large number of SARS-CoV-2 infected individuals, clinical detection has proved challenging. The wastewater-based epidemiological paradigm would cover the clinically escaped asymptomatic individuals owing to the faecal shedding of the virus. We hypothesised using wastewater as a valuable resource for analysing SARS-CoV-2 mutations circulating in the wastewater of Pune region (Maharashtra; India), one of the most affected during the covid-19 pandemic. We conducted study in open wastewater drains from December 2020-March 2021 to assess the presence of SARS-CoV-2 nucleic acid and further detect mutations using ARTIC protocol of MinION sequencing. The analysis revealed 108 mutations across six samples categorised into 39 types of mutations. We report the occurrence of mutations associated with Delta variant lineage in March-2021 samples, simultaneously also reported as a Variant of Concern (VoC) responsible for the rapid increase in infections. The study also revealed four mutations; S:N801, S:C480R, NSP14:C279F and NSP3:L550del not currently reported from wastewater or clinical data in India but reported worldwide. Further, a novel mutation NSP13:G206F mapping to NSP13 region was observed from wastewater. Notably, S:P1140del mutation was detected in December 2020 samples while it was reported in February 2021 from clinical data, indicating the instrumentality of wastewater data in early detection. This is the first study in India to demonstrate utility of sequencing in wastewater-based epidemiology to identify mutations associated with SARS-CoV-2 virus fragments from wastewater as an early warning indicator system.
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Affiliation(s)
- Tanmay Dharmadhikari
- National Collection of Industrial Microorganisms (NCIM), Biochemical Sciences Division, CSIR-National Chemical Laboratory, Pune 411008, India
| | - Vinay Rajput
- National Collection of Industrial Microorganisms (NCIM), Biochemical Sciences Division, CSIR-National Chemical Laboratory, Pune 411008, India
| | - Rakeshkumar Yadav
- National Collection of Industrial Microorganisms (NCIM), Biochemical Sciences Division, CSIR-National Chemical Laboratory, Pune 411008, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | | | - Dhawal Patil
- Ecosan Services Foundation (ESF), Pune 411030, India
| | - Saurabh Kale
- Ecosan Services Foundation (ESF), Pune 411030, India
| | - Sanjay P Kamble
- Chemical Engineering and Process Development Division, CSIR-National Chemical Laboratory, Pune 411008, India
| | - Syed G Dastager
- National Collection of Industrial Microorganisms (NCIM), Biochemical Sciences Division, CSIR-National Chemical Laboratory, Pune 411008, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Mahesh S Dharne
- National Collection of Industrial Microorganisms (NCIM), Biochemical Sciences Division, CSIR-National Chemical Laboratory, Pune 411008, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India.
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20
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Barrios RE, Lim C, Kelley MS, Li X. SARS-CoV-2 concentrations in a wastewater collection system indicated potential COVID-19 hotspots at the zip code level. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 800:149480. [PMID: 34392211 PMCID: PMC8330136 DOI: 10.1016/j.scitotenv.2021.149480] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/31/2021] [Accepted: 08/01/2021] [Indexed: 05/03/2023]
Abstract
Wastewater based epidemiology (WBE) has been successfully applied for SARS-CoV-2 surveillance at the city and building levels. However, sampling at the city level does not provide sufficient spatial granularity to identify COVID-19 hotspots, while data from building-level sampling are too narrow in scope for broader public health application. The objective of this study was to examine the feasibility of using wastewater from wastewater collection systems (WCSs) to monitor COVID-19 hotspots at the zip code level. In this study, 24-h composite wastewater samples were collected from five manholes and two wastewater treatment plants (WWTPs) in the City of Lincoln, Nebraska. By comparing to the reported weekly COVID-19 case numbers, we identified different hotspots responsible for two COVID-19 surges during the study period. One zip code was the only sampling locations that was consistently tested positive during the first COVID-19 surge. In comparison, nearly all the zip codes tested exhibited virus concentration increases that overlapped with the second COVID-19 surge, suggesting broader spread of the virus at that time. These findings demonstrate the feasibility of using WBE to monitor COVID-19 at the zip code level. Highly localized disease surveillance methods can improve public health prevention and mitigation measures at the community level.
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Affiliation(s)
- Renys E Barrios
- Department of Civil and Environmental Engineering, University of Nebraska-Lincoln, Lincoln, NE 68588, United States
| | - Chin Lim
- City of Lincoln Transportation and Utilities, Lincoln, NE 68521, United States
| | - Megan S Kelley
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, 68583, United States.
| | - Xu Li
- Department of Civil and Environmental Engineering, University of Nebraska-Lincoln, Lincoln, NE 68588, United States.
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21
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Palmer EJ, Maestre JP, Jarma D, Lu A, Willmann E, Kinney KA, Kirisits MJ. Development of a reproducible method for monitoring SARS-CoV-2 in wastewater. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 799:149405. [PMID: 34365266 PMCID: PMC8328530 DOI: 10.1016/j.scitotenv.2021.149405] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 05/06/2023]
Abstract
Monitoring the genetic signal of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through RNA titers in wastewater has emerged as a promising strategy for tracking community-scale prevalence of coronavirus disease 2019 (COVID-19). Although many studies of SARS-CoV-2 in wastewater have been conducted around the world, a uniform procedure for concentrating the virus in wastewater is lacking. The goal of this study was to comprehensively evaluate how different methods for concentrating the suspended solids in wastewater affect the associated SARS-CoV-2 RNA signal and the time required for processing samples for wastewater-based epidemiology efforts. We additionally consider the effects of sampling location in the wastewater treatment train (i.e., following preliminary or primary treatment), pasteurization, and RNA extraction method. Comparison of the liquid phase to suspended solids obtained via centrifugation or vacuum filtration suggests that the RNA signal of SARS-CoV-2 preferentially occurs in the solids. Therefore, we assert that the recovery of SARS-CoV-2 from wastewater should focus on suspended solids. Our data indicate that the measured SARS-CoV-2 signal is higher among samples taken from the primary clarifier effluent, as opposed to those taken after preliminary treatment. Additionally, we provide evidence that sample pasteurization at 60 °C for 90 min reduces the SARS-CoV-2 signal by approximately 50-55%. Finally, the results indicate that a magnetic bead approach to RNA extraction leads to a higher SARS-CoV-2 signal than does a silica membrane approach.
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Affiliation(s)
- Emma J Palmer
- The University of Texas at Austin, Department of Civil, Architectural, and Environmental Engineering, 301 E. Dean Keeton St., Stop C1786, Austin, TX 78712, United States of America.
| | - Juan P Maestre
- The University of Texas at Austin, Department of Civil, Architectural, and Environmental Engineering, 301 E. Dean Keeton St., Stop C1786, Austin, TX 78712, United States of America.
| | - David Jarma
- The University of Texas at Austin, Department of Civil, Architectural, and Environmental Engineering, 301 E. Dean Keeton St., Stop C1786, Austin, TX 78712, United States of America.
| | - Alisa Lu
- The University of Texas at Austin, Department of Civil, Architectural, and Environmental Engineering, 301 E. Dean Keeton St., Stop C1786, Austin, TX 78712, United States of America.
| | - Elisabeth Willmann
- The University of Texas at Austin, Department of Civil, Architectural, and Environmental Engineering, 301 E. Dean Keeton St., Stop C1786, Austin, TX 78712, United States of America.
| | - Kerry A Kinney
- The University of Texas at Austin, Department of Civil, Architectural, and Environmental Engineering, 301 E. Dean Keeton St., Stop C1786, Austin, TX 78712, United States of America.
| | - Mary Jo Kirisits
- The University of Texas at Austin, Department of Civil, Architectural, and Environmental Engineering, 301 E. Dean Keeton St., Stop C1786, Austin, TX 78712, United States of America.
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22
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Zahedi A, Monis P, Deere D, Ryan U. Wastewater-based epidemiology-surveillance and early detection of waterborne pathogens with a focus on SARS-CoV-2, Cryptosporidium and Giardia. Parasitol Res 2021; 120:4167-4188. [PMID: 33409629 PMCID: PMC7787619 DOI: 10.1007/s00436-020-07023-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/14/2020] [Indexed: 12/21/2022]
Abstract
Waterborne diseases are a major global problem, resulting in high morbidity and mortality, and massive economic costs. The ability to rapidly and reliably detect and monitor the spread of waterborne diseases is vital for early intervention and preventing more widespread disease outbreaks. Pathogens are, however, difficult to detect in water and are not practicably detectable at acceptable concentrations that need to be achieved in treated drinking water (which are of the order one per million litre). Furthermore, current clinical-based surveillance methods have many limitations such as the invasive nature of the testing and the challenges in testing large numbers of people. Wastewater-based epidemiology (WBE), which is based on the analysis of wastewater to monitor the emergence and spread of infectious disease at a population level, has received renewed attention in light of the current coronavirus disease 2019 (COVID-19) pandemic. The present review will focus on the application of WBE for the detection and surveillance of pathogens with a focus on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the waterborne protozoan parasites Cryptosporidium and Giardia. The review highlights the benefits and challenges of WBE and the future of this tool for community-wide infectious disease surveillance.
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Affiliation(s)
- Alireza Zahedi
- Harry Butler Institute, Murdoch University, Perth, Australia
| | - Paul Monis
- South Australian Water Corporation, Adelaide, Australia
| | - Daniel Deere
- Water Futures and Water Research Australia, Sydney, Australia
| | - Una Ryan
- Harry Butler Institute, Murdoch University, Perth, Australia.
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23
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Gibas C, Lambirth K, Mittal N, Juel MAI, Barua VB, Roppolo Brazell L, Hinton K, Lontai J, Stark N, Young I, Quach C, Russ M, Kauer J, Nicolosi B, Chen D, Akella S, Tang W, Schlueter J, Munir M. Implementing building-level SARS-CoV-2 wastewater surveillance on a university campus. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 782:146749. [PMID: 33838367 PMCID: PMC8007530 DOI: 10.1016/j.scitotenv.2021.146749] [Citation(s) in RCA: 166] [Impact Index Per Article: 55.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/20/2021] [Accepted: 03/21/2021] [Indexed: 05/17/2023]
Abstract
The COVID-19 pandemic has been a source of ongoing challenges and presents an increased risk of illness in group environments, including jails, long-term care facilities, schools, and residential college campuses. Early reports that the SARS-CoV-2 virus was detectable in wastewater in advance of confirmed cases sparked widespread interest in wastewater-based epidemiology (WBE) as a tool for mitigation of COVID-19 outbreaks. One hypothesis was that wastewater surveillance might provide a cost-effective alternative to other more expensive approaches such as pooled and random testing of groups. In this paper, we report the outcomes of a wastewater surveillance pilot program at the University of North Carolina at Charlotte, a large urban university with a substantial population of students living in on-campus dormitories. Surveillance was conducted at the building level on a thrice-weekly schedule throughout the university's fall residential semester. In multiple cases, wastewater surveillance enabled the identification of asymptomatic COVID-19 cases that were not detected by other components of the campus monitoring program, which also included in-house contact tracing, symptomatic testing, scheduled testing of student athletes, and daily symptom reporting. In the context of all cluster events reported to the University community during the fall semester, wastewater-based testing events resulted in the identification of smaller clusters than were reported in other types of cluster events. Wastewater surveillance was able to detect single asymptomatic individuals in dorms with resident populations of 150-200. While the strategy described was developed for COVID-19, it is likely to be applicable to mitigation of future pandemics in universities and other group-living environments.
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Affiliation(s)
- Cynthia Gibas
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America; Bioinformatics Research Center, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America.
| | - Kevin Lambirth
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America.
| | - Neha Mittal
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Md Ariful Islam Juel
- Department of Civil and Environmental Engineering, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Visva Bharati Barua
- Department of Civil and Environmental Engineering, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Lauren Roppolo Brazell
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Keshawn Hinton
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Jordan Lontai
- Department of Geography and Earth Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Nicholas Stark
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Isaiah Young
- Department of Civil and Environmental Engineering, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Cristine Quach
- Department of Civil and Environmental Engineering, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Morgan Russ
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Jacob Kauer
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Bridgette Nicolosi
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Don Chen
- Department of Engineering Technology and Construction Management, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Srinivas Akella
- Department of Computer Science, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Wenwu Tang
- Department of Geography and Earth Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America; Center for Applied Geographic Information Systems, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Jessica Schlueter
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America; Bioinformatics Research Center, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Mariya Munir
- Department of Civil and Environmental Engineering, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
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24
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Gibas C, Lambirth K, Mittal N, Juel MAI, Barua VB, Roppolo Brazell L, Hinton K, Lontai J, Stark N, Young I, Quach C, Russ M, Kauer J, Nicolosi B, Chen D, Akella S, Tang W, Schlueter J, Munir M. Implementing building-level SARS-CoV-2 wastewater surveillance on a university campus. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 782:146749. [PMID: 33838367 DOI: 10.1101/2020.12.31.20248843] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/20/2021] [Accepted: 03/21/2021] [Indexed: 05/18/2023]
Abstract
The COVID-19 pandemic has been a source of ongoing challenges and presents an increased risk of illness in group environments, including jails, long-term care facilities, schools, and residential college campuses. Early reports that the SARS-CoV-2 virus was detectable in wastewater in advance of confirmed cases sparked widespread interest in wastewater-based epidemiology (WBE) as a tool for mitigation of COVID-19 outbreaks. One hypothesis was that wastewater surveillance might provide a cost-effective alternative to other more expensive approaches such as pooled and random testing of groups. In this paper, we report the outcomes of a wastewater surveillance pilot program at the University of North Carolina at Charlotte, a large urban university with a substantial population of students living in on-campus dormitories. Surveillance was conducted at the building level on a thrice-weekly schedule throughout the university's fall residential semester. In multiple cases, wastewater surveillance enabled the identification of asymptomatic COVID-19 cases that were not detected by other components of the campus monitoring program, which also included in-house contact tracing, symptomatic testing, scheduled testing of student athletes, and daily symptom reporting. In the context of all cluster events reported to the University community during the fall semester, wastewater-based testing events resulted in the identification of smaller clusters than were reported in other types of cluster events. Wastewater surveillance was able to detect single asymptomatic individuals in dorms with resident populations of 150-200. While the strategy described was developed for COVID-19, it is likely to be applicable to mitigation of future pandemics in universities and other group-living environments.
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Affiliation(s)
- Cynthia Gibas
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America; Bioinformatics Research Center, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America.
| | - Kevin Lambirth
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America.
| | - Neha Mittal
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Md Ariful Islam Juel
- Department of Civil and Environmental Engineering, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Visva Bharati Barua
- Department of Civil and Environmental Engineering, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Lauren Roppolo Brazell
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Keshawn Hinton
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Jordan Lontai
- Department of Geography and Earth Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Nicholas Stark
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Isaiah Young
- Department of Civil and Environmental Engineering, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Cristine Quach
- Department of Civil and Environmental Engineering, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Morgan Russ
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Jacob Kauer
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Bridgette Nicolosi
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Don Chen
- Department of Engineering Technology and Construction Management, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Srinivas Akella
- Department of Computer Science, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Wenwu Tang
- Department of Geography and Earth Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America; Center for Applied Geographic Information Systems, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Jessica Schlueter
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America; Bioinformatics Research Center, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
| | - Mariya Munir
- Department of Civil and Environmental Engineering, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America
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Rapid, Large-Scale Wastewater Surveillance and Automated Reporting System Enable Early Detection of Nearly 85% of COVID-19 Cases on a University Campus. mSystems 2021; 6:e0079321. [PMID: 34374562 PMCID: PMC8409724 DOI: 10.1128/msystems.00793-21] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Wastewater-based surveillance has gained prominence and come to the forefront as a leading indicator of forecasting COVID-19 (coronavirus disease 2019) infection dynamics owing to its cost-effectiveness and its ability to inform early public health interventions. A university campus could especially benefit from wastewater surveillance, as universities are characterized by largely asymptomatic populations and are potential hot spots for transmission that necessitate frequent diagnostic testing. In this study, we employed a large-scale GIS (geographic information systems)-enabled building-level wastewater monitoring system associated with the on-campus residences of 7,614 individuals. Sixty-eight automated wastewater samplers were deployed to monitor 239 campus buildings with a focus on residential buildings. Time-weighted composite samples were collected on a daily basis and analyzed on the same day. Sample processing was streamlined significantly through automation, reducing the turnaround time by 20-fold and exceeding the scale of similar surveillance programs by 10- to 100-fold, thereby overcoming one of the biggest bottlenecks in wastewater surveillance. An automated wastewater notification system was developed to alert residents to a positive wastewater sample associated with their residence and to encourage uptake of campus-provided asymptomatic testing at no charge. This system, integrated with the rest of the "Return to Learn" program at the University of California (UC) San Diego-led to the early diagnosis of nearly 85% of all COVID-19 cases on campus. COVID-19 testing rates increased by 1.9 to 13× following wastewater notifications. Our study shows the potential for a robust, efficient wastewater surveillance system to greatly reduce infection risk as college campuses and other high-risk environments reopen. IMPORTANCE Wastewater-based epidemiology can be particularly valuable at university campuses where high-resolution spatial sampling in a well-controlled context could not only provide insight into what affects campus community as well as how those inferences can be extended to a broader city/county context. In the present study, a large-scale wastewater surveillance was successfully implemented on a large university campus enabling early detection of 85% of COVID-19 cases thereby averting potential outbreaks. The highly automated sample processing to reporting system enabled dramatic reduction in the turnaround time to 5 h (sample to result time) for 96 samples. Furthermore, miniaturization of the sample processing pipeline brought down the processing cost significantly ($13/sample). Taken together, these results show that such a system could greatly ameliorate long-term surveillance on such communities as they look to reopen.
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Weidhaas J, Aanderud ZT, Roper DK, VanDerslice J, Gaddis EB, Ostermiller J, Hoffman K, Jamal R, Heck P, Zhang Y, Torgersen K, Laan JV, LaCross N. Correlation of SARS-CoV-2 RNA in wastewater with COVID-19 disease burden in sewersheds. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 775:145790. [PMID: 33618308 PMCID: PMC7879159 DOI: 10.1016/j.scitotenv.2021.145790] [Citation(s) in RCA: 186] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 05/17/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the coronavirus disease (COVID-19), is shed in feces and the viral ribonucleic acid (RNA) is detectable in wastewater. A nine-week wastewater epidemiology study of ten wastewater facilities, serving 39% of the state of Utah or 1.26 M individuals was conducted in April and May of 2020. COVID-19 cases were tabulated from within each sewershed boundary. RNA from SARS-CoV-2 was detectable in 61% of 126 wastewater samples. Urban sewersheds serving >100,000 individuals and tourist communities had higher detection frequencies. An outbreak of COVID-19 across two communities positively correlated with an increase in wastewater SARS-CoV-2 RNA, while a decline in COVID-19 cases preceded a decline in RNA. SARS-CoV-2 RNA followed a first order decay rate in wastewater, while 90% of the RNA was present in the liquid phase of the influent. Infiltration and inflow, virus decay and sewershed characteristics should be considered during correlation analysis of SAR-CoV-2 with COVID-19 cases. These results provide evidence of the utility of wastewater epidemiology to assist in public health responses to COVID-19.
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Affiliation(s)
- Jennifer Weidhaas
- University of Utah, Civil and Environmental Engineering, 110 Central Campus Drive, Suite 2000, Salt Lake City, UT, USA.
| | - Zachary T Aanderud
- Brigham Young University, Department of Plant & Wildlife Sciences, Provo, UT, USA
| | - D Keith Roper
- Utah State University, Biological Engineering, 4105 Old Main Hill, Logan, UT, USA
| | - James VanDerslice
- University of Utah, Family and Preventive Medicine, 275 Chipeta Way, Suite A, Salt Lake City, UT, USA
| | - Erica Brown Gaddis
- Utah Department of Environmental Quality, Division of Water Quality, 195 N 1950 West, Salt Lake City, UT, USA
| | - Jeff Ostermiller
- Utah Department of Environmental Quality, Division of Water Quality, 195 N 1950 West, Salt Lake City, UT, USA
| | - Ken Hoffman
- Utah Department of Environmental Quality, Division of Water Quality, 195 N 1950 West, Salt Lake City, UT, USA
| | - Rubayat Jamal
- University of Utah, Civil and Environmental Engineering, 110 Central Campus Drive, Suite 2000, Salt Lake City, UT, USA
| | - Phillip Heck
- Central Valley Water Reclamation Facility, 800 West Central Valley Road, Salt Lake City, UT, USA
| | - Yue Zhang
- University of Utah, School of Medicine, Department of Internal Medicine, Division of Epidemiology, 295 South Chipeta Way, Salt Lake City, UT, USA
| | - Kevin Torgersen
- Brigham Young University, Department of Plant & Wildlife Sciences, Provo, UT, USA
| | - Jacob Vander Laan
- Utah Department of Environmental Quality, Division of Water Quality, 195 N 1950 West, Salt Lake City, UT, USA
| | - Nathan LaCross
- Utah Department of Health, Division of Disease Control and Prevention, Bureau of Epidemiology, 288 N 1460 W, Salt Lake City, UT, USA
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LaTurner ZW, Zong DM, Kalvapalle P, Gamas KR, Terwilliger A, Crosby T, Ali P, Avadhanula V, Santos HH, Weesner K, Hopkins L, Piedra PA, Maresso AW, Stadler LB. Evaluating recovery, cost, and throughput of different concentration methods for SARS-CoV-2 wastewater-based epidemiology. WATER RESEARCH 2021; 197:117043. [PMID: 33784608 PMCID: PMC7957301 DOI: 10.1016/j.watres.2021.117043] [Citation(s) in RCA: 103] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/12/2021] [Accepted: 03/10/2021] [Indexed: 05/18/2023]
Abstract
As the COVID-19 pandemic continues to affect communities across the globe, the need to contain the spread of the outbreaks is of paramount importance. Wastewater monitoring of the SARS-CoV-2 virus, the causative agent responsible for COVID-19, has emerged as a promising tool for health officials to anticipate outbreaks. As interest in wastewater monitoring continues to grow and municipalities begin to implement this approach, there is a need to further identify and evaluate methods used to concentrate SARS-CoV-2 virus RNA from wastewater samples. Here we evaluate the recovery, cost, and throughput of five different concentration methods for quantifying SARS-CoV-2 virus RNA in wastewater samples. We tested the five methods on six different wastewater samples. We also evaluated the use of a bovine coronavirus vaccine as a process control and pepper mild mottle virus as a normalization factor. Of the five methods we tested head-to-head, we found that HA filtration with bead beating performed the best in terms of sensitivity and cost. This evaluation can serve as a guide for laboratories establishing a protocol to perform wastewater monitoring of SARS-CoV-2.
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Affiliation(s)
- Zachary W LaTurner
- Department of Civil and Environmental Engineering, Rice University, 6100 Main Street MS 519, Houston, TX 77005, USA
| | - David M Zong
- Department of Civil and Environmental Engineering, Rice University, 6100 Main Street MS 519, Houston, TX 77005, USA
| | - Prashant Kalvapalle
- Graduate Program in Systems, Synthetic, and Physical Biology, Rice University, 6100 Main Street MS 519, Houston, TX 77005, USA
| | - Kiara Reyes Gamas
- Graduate Program in Systems, Synthetic, and Physical Biology, Rice University, 6100 Main Street MS 519, Houston, TX 77005, USA
| | - Austen Terwilliger
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Tessa Crosby
- Department of Civil and Environmental Engineering, Rice University, 6100 Main Street MS 519, Houston, TX 77005, USA
| | - Priyanka Ali
- Department of Civil and Environmental Engineering, Rice University, 6100 Main Street MS 519, Houston, TX 77005, USA
| | - Vasanthi Avadhanula
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Haroldo Hernandez Santos
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Kyle Weesner
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Loren Hopkins
- Houston Health Department, 8000 N. Stadium Dr., Houston, TX 77054
| | - Pedro A Piedra
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Anthony W Maresso
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Lauren B Stadler
- Department of Civil and Environmental Engineering, Rice University, 6100 Main Street MS 519, Houston, TX 77005, USA.
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Achak M, Alaoui Bakri S, Chhiti Y, M'hamdi Alaoui FE, Barka N, Boumya W. SARS-CoV-2 in hospital wastewater during outbreak of COVID-19: A review on detection, survival and disinfection technologies. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 761:143192. [PMID: 33153744 PMCID: PMC7585361 DOI: 10.1016/j.scitotenv.2020.143192] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 10/18/2020] [Indexed: 05/17/2023]
Abstract
Currently, the apparition of new SARS-CoV, known as SARS-CoV-2, affected more than 34 million people and causing high death rates worldwide. Recently, several studies reported SARS-CoV-2 ribonucleic acid (RNA) in hospital wastewater. SARS-CoV-2 can be transmitted between humans via respiratory droplets, close contact and fomites. Fecal-oral transmission is considered also as a potential route of transmission since several scientists confirmed the presence of SARS-CoV-2 RNA in feces of infected patients, therefore its transmission via feces in aquatic environment, particularly hospital wastewater. Hospitals are one of the important classes of polluting sectors around the world. It was identified that hospital wastewater contains hazardous elements and a wide variety of microbial pathogens and viruses. Therefore, this may potentially pose a significant risk of public health and environment infection. This study reported an introduction about the Physical-chemical and microbiological characterization of hospital wastewater, which can be a route to identify potential technology to reduce the impact of hospital contaminants before evacuation. The presence of SARS-CoV-2 in aqueous environment was reviewed. The knowledge of the detection and survival of SARS-CoV-2 in wastewater and hospital wastewater were described to understand the different routes of SARS-CoV-2 transmission, which is also useful to avoid the outbreak of CoV-19. In addition, disinfection technologies used commonly for deactivation of SARS-CoV-2 were highlighted. It was revealed that, chlorine-containing disinfectants are the most commonly used disinfectants in this field of research. Meanwhile, other efficient technologies must be developed and improved to avoid another wave of the pandemic of COVID-19 infections.
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Affiliation(s)
- Mounia Achak
- Science Engineer Laboratory for Energy, National School of Applied Sciences, Chouaïb Doukkali University, El Jadida, Morocco; Chemical & Biochemical Sciences, Green Process Engineering, CBS, Mohammed VI Polytechnic University, Ben Guerir, Morocco.
| | - Soufiane Alaoui Bakri
- Science Engineer Laboratory for Energy, National School of Applied Sciences, Chouaïb Doukkali University, El Jadida, Morocco
| | - Younes Chhiti
- Advanced Materials and Process Engineering Laboratory, National School of Chemistry, Ibn Tofail University, Kenitra, Morocco; Mohamed VI Polytechnic University, Ben Guerir, Morocco
| | - Fatima Ezzahrae M'hamdi Alaoui
- Science Engineer Laboratory for Energy, National School of Applied Sciences, Chouaïb Doukkali University, El Jadida, Morocco
| | - Noureddine Barka
- Sultan Moulay Slimane University of Beni Mellal, Research Group in Environmental Sciences and Applied Materials (SEMA), FP Khouribga, Khouribga, Morocco
| | - Wafaa Boumya
- Science Engineer Laboratory for Energy, National School of Applied Sciences, Chouaïb Doukkali University, El Jadida, Morocco; Sultan Moulay Slimane University of Beni Mellal, Research Group in Environmental Sciences and Applied Materials (SEMA), FP Khouribga, Khouribga, Morocco
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29
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Hamouda M, Mustafa F, Maraqa M, Rizvi T, Aly Hassan A. Wastewater surveillance for SARS-CoV-2: Lessons learnt from recent studies to define future applications. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 759:143493. [PMID: 33190883 PMCID: PMC7648500 DOI: 10.1016/j.scitotenv.2020.143493] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/15/2020] [Accepted: 10/17/2020] [Indexed: 05/02/2023]
Abstract
Wastewater-based epidemiology (WBE) is successful in the detection of the spread of SARS-CoV-2. This review examines the methods used and results of recent studies on the quantification of SARS-CoV-2 in wastewater. WBE becomes essential, especially with virus transmission path uncertainty, limitations on the number of clinical tests that could be conducted, and a relatively long period for infected people to show symptoms. Wastewater surveillance was used to show the effect of lockdown on the virus spread. A WBE framework tailored for SARS-CoV-2 that incorporates lessons learnt from the reviewed studies was developed. Results of the review helped outline challenges facing the detection of SARS-CoV-2 in wastewater samples. A comparison between the various studies with regards to sample concentration and virus quantification was conducted. Five different primers sets were used for qPCR quantification; however, due to limited data availability, there is no consensus on the most sensitive primer. Correlating the slope of the relationship between the number of gene copies vs. the cumulative number of infections normalized to the total population served with the average new cases, suggests that qPCR results could help estimating the number of new infections. The correlation is improved when a lag period was introduced to account for asymptomatic infections. Based on lessons learnt from recent studies, it is recommended that future applications should consider the following: 1) ensuring occupational safety in managing sewage collection and processing, 2) evaluating the effectiveness of greywater disinfection, 3) measuring viral RNA decay due to biological and chemical activities during collection and treatment, 4) assessing the effectiveness of digital PCR, and 5) conducting large scale international studies that follow standardized protocols.
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Affiliation(s)
- Mohamed Hamouda
- Civil and Environmental Engineering and the National Water Center, United Arab Emirates University, P.O. Box 15551, Al Ain, Abu Dhabi, United Arab Emirates.
| | - Farah Mustafa
- Department of Biochemistry, College of Medicine & Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, Abu Dhabi, United Arab Emirates.
| | - Munjed Maraqa
- Civil and Environmental Engineering and the National Water Center, United Arab Emirates University, P.O. Box 15551, Al Ain, Abu Dhabi, United Arab Emirates.
| | - Tahir Rizvi
- Department of Microbiology & Immunology, College of Medicine & Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, Abu Dhabi, United Arab Emirates.
| | - Ashraf Aly Hassan
- Civil and Environmental Engineering and the National Water Center, United Arab Emirates University, P.O. Box 15551, Al Ain, Abu Dhabi, United Arab Emirates; Civil and Environmental Engineering, University of Nebraska Lincoln, 900 N 16th St., Lincoln, NE 68588-0531, USA.
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30
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Ahmed W, Bivins A, Bertsch PM, Bibby K, Gyawali P, Sherchan SP, Simpson SL, Thomas KV, Verhagen R, Kitajima M, Mueller JF, Korajkic A. Intraday variability of indicator and pathogenic viruses in 1-h and 24-h composite wastewater samples: Implications for wastewater-based epidemiology. ENVIRONMENTAL RESEARCH 2021; 193:110531. [PMID: 33249042 PMCID: PMC8267967 DOI: 10.1016/j.envres.2020.110531] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/12/2020] [Accepted: 11/21/2020] [Indexed: 05/06/2023]
Abstract
We monitored the concentration of indicator viruses crAssphage and pepper mild mottle virus (PMMoV) and human pathogen adenovirus (HAdV) in influent from a wastewater treatment plant in Brisbane, Australia in 1-h and 24-h composite samples. Over three days of sampling, the mean concentration of crAssphage gene copies (GC)/mL in 24-h composite samples did not differ significantly (p = 0.72-0.92), while for PMMoV GC/mL (p value range: 0.0002-0.0321) and HAdV GC/mL (p value range: 0.0028-0.0068) significant differences in concentrations were observed on one day of sampling compared to the other two. For all three viruses, the variation observed in 1-h composite samples was greater than the variation observed in 24-h composite samples. For crAssphage, in 54.1% of 1-h composite samples, the concentration was less than that observed in 24-h composite samples; whereas for PMMoV and HAdV the concentration was less in 79.2 and 70.9% of 1-h composite samples, respectively, compared to the relevant 24-h composite samples. Similarly, the concentration of crAssphage in 1-h compared to 24-h composite samples did not differ (p = 0.1082) while the concentrations of PMMoV (p < 0.0001) and HAdV (p < 0.0001) in 1-h composite samples were significantly different from 24-h composite samples. These results suggest that 24-h composite samples offer increased analytical sensitivity and decreased variability compared to 1-h composite samples when monitoring wastewater, especially for pathogenic viruses with low infection rates within a community. Thus, for wastewater-based epidemiology applications, 24-h composite samples are less likely to produce false negative results and erroneous public health information.
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Affiliation(s)
- Warish Ahmed
- CSIRO Land and Water, Ecosciences Precinct, 41 Boggo Road, QLD, 4102, Australia.
| | - Aaron Bivins
- Department of Civil & Environmental Engineering & Earth Sciences, 156 Fitzpatrick Hall, University of Notre Dame, Notre Dame, IN, 46656, USA
| | - Paul M Bertsch
- CSIRO Land and Water, Ecosciences Precinct, 41 Boggo Road, QLD, 4102, Australia
| | - Kyle Bibby
- Department of Civil & Environmental Engineering & Earth Sciences, 156 Fitzpatrick Hall, University of Notre Dame, Notre Dame, IN, 46656, USA
| | - Pradip Gyawali
- Institute of Environmental Science and Research Ltd (ESR), Porirua, 5240, New Zealand
| | - Samendra P Sherchan
- Department of Environmental Health Sciences, Tulane University, 1440 Canal Street, New Orleans, LA, 70112, USA
| | | | - Kevin V Thomas
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD, 4103, Australia
| | - Rory Verhagen
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD, 4103, Australia
| | - Masaaki Kitajima
- Division of Environmental Engineering, Faculty of Engineering, Hokkaido University, North 13 West 8, Kita-ku, Sapporo, Hokkaido 060-0032, Japan
| | - Jochen F Mueller
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD, 4103, Australia
| | - Asja Korajkic
- United States Environmental Protection Agency, Office of Research and Development, 26W Martin Luther King Jr. Drive, Cincinnati, OH, 45268, USA
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Pecson BM, Darby E, Haas CN, Amha YM, Bartolo M, Danielson R, Dearborn Y, Di Giovanni G, Ferguson C, Fevig S, Gaddis E, Gray D, Lukasik G, Mull B, Olivas L, Olivieri A, Qu Y. Reproducibility and sensitivity of 36 methods to quantify the SARS-CoV-2 genetic signal in raw wastewater: findings from an interlaboratory methods evaluation in the U.S. ENVIRONMENTAL SCIENCE : WATER RESEARCH & TECHNOLOGY 2021; 7:504-520. [PMID: 34017594 PMCID: PMC8129921 DOI: 10.1039/d0ew00946f] [Citation(s) in RCA: 143] [Impact Index Per Article: 47.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
In response to COVID-19, the international water community rapidly developed methods to quantify the SARS-CoV-2 genetic signal in untreated wastewater. Wastewater surveillance using such methods has the potential to complement clinical testing in assessing community health. This interlaboratory assessment evaluated the reproducibility and sensitivity of 36 standard operating procedures (SOPs), divided into eight method groups based on sample concentration approach and whether solids were removed. Two raw wastewater samples were collected in August 2020, amended with a matrix spike (betacoronavirus OC43), and distributed to 32 laboratories across the U.S. Replicate samples analyzed in accordance with the project's quality assurance plan showed high reproducibility across the 36 SOPs: 80% of the recovery-corrected results fell within a band of ±1.15 log10 genome copies per L with higher reproducibility observed within a single SOP (standard deviation of 0.13 log10). The inclusion of a solids removal step and the selection of a concentration method did not show a clear, systematic impact on the recovery-corrected results. Other methodological variations (e.g., pasteurization, primer set selection, and use of RT-qPCR or RT-dPCR platforms) generally resulted in small differences compared to other sources of variability. These findings suggest that a variety of methods are capable of producing reproducible results, though the same SOP or laboratory should be selected to track SARS-CoV-2 trends at a given facility. The methods showed a 7 log10 range of recovery efficiency and limit of detection highlighting the importance of recovery correction and the need to consider method sensitivity when selecting methods for wastewater surveillance.
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Affiliation(s)
| | - Emily Darby
- Trussell Technologies Inc., Oakland, California, USA
| | | | | | | | | | | | - George Di Giovanni
- Metropolitan Water District of Southern California, Los Angeles, California, USA
| | | | | | - Erica Gaddis
- Utah Department of Environmental Quality, Salt Lake City, Utah, USA
| | - Donald Gray
- East Bay Municipal Utility District, Oakland, California, USA
| | | | - Bonnie Mull
- BCS Laboratories Inc., Gainesville, Florida, USA
| | - Liana Olivas
- Trussell Technologies Inc., Pasadena, California, USA
| | | | - Yan Qu
- Trussell Technologies Inc., Pasadena, California, USA
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32
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Pecson BM, Darby E, Haas CN, Amha YM, Bartolo M, Danielson R, Dearborn Y, Di Giovanni G, Ferguson C, Fevig S, Gaddis E, Gray D, Lukasik G, Mull B, Olivas L, Olivieri A, Qu Y. Reproducibility and sensitivity of 36 methods to quantify the SARS-CoV-2 genetic signal in raw wastewater: findings from an interlaboratory methods evaluation in the U.S. ENVIRONMENTAL SCIENCE : WATER RESEARCH & TECHNOLOGY 2021; 7:504-520. [PMID: 34017594 DOI: 10.1101/2020.11.02.20221622] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
In response to COVID-19, the international water community rapidly developed methods to quantify the SARS-CoV-2 genetic signal in untreated wastewater. Wastewater surveillance using such methods has the potential to complement clinical testing in assessing community health. This interlaboratory assessment evaluated the reproducibility and sensitivity of 36 standard operating procedures (SOPs), divided into eight method groups based on sample concentration approach and whether solids were removed. Two raw wastewater samples were collected in August 2020, amended with a matrix spike (betacoronavirus OC43), and distributed to 32 laboratories across the U.S. Replicate samples analyzed in accordance with the project's quality assurance plan showed high reproducibility across the 36 SOPs: 80% of the recovery-corrected results fell within a band of ±1.15 log10 genome copies per L with higher reproducibility observed within a single SOP (standard deviation of 0.13 log10). The inclusion of a solids removal step and the selection of a concentration method did not show a clear, systematic impact on the recovery-corrected results. Other methodological variations (e.g., pasteurization, primer set selection, and use of RT-qPCR or RT-dPCR platforms) generally resulted in small differences compared to other sources of variability. These findings suggest that a variety of methods are capable of producing reproducible results, though the same SOP or laboratory should be selected to track SARS-CoV-2 trends at a given facility. The methods showed a 7 log10 range of recovery efficiency and limit of detection highlighting the importance of recovery correction and the need to consider method sensitivity when selecting methods for wastewater surveillance.
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Affiliation(s)
| | - Emily Darby
- Trussell Technologies Inc., Oakland, California, USA
| | | | - Yamrot M Amha
- Trussell Technologies Inc., Pasadena, California, USA
| | | | | | | | - George Di Giovanni
- Metropolitan Water District of Southern California, Los Angeles, California, USA
| | | | | | - Erica Gaddis
- Utah Department of Environmental Quality, Salt Lake City, Utah, USA
| | - Donald Gray
- East Bay Municipal Utility District, Oakland, California, USA
| | | | - Bonnie Mull
- BCS Laboratories Inc., Gainesville, Florida, USA
| | - Liana Olivas
- Trussell Technologies Inc., Pasadena, California, USA
| | | | - Yan Qu
- Trussell Technologies Inc., Pasadena, California, USA
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Gamage D, Mach O, Ginige S, Weldon WC, Oberste MS, Jeyaseelan V, Sutter RW. Poliovirus Type 2 Seroprevalence Following Full- or Fractional-Dose Inactivated Poliovirus Vaccine in the Period After Sabin Type 2 Withdrawal in Sri Lanka. J Infect Dis 2020; 219:1887-1892. [PMID: 30649505 DOI: 10.1093/infdis/jiz026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 01/11/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In July 2016, Sri Lanka replaced 1 intramuscular dose of inactivated poliovirus vaccine (IPV) with 2 doses of intradermal fractional-dose IPV (fIPV) in its routine immunization schedule. We carried out a survey of seroprevalence of antipolio antibodies in children who received 2 fIPV doses and compared it with those who received 1 full IPV dose. METHODS Children born between March and December 2016 were randomly selected from 3 Sri Lankan districts (Colombo, Badulla, and Anuradhapura). Serum samples were collected and tested for presence of neutralizing antibodies to poliovirus types 1, 2, and 3. RESULTS Seroprevalence of antipolio antibodies was 100% in all districts for poliovirus type 1 and poliovirus type 3; it ranged between 90% and 93% for poliovirus type 2 (PV2) in children who received 1 full IPV dose and between 78% and 100% in those receiving 2 fIPV doses (P = .22). The median reciprocal titers of anti-PV2 antibodies were similar in children who received full-dose IPV and those who received fIPV (1:64 vs 1:45, respectively; P = .11). CONCLUSIONS Our study demonstrated not only that Sri Lanka succeeded in maintaining very high primary immunization coverage also but that it is feasible for a national immunization program to implement fIPV immunization and achieve high coverage with intradermal application. The seroprevalence of anti-PV2 antibodies did not decrease after the introduction of fIPV.
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Affiliation(s)
- Deepa Gamage
- Epidemiology Unit, Ministry of Health, Colombo, Sri Lanka
| | - Ondrej Mach
- Polio Eradication Department, World Health Organization, Geneva, Switzerland
| | - Samitha Ginige
- Epidemiology Unit, Ministry of Health, Colombo, Sri Lanka
| | - William C Weldon
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - M Steven Oberste
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Roland W Sutter
- Polio Eradication Department, World Health Organization, Geneva, Switzerland
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Capone D, Berendes D, Cumming O, Knee J, Nalá R, Risk BB, Stauber C, Zhu K, Brown J. Analysis of fecal sludges reveals common enteric pathogens in urban Maputo, Mozambique. ENVIRONMENTAL SCIENCE & TECHNOLOGY LETTERS 2020; 7:889-895. [PMID: 38881628 PMCID: PMC11177333 DOI: 10.1021/acs.estlett.0c00610] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Sewage surveillance is increasingly used in public health applications: metabolites, biomarkers, and pathogens are detectable in wastewater and can provide useful information about community health. Work on this topic has been limited to wastewaters in mainly high-income settings, however. In low-income countries, where the burden of enteric infection is high, non-sewered sanitation predominates. In order to assess the utility of fecal sludge surveillance as a tool to identify the most prevalent enteric pathogens circulating among at-risk children, we collected 95 matched child stool and fecal sludge samples from household clusters sharing latrines in urban Maputo, Mozambique. We analyzed samples for 20 common enteric pathogens via multiplex real-time quantitative PCR. Among the 95 stools matched to fecal sludges, we detected the six most prevalent bacterial pathogens (Enteroaggregative E. coli, Shigella/Enteroinvasive E. coli, Enterotoxigenic E. coli, Enteropathogenic E. coli, shiga-toxin producing E. coli, Salmonella) and all three protozoan pathogens (Giardia duodenalis, Cryptosporidium parvum, Entamoeba histolytica) in the same rank order in both matrices. We did not observe the same trend for viral pathogens or soil-transmitted helminths, however. Our results suggest that sampling fecal sludges from onsite sanitation offers potential for localized pathogen surveillance in low-income settings where enteric pathogen prevalence is high.
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Affiliation(s)
- Drew Capone
- Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, 30332, United States of America
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7431, United States
| | - David Berendes
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, 30329, United States of America
| | - Oliver Cumming
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, WC1E 7HT, London, United Kingdom
| | - Jackie Knee
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, WC1E 7HT, London, United Kingdom
| | - Rassul Nalá
- Ministério da Saúde, Instituto Nacional de Saúde Maputo, Maputo, Mozambique
| | - Benjamin B. Risk
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, 30322, United States of America
| | - Christine Stauber
- School of Public Health, Georgia State University, Atlanta, Georgia, 30302, United States of America
| | - Kevin Zhu
- Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, 30332, United States of America
| | - Joe Brown
- Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, 30332, United States of America
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7431, United States
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Estívariz CF, Pérez-Sánchez EE, Bahena A, Burns CC, Gary HE, García-Lozano H, Rey-Benito G, Peñaranda S, Castillo-Montufar KV, Nava-Acosta RS, Meschke JS, Oberste MS, Lopez-Martínez I, Díaz-Quiñonez JA. Field Performance of Two Methods for Detection of Poliovirus in Wastewater Samples, Mexico 2016-2017. FOOD AND ENVIRONMENTAL VIROLOGY 2019; 11:364-373. [PMID: 31571037 PMCID: PMC10389298 DOI: 10.1007/s12560-019-09399-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 07/29/2019] [Indexed: 06/10/2023]
Abstract
To enhance our ability to monitor poliovirus circulation and certify eradication, we evaluated the performance of the bag-mediated filtration system (BMFS) against the two-phase separation (TPS) method for concentrating wastewater samples for poliovirus detection. Sequential samples were collected at two sites in Mexico; one L was collected by grab and ~ 5 L were collected and filtered in situ with the BMFS. In the laboratory, 500 mL collected by grab were concentrated using TPS and the sample contained in the filter of the BMFS was eluted without secondary concentration. Concentrates were tested for the presence of poliovirus and non-poliovirus enterovirus (NPEV) using Global Poliovirus Laboratory Network standard procedures. Between February 16, 2016, and April 18, 2017, 125 pairs of samples were obtained. Collectors spent an average (± standard deviation) of 4.3 ± 2.2 min collecting the TPS sample versus 73.5 ± 30.5 min collecting and filtering the BMFS sample. Laboratory processing required an estimated 5 h for concentration by TPS and 3.5 h for elution. Sabin 1 poliovirus was detected in 37 [30%] samples with the TPS versus 24 [19%] samples with the BMFS (McNemar's mid p value = 0.004). Sabin 3 poliovirus was detected in 59 [47%] versus 49 (39%) samples (p = 0.043), and NPEV was detected in 67 [54%] versus 40 [32%] samples (p < 0.001). The BMFS method without secondary concentration did not perform as well as the TPS method for detecting Sabin poliovirus and NPEV. Further studies are needed to guide the selection of cost-effective environmental surveillance methods for the polio endgame.
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Affiliation(s)
- Concepción F Estívariz
- Global Immunization Division, Global Health Center, Centers for Control Disease and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA.
| | - Elda E Pérez-Sánchez
- Instituto de Diagnóstico y Referencia Epidemiológico, Francisco de P. Miranda 177, Lomas de Plateros-Alvaro Obregon, Ciudad De México, 01480, Mexico
| | - Anita Bahena
- Organización Panamericana de la Salud, Ciudad de México, Montes Urales 440, 2nd floor, Col. Lomas de Chapultepec, 11000, Ciudad De Mexico, Mexico
| | - Cara C Burns
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Howard E Gary
- Global Immunization Division, Global Health Center, Centers for Control Disease and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA
| | - Herlinda García-Lozano
- Instituto de Diagnóstico y Referencia Epidemiológico, Francisco de P. Miranda 177, Lomas de Plateros-Alvaro Obregon, Ciudad De México, 01480, Mexico
| | - Gloria Rey-Benito
- Immunization Unit, Pan American Health Organization, 525 23rd Street NW, Washington, DC, 20037, USA
| | - Silvia Peñaranda
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Katy V Castillo-Montufar
- Organización Panamericana de la Salud, Ciudad de México, Montes Urales 440, 2nd floor, Col. Lomas de Chapultepec, 11000, Ciudad De Mexico, Mexico
| | - Raúl S Nava-Acosta
- Organización Panamericana de la Salud, Ciudad de México, Montes Urales 440, 2nd floor, Col. Lomas de Chapultepec, 11000, Ciudad De Mexico, Mexico
| | - John Scott Meschke
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98195, USA
| | - M Steven Oberste
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Irma Lopez-Martínez
- Instituto de Diagnóstico y Referencia Epidemiológico, Francisco de P. Miranda 177, Lomas de Plateros-Alvaro Obregon, Ciudad De México, 01480, Mexico
| | - José A Díaz-Quiñonez
- Instituto de Diagnóstico y Referencia Epidemiológico, Francisco de P. Miranda 177, Lomas de Plateros-Alvaro Obregon, Ciudad De México, 01480, Mexico
- División de Estudios de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad De México, Mexico
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Resik S, Tejeda A, Mach O, Fonseca M, Diaz M, Alemany N, Heng Hung L, Aleman Y, Mesa I, Garcia G, Sutter RW. Does Simultaneous Administration of Bivalent (Types 1 and 3) Oral Poliovirus Vaccine and Inactivated Poliovirus Vaccine Induce Mucosal Cross-immunity to Poliovirus Type 2? Clin Infect Dis 2019; 67:S51-S56. [PMID: 30376088 PMCID: PMC6206124 DOI: 10.1093/cid/ciy604] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Inactivated poliovirus vaccine (IPV) alone does not induce mucosal immunity. However, it was hypothesized that administration of IPV together with bivalent (types 1+3) oral poliovirus vaccine (bOPV) may stimulate mucosal cross-immunity to poliovirus type 2 (PV2). Methods Cuban infants were randomized to receive either one dose of IPV (Arm A); one dose of IPV with bOPV (Arm B) at about 6 months of age or no vaccine (Arm C). Subjects were challenged with one dose of trivalent OPV (tOPV); they were about 7 months old in arms A and B, and about 3 months old in arm C at a time of the tOPV challenge. Sera were collected before vaccination and 30 days after tOPV challenge and tested for presence of poliovirus neutralizing antibodies; stool samples were collected at days 0, 7, 14, 21 and 49 post-challenge and tested for presence of poliovirus. Results We enrolled 333 children. Excretion of PV2 following tOPV challenge was highest on day 7 (75 [CI 95% = 65-82%], 68 [CI 95% = 58-75%] and 73 [CI 95% = 63-80%] for study arms A, B, and C respectively); excretion decreased with every subsequent stool sampling; no significant differences either in proportion of PV2 excretion or in its duration were observed between study arms. Conclusions There was no reduction in excretion of PV2 after tOPV challenge in children who had received IPV with bOPV when compared to those who had received IPV alone or no vaccine. Polio eradication program cannot assume any PV2 mucosal response with the current polio immunization schedule. Clinical Trials Registration The trial was registered with the Australian New Zealand Clinical Trials Registry and allocated trial number ACTRN12616000169448.
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Affiliation(s)
- Sonia Resik
- Pedro Kouri Institute of Tropical Medicine, Havana, Cuba
| | - Alina Tejeda
- Provincial Center of Hygiene, Epidemiology and Microbiology, Camaguey, Cuba
| | - Ondrej Mach
- The World Health Organization, Geneva, Switzerland
| | - Magile Fonseca
- Pedro Kouri Institute of Tropical Medicine, Havana, Cuba
| | - Manuel Diaz
- Pedro Kouri Institute of Tropical Medicine, Havana, Cuba
| | - Nilda Alemany
- Provincial Center of Hygiene, Epidemiology and Microbiology, Camaguey, Cuba
| | - Lai Heng Hung
- Pedro Kouri Institute of Tropical Medicine, Havana, Cuba
| | - Yoan Aleman
- Pedro Kouri Institute of Tropical Medicine, Havana, Cuba
| | - Ileana Mesa
- Provincial Center of Hygiene, Epidemiology and Microbiology, Camaguey, Cuba
| | - Gloria Garcia
- Provincial Center of Hygiene, Epidemiology and Microbiology, Camaguey, Cuba
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González MM, Fonseca MC, Rodríguez CA, Giraldo AM, Vila JJ, Castaño JC, Padilla L, Sarmiento L. Environmental Surveillance of Polioviruses in Armenia, Colombia before Trivalent Oral Polio Vaccine Cessation. Viruses 2019; 11:E775. [PMID: 31450757 PMCID: PMC6783851 DOI: 10.3390/v11090775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 08/17/2019] [Accepted: 08/18/2019] [Indexed: 11/16/2022] Open
Abstract
Although acute flaccid paralysis (AFP) surveillance is the "gold standard" for detecting cases of polio, environmental surveillance can provide supplementary information in the absence of paralytic poliomyelitis cases. This study aimed to detect the introduction and/or circulation of wild poliovirus or vaccine-derived polioviruses (VDPV) in wastewater, covering a significant population of Armenia, Colombia, before trivalent oral polio vaccine (OPV) cessation. Between March and September 2015, 24 wastewater samples were collected from eight study sites in eight communes of Armenia, Colombia. Virus detection and characterization were performed using both cell culture (i.e., RD or L20B cells) and RT-PCR. Polioviruses were isolated in 11 (45.8%) of 24 wastewater samples. All isolates were identified as Sabin strains (type 1 = 9, type 3 = 2) by intratypic differentiation. Type 2 poliovirus was not detected in any of the samples. No wild poliovirus or VDPV was detected among the isolates. Non-polio enterovirus was identified in 8.3% (2/24) of the samples. This study revealed the excretion of Sabin poliovirus from OPV-immunized individuals, as well as the absence of VDPV and wild poliovirus in wastewaters of Armenia, Colombia. This confirms that environmental surveillance is an effective method, as an additional support to AFP surveillance, to monitor poliovirus during the OPV-to-IPV (inactivated polio vaccine) transition period.
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Affiliation(s)
- María Mercedes González
- Center of Biomedical Research, Faculty of Health Sciences, Universidad del Quindío, Armenia 630003, Colombia.
| | - Magile C Fonseca
- Enterovirus Laboratory, Department of Virology, Pedro Kourí Institute of Tropical Medicine, Havana 11400, Cuba
| | - Carlos Andrés Rodríguez
- Center of Biomedical Research, Faculty of Health Sciences, Universidad del Quindío, Armenia 630003, Colombia
| | - Alejandra María Giraldo
- Center of Biomedical Research, Faculty of Health Sciences, Universidad del Quindío, Armenia 630003, Colombia
| | - José Joaquín Vila
- Center of Biomedical Research, Faculty of Health Sciences, Universidad del Quindío, Armenia 630003, Colombia
| | - Jhon Carlos Castaño
- Center of Biomedical Research, Faculty of Health Sciences, Universidad del Quindío, Armenia 630003, Colombia
| | - Leonardo Padilla
- Center of Biomedical Research, Faculty of Health Sciences, Universidad del Quindío, Armenia 630003, Colombia
| | - Luis Sarmiento
- Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmo 21428, Sweden.
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38
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Huyen DTT, Mach O, Thanh Trung N, Thai PQ, Thang HV, Weldon WC, Oberste MS, Jeyaseelan V, Sutter RW, Anh DD. Rapid Disappearance of Poliovirus Type 2 (PV2) Immunity in Young Children Following Withdrawal of Oral PV2-Containing Vaccine in Vietnam. J Infect Dis 2019; 220:386-391. [PMID: 30869149 PMCID: PMC9069936 DOI: 10.1093/infdis/jiz124] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 03/13/2019] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Due to global shortage of inactivated poliovirus vaccine and withdrawal of oral vaccine containing poliovirus type 2 (PV2), a PV2-containing vaccine was not used in Vietnam May 2016 to October 2018. We assessed the population immunity gap to PV2. METHODS A cross-sectional survey in children aged 1-18 months was carried out in January 2018. One blood sample per child was analyzed for presence of poliovirus neutralizing antibodies. In children with detectable anti-PV2 antibodies, a second sample was analyzed 4 months later to distinguish between passive (maternally derived) and active (induced by secondary transmission or vaccination) immunity. RESULTS Sera were obtained from 1106/1110 children. Seroprevalence of PV2 antibodies was 87/368 (23.6%) at age 1-7 months, 27/471 (5.7%) at 8-15 months, and 19/267 (7.1%) at 16-18 months. Seroprevalence declined with age in the 1-7 months group; in the 8-18 months group there was no significant change with age. Four months later, 11/87 (14%), 9/27 (32%), and 12/19 (37%) remained seropositive in 1-7, 8-15, and 16-18 months age groups, respectively. CONCLUSIONS We found declining immunity to PV2, suggesting Vietnam is at risk for an outbreak of type 2 vaccine-derived poliovirus following virus importation or new emergence.
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Affiliation(s)
| | - Ondrej Mach
- Polio Eradication Department, World Health Organization, Geneva, Switzerland
| | | | - Pham Quang Thai
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | - William C Weldon
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - M Steven Oberste
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Roland W Sutter
- Polio Eradication Department, World Health Organization, Geneva, Switzerland
| | - Dang Duc Anh
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
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O'Brien E, Xagoraraki I. A water-focused one-health approach for early detection and prevention of viral outbreaks. One Health 2019; 7:100094. [PMID: 31080867 PMCID: PMC6501061 DOI: 10.1016/j.onehlt.2019.100094] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 04/17/2019] [Accepted: 04/18/2019] [Indexed: 12/21/2022] Open
Abstract
Despite consistent efforts to protect public health there is still a heavy burden of viral disease, both in the United States and abroad. In addition to conventional medical treatment, there is a need for a holistic approach for early detection and prevention of viral outbreaks at a population level. One-Health is a relatively new integrative approach to the solving of global health challenges. A key component to the One-Health approach is the notion that human health, animal health, and environmental health are all innately interrelated. One-Health interventions, initiated by veterinary doctors, have proven to be effective in controlling outbreaks, but thus far the applications focus on zoonotic viruses transmitted from animals to humans. Environmental engineers and environmental scientists hold a critical role in the further development of One-Health approaches that include water-related transport and transmission of human, animal, and zoonotic viruses. In addition to waterborne viruses, the proposed approach is applicable to a wide range of viruses that are found in human excrement since contaminated water-based surveillance systems may be used for early detection of viral disease. This paper proposes a greater One-Health based framework that involves water-related pathways. The first step in the proposed framework is the identification of critical exposure pathways of viruses in the water environment. Identification of critical pathways informs the second and third steps, which include water-based surveillance systems for early detection at a population level and implementation of intervention approaches to block the critical pathways of exposure.
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Affiliation(s)
| | - Irene Xagoraraki
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI 48824, USA
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40
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Abstract
The immense global burden of infectious disease outbreaks and the need to establish prediction and prevention systems have been recognized by the World Health Organization (WHO), the National Institutes of Health (NIH), the United States Agency of International Development (USAID), the Bill and Melinda Gates Foundation, and the international scientific community. Despite multiple efforts, this infectious burden is still increasing. For example, it has been reported that between 1.5 and 12 million people die each year from waterborne diseases and diarrheal diseases are listed within the top 15 leading causes of death worldwide. Rapid population growth, climate change, natural disasters, immigration, globalization, and the corresponding sanitation and waste management challenges are expected to intensify the problem in the years to come.
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Kroiss SJ, Ahmadzai M, Ahmed J, Alam MM, Chabot-Couture G, Famulare M, Mahamud A, McCarthy KA, Mercer LD, Muhammad S, Safdar RM, Sharif S, Shaukat S, Shukla H, Lyons H. Assessing the sensitivity of the polio environmental surveillance system. PLoS One 2018; 13:e0208336. [PMID: 30592720 PMCID: PMC6310268 DOI: 10.1371/journal.pone.0208336] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 11/15/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The polio environmental surveillance (ES) system has been an incredible tool for advancing polio eradication efforts because of its ability to highlight the spatial and temporal extent of poliovirus circulation. While ES often outperforms, or is more sensitive than AFP surveillance, the sensitivity of the ES system has not been well characterized. Fundamental uncertainty of ES site sensitivity makes it difficult to interpret results from ES, particularly negative results. METHODS AND FINDINGS To study ES sensitivity, we used data from Afghanistan and Pakistan to examine the probability that each ES site detected the Sabin 1, 2, or 3 components of the oral polio vaccine (OPV) as a function of virus prevalence within the same district (estimated from AFP data). Accounting for virus prevalence is essential for estimating site sensitivity because Sabin detection rates should vary with prevalence-high immediately after supplemental immunization activities (SIAs), but low in subsequent months. We found that most ES sites in Pakistan and Afghanistan are highly sensitive for detecting poliovirus relative to AFP surveillance in the same districts. For example, even when Sabin poliovirus is at low prevalence of ~0.5-3% in AFP surveillance, most ES sites have ~34-50% probability of detecting Sabin. However, there was considerable variation in ES site sensitivity and we flagged several sites for re-evaluation based on low sensitivity rankings and low wild polio virus detection rates. In these areas, adding new sites or modifying collection methods in current sites could improve sensitivity of environmental surveillance. CONCLUSIONS Relating ES detections to virus prevalence significantly improved our ability to evaluate site sensitivity compared to evaluations based solely on ES detection rates. To extend our approach to new sites and regions, we provide a preliminary framework for relating ES and AFP detection rates, and descriptions of how detection rates might relate to SIAs and natural seasonality.
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Affiliation(s)
- Steve J. Kroiss
- Institute for Disease Modeling, Bellevue, WA, United States of America
| | - Maiwand Ahmadzai
- National Emergency Operations Centre for Polio Eradication, Kabul, Afghanistan
| | - Jamal Ahmed
- World Health Organization, Geneva, Switzerland
| | - Muhammad Masroor Alam
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
- World Health Organization, Islamabad, Pakistan
| | | | - Michael Famulare
- Institute for Disease Modeling, Bellevue, WA, United States of America
| | - Abdirahman Mahamud
- World Health Organization, Islamabad, Pakistan
- National Emergency Operations Centre for Polio Eradication, Islamabad, Pakistan
| | - Kevin A. McCarthy
- Institute for Disease Modeling, Bellevue, WA, United States of America
| | - Laina D. Mercer
- Institute for Disease Modeling, Bellevue, WA, United States of America
| | - Salman Muhammad
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Rana M. Safdar
- National Emergency Operations Centre for Polio Eradication, Islamabad, Pakistan
| | - Salmaan Sharif
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
- World Health Organization, Islamabad, Pakistan
| | - Shahzad Shaukat
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
- World Health Organization, Islamabad, Pakistan
| | - Hemant Shukla
- National Emergency Operations Centre for Polio Eradication, Kabul, Afghanistan
| | - Hil Lyons
- Institute for Disease Modeling, Bellevue, WA, United States of America
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Altamirano J, Leary S, van Hoorebeke C, Sarnquist C, Behl R, García-García L, Ferreyra-Reyes L, Huang C, Sommer M, Maldonado Y. Validation of a High-throughput, Multiplex, Real-time Qualitative Polymerase Chain Reaction Assay for the Detection of Sabin Oral Polio Vaccine in Environmental Samples. Clin Infect Dis 2018; 67:S98-S102. [PMID: 30376093 PMCID: PMC6206112 DOI: 10.1093/cid/ciy639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Currently, the primary mechanism for poliovirus detection is acute flaccid paralysis (AFP) surveillance, with environmental sampling serving as a complement. However, as AFP cases drop, environmental surveillance will become increasingly critical for poliovirus detection. Mexico provides a natural environment to study oral polio vaccine (OPV) transmission, as it provides routine injected polio vaccine immunization and biannual OPV campaigns in February and May. Methods As part of a study of OPV transmission in which 155 children were vaccinated with OPV, monthly sewage samples were collected from rivers leading from 3 indigenous Mexican villages (Capoluca, Campo Grande, and Tuxpanguillo) from February to May 2015. Samples were also collected from October 2015 to October 2017, during which time there were standard OPV campaigns. Samples were analyzed for the presence of OPV serotypes, using a real-time qualitative polymerase chain reaction assay capable of detecting as few as 9, 12, and 10 copies/100 µL of viral ribonucleic acid for OPV serotypes 1, 2, and 3 (OPV-1, -2, and -3), respectively. Included here are 54 samples, taken up to November 2016. Results Of the 54 samples, 13 (24%) were positive for OPV. After the vaccination of 155 children in February 2015, OPV was found 2 months after vaccination. After unrestricted OPV administration in February 2016, OPV was detected in sewage up to 8 months after vaccination. OPV-3 was found in 11 of the 13 positive samples (85%), OPV-2 was found in 3 positive samples (23%), and OPV-1 was found in 1 sample (8%). Conclusions OPV can be detected even when small amounts of the vaccine are introduced into a community, as shown by OPV-positive sewage samples even when only 155 children were vaccinated. When OPV vaccination was unrestricted, sewage samples were positive up to 8 months after vaccination, implying community OPV circulation for at least 8 months. OPV-3 was the serotype most found in these samples, indicating prolonged transmission of OPV-3 when compared to the other serotypes. Future work could compare the phylogenetic variance of OPV isolates from sewage after OPV vaccinations.
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Affiliation(s)
| | - Sean Leary
- Stanford University School of Medicine, California
| | | | | | - Rasika Behl
- Stanford University School of Medicine, California
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43
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Duintjer Tebbens RJ, Thompson KM. Polio endgame risks and the possibility of restarting the use of oral poliovirus vaccine. Expert Rev Vaccines 2018; 17:739-751. [PMID: 30056767 PMCID: PMC6168953 DOI: 10.1080/14760584.2018.1506333] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/26/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Ending all cases of poliomyelitis requires successful cessation of all oral poliovirus vaccine (OPV), but the Global Polio Eradication Initiative (GPEI) partners should consider the possibility of an OPV restart. AREAS COVERED We review the risks of continued live poliovirus transmission after OPV cessation and characterize events that led to OPV restart in a global model that focused on identifying optimal strategies for OPV cessation and the polio endgame. Numerous different types of events that occurred since the globally coordinated cessation of serotype 2-containing OPV in 2016 highlight the possibility of continued outbreaks after homotypic OPV cessation. Modeling suggests a high risk of uncontrolled outbreaks once more than around 5,000 homotypic polio cases occur after cessation of an OPV serotype, at which point restarting OPV would become necessary to protect most populations. Current efforts to sunset the GPEI and transition its responsibilities to national governments poses risks that may limit the ability to implement management strategies needed to minimize the probability of an OPV restart. EXPERT COMMENTARY OPV restart remains a real possibility, but risk management choices made by the GPEI partners and national governments can reduce the risks of this low-probability but high-consequence event.
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O'Brien E, Nakyazze J, Wu H, Kiwanuka N, Cunningham W, Kaneene JB, Xagoraraki I. Viral diversity and abundance in polluted waters in Kampala, Uganda. WATER RESEARCH 2017; 127:41-49. [PMID: 29031798 DOI: 10.1016/j.watres.2017.09.063] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 09/29/2017] [Accepted: 09/30/2017] [Indexed: 05/02/2023]
Abstract
Waterborne viruses are a significant cause of human disease, especially in developing countries such as Uganda. A total of 15 virus-selective samples were collected at five sites (Bugolobi Wastewater Treatment Plant (WWTP) influent and effluent, Nakivubo Channel upstream and downstream of the WWTP, and Nakivubo Swamp) in July and August 2016. Quantitative PCR and quantitative RT-PCR was performed to determine the concentrations of four human viruses (adenovirus, enterovirus, rotavirus, and hepatitis A virus) in the samples. Adenovirus (1.53*105-1.98*107 copies/L) and enterovirus (3.17*105-8.13*107 copies/L) were found to have the highest concentrations in the samples compared to rotavirus (5.79*101-3.77*103 copies/L) and hepatitis A virus (9.93*102-1.11*104 copies/L). In addition, next-generation sequencing and metagenomic analyses were performed to assess viral diversity, and several human and vertebrate viruses were detected, including Herpesvirales, Iridoviridae, Poxviridae, Circoviridae, Parvoviridae, Bunyaviridae and others. Effluent from the wastewater treatment plant appears to impact surface water, as samples taken from surface water downstream of the treatment plant had higher viral concentrations than samples taken upstream. Temporal fluctuations in viral abundance and diversity were also observed. Continuous monitoring of wastewater may contribute to assessing viral disease patterns at a population level and provide early warning of potential outbreaks using wastewater-based epidemiology methods.
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Affiliation(s)
- Evan O'Brien
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, 48824, USA
| | - Joyce Nakyazze
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, 48824, USA
| | - Huiyun Wu
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, 48824, USA
| | - Noah Kiwanuka
- Department of Epidemiology and Biostatistics, College of Health Sciences, Makerere University, Kampala, Uganda
| | - William Cunningham
- College of Osteopathic Medicine, Michigan State University, East Lansing, MI, 48824, USA
| | - John B Kaneene
- Center for Comparative Epidemiology, College of Veterinary Medicine, Michigan State University, East Lansing, MI, 48824, USA
| | - Irene Xagoraraki
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, 48824, USA.
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45
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Duintjer Tebbens RJ, Zimmermann M, Pallansch M, Thompson KM. Insights from a Systematic Search for Information on Designs, Costs, and Effectiveness of Poliovirus Environmental Surveillance Systems. FOOD AND ENVIRONMENTAL VIROLOGY 2017; 9:361-382. [PMID: 28687986 PMCID: PMC7879701 DOI: 10.1007/s12560-017-9314-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 06/30/2017] [Indexed: 05/20/2023]
Abstract
Poliovirus surveillance plays a critical role in achieving and certifying eradication and will play a key role in the polio endgame. Environmental surveillance can provide an opportunity to detect circulating polioviruses prior to the observation of any acute flaccid paralysis cases. We completed a systematic review of peer-reviewed publications on environmental surveillance for polio including the search terms "environmental surveillance" or "sewage," and "polio," "poliovirus," or "poliomyelitis," and compared characteristics of the resulting studies. The review included 146 studies representing 101 environmental surveillance activities from 48 countries published between 1975 and 2016. Studies reported taking samples from sewage treatment facilities, surface waters, and various other environmental sources, although they generally did not present sufficient details to thoroughly evaluate the sewage systems and catchment areas. When reported, catchment areas varied from 50 to over 7.3 million people (median of 500,000 for the 25% of activities that reported catchment areas, notably with 60% of the studies not reporting this information and 16% reporting insufficient information to estimate the catchment area population size). While numerous studies reported the ability of environmental surveillance to detect polioviruses in the absence of clinical cases, the review revealed very limited information about the costs and limited information to support quantitative population effectiveness of conducting environmental surveillance. This review motivates future studies to better characterize poliovirus environmental surveillance systems and the potential value of information that they may provide in the polio endgame.
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Affiliation(s)
| | - Marita Zimmermann
- Kid Risk, Inc., 10524 Moss Park Rd., Ste. 204-364, Orlando, FL 32832
- Correspondence to: Radboud J. Duintjer Tebbens, Kid Risk, Inc., 10524 Moss Park Rd., Ste. 204-364, Orlando, FL 32832, USA,
| | - Mark Pallansch
- Centers for Disease Control and Prevention, Division of Viral Diseases, Atlanta, GA 30333
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Kroiss SJ, Famulare M, Lyons H, McCarthy KA, Mercer LD, Chabot-Couture G. Evaluating cessation of the type 2 oral polio vaccine by modeling pre- and post-cessation detection rates. Vaccine 2017; 35:5674-5681. [DOI: 10.1016/j.vaccine.2017.08.048] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 08/02/2017] [Accepted: 08/19/2017] [Indexed: 11/26/2022]
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Furtak V, Roivainen M, Mirochnichenko O, Zagorodnyaya T, Laassri M, Zaidi SZ, Rehman L, Alam MM, Chizhikov V, Chumakov K. Environmental surveillance of viruses by tangential flow filtration and metagenomic reconstruction. ACTA ACUST UNITED AC 2017; 21:30193. [PMID: 27105043 DOI: 10.2807/1560-7917.es.2016.21.15.30193] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 04/14/2016] [Indexed: 11/20/2022]
Abstract
An approach is proposed for environmental surveillance of poliovirus by concentrating sewage samples with tangential flow filtration (TFF) followed by deep sequencing of viral RNA. Subsequent to testing the method with samples from Finland, samples from Pakistan, a country endemic for poliovirus, were investigated. Genomic sequencing was either performed directly, for unbiased identification of viruses regardless of their ability to grow in cell cultures, or after virus enrichment by cell culture or immunoprecipitation. Bioinformatics enabled separation and determination of individual consensus sequences. Overall, deep sequencing of the entire viral population identified polioviruses, non-polio enteroviruses, and other viruses. In Pakistani sewage samples, adeno-associated virus, unable to replicate autonomously in cell cultures, was the most abundant human virus. The presence of recombinants of wild polioviruses of serotype 1 (WPV1) was also inferred, whereby currently circulating WPV1 of south-Asian (SOAS) lineage comprised two sub-lineages depending on their non-capsid region origin. Complete genome analyses additionally identified point mutants and intertypic recombinants between attenuated Sabin strains in the Pakistani samples, and in one Finnish sample. The approach could allow rapid environmental surveillance of viruses causing human infections. It creates a permanent digital repository of the entire virome potentially useful for retrospective screening of future discovered viruses.
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Affiliation(s)
- Vyacheslav Furtak
- Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, United States
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48
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Thompson KM, Duintjer Tebbens RJ. Lessons From Globally Coordinated Cessation of Serotype 2 Oral Poliovirus Vaccine for the Remaining Serotypes. J Infect Dis 2017; 216:S168-S175. [PMID: 28838198 PMCID: PMC5853947 DOI: 10.1093/infdis/jix128] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 03/06/2017] [Accepted: 03/13/2017] [Indexed: 12/12/2022] Open
Abstract
Background Comparing model expectations with the experience of oral poliovirus vaccine (OPV) containing serotype 2 (OPV2) cessation can inform risk management for the expected cessation of OPV containing serotypes 1 and 3 (OPV13). Methods We compare the expected post-OPV2-cessation OPV2-related viruses from models with the evidence available approximately 6 months after OPV2 cessation. We also model the trade-offs of use vs nonuse of monovalent OPV (mOPV) for outbreak response considering all 3 serotypes. Results Although too early to tell definitively, the observed die-out of OPV2-related viruses in populations that attained sufficiently intense trivalent OPV (tOPV) use prior to OPV2 cessation appears consistent with model expectations. As expected, populations that did not intensify tOPV use prior to OPV2 cessation show continued circulation of serotype 2 vaccine-derived polioviruses (VDPVs). Failure to aggressively use mOPV to respond to circulating VDPVs results in a high risk of uncontrolled outbreaks that would require restarting OPV. Conclusions Ensuring a successful endgame requires more aggressive OPV cessation risk management than has occurred to date for OPV2 cessation. This includes maintaining high population immunity to transmission up until OPV13 cessation, meeting all prerequisites for OPV cessation, and ensuring sufficient vaccine supply to prevent and respond to outbreaks.
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Farrell M, Hampton LM, Shendale S, Menning L, Gonzalez AR, Garon J, Dolan SB, du Châtellier GM, Wanyoike S, Chang Blanc D, Patel MM. Monitoring and Validation of the Global Replacement of tOPV with bOPV, April-May 2016. J Infect Dis 2017; 216:S193-S201. [PMID: 28838162 PMCID: PMC5853513 DOI: 10.1093/infdis/jiw558] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The phased withdrawal of oral polio vaccine (OPV) associated with the Polio Eradication and Endgame Strategic Plan 2013-2018 began with the synchronized global replacement of trivalent OPV (tOPV) with bivalent OPV (bOPV) during April - May 2016, a transition referred to as the "switch." The World Health Organization's (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization recommended conducting this synchronized switch in all 155 OPV-using countries and territories (which collectively administered several hundred million doses of tOPV each year via several hundred thousand facilities) to reduce risks of re-emergence of vaccine-derived polioviruses. Safe execution of this switch required implementation of an associated independent monitoring strategy, the primary objective of which was verification that tOPV was no longer available for administration post-switch. This strategy had to be both practical and rigorous such that tOPV withdrawal could be reasonably employed and confirmed in all countries and territories within a discreet timeframe. Following these principles, WHO recommended that designated monitors in each of the 155 countries and territories visit all vaccine stores as well as a 10% sample of highest-risk health facilities within two weeks of the national switch date, removing any tOPV vials found. National governments were required to provide the WHO with formal validation of execution and monitoring of the switch. In practice, all countries reported cessation of tOPV by 12 May 2016 and 95% of countries and territories submitted detailed monitoring data to WHO. According to these data, 272 out of 276 (99%) national stores, 3,741 out of 3.968 (94%) regional stores, 16,144 out of 22,372 (72%) district level stores, and 143,050 out of 595,401 (24%) of health facilities were monitored. These data, along with field reports suggest that monitoring and validation of the switch was efficient and effective, and that the strategies used during the process could be adapted to future stages of OPV withdrawal.
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Affiliation(s)
| | - Lee M Hampton
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stephanie Shendale
- Expanded Programme on Immunization, World Health Organization, Geneva, Switzerland
| | - Lisa Menning
- Expanded Programme on Immunization, World Health Organization, Geneva, Switzerland
| | | | | | - Samantha B Dolan
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Diana Chang Blanc
- Expanded Programme on Immunization, World Health Organization, Geneva, Switzerland
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Giri S, Rajan AK, Kumar N, Dhanapal P, Venkatesan J, Iturriza-Gomara M, Taniuchi M, John J, Abraham AM, Kang G. Comparison of culture, single and multiplex real-time PCR for detection of Sabin poliovirus shedding in recently vaccinated Indian children. J Med Virol 2017; 89:1485-1488. [PMID: 28213965 PMCID: PMC6139431 DOI: 10.1002/jmv.24793] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 01/30/2017] [Indexed: 11/30/2022]
Abstract
Although, culture is considered the gold standard for poliovirus detection from stool samples, real‐time PCR has emerged as a faster and more sensitive alternative. Detection of poliovirus from the stool of recently vaccinated children by culture, single and multiplex real‐time PCR was compared. Of the 80 samples tested, 55 (68.75%) were positive by culture compared to 61 (76.25%) and 60 (75%) samples by the single and one step multiplex real‐time PCR assays respectively. Real‐time PCR (singleplex and multiplex) is more sensitive than culture for poliovirus detection in stool, although the difference was not statistically significant.
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Affiliation(s)
- Sidhartha Giri
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Anand K Rajan
- Department of Clinical Virology, Christian Medical College, Vellore, India
| | - Nirmal Kumar
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Pavithra Dhanapal
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | | | - Miren Iturriza-Gomara
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Mami Taniuchi
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Jacob John
- Department of Community Medicine, Christian Medical College, Vellore, India
| | - Asha Mary Abraham
- Department of Clinical Virology, Christian Medical College, Vellore, India
| | - Gagandeep Kang
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
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