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Róka E, Khayer B, Kis Z, Kovács LB, Schuler E, Magyar N, Málnási T, Oravecz O, Pályi B, Pándics T, Vargha M. Ahead of the second wave: Early warning for COVID-19 by wastewater surveillance in Hungary. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 786:147398. [PMID: 33971598 PMCID: PMC8081569 DOI: 10.1016/j.scitotenv.2021.147398] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/23/2021] [Accepted: 04/23/2021] [Indexed: 05/22/2023]
Abstract
Wastewater based epidemiology is a potential early warning tool for the detection of COVID-19 outbreak. Sewage surveillance for SARS-CoV-2 RNA was introduced in Hungary after the successful containment of the first wave of the pandemic to forecast the resurge of infections. Three wastewater treatment plants servicing the entire population (1.8 million) of the capital, Budapest were sampled weekly. 24 h composite (n = 44) and grab samples (n = 21) were concentrated by an in-house flat sheet membrane ultrafiltration method. The efficiency and reproducibility of the method was comparable to those previously published. SARS-CoV-2 RNA was quantified using RT-qPCR of the N gene. The first positive signal in sewage was detected 2 weeks before the rise in case numbers. Viral concentration and volume-adjusted viral load correlated to the weekly new cases from the same week and the rolling 7-day average of active cases in the subsequent week. The correlation was more pronounced in the ascending phase of the outbreak, data was divergent once case numbers plateaued. Wastewater surveillance was found to be effective in predicting the second wave of the outbreak in Hungary. Data indicated that even relatively low frequency (weekly) sampling is useful and at the same time, cost effective tool in outbreak detection.
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Affiliation(s)
- Eszter Róka
- Department of Public Health Laboratory, National Public Health Centre, Albert Flórián út 2-6, H-1097 Budapest, Hungary
| | - Bernadett Khayer
- Department of Public Health Laboratory, National Public Health Centre, Albert Flórián út 2-6, H-1097 Budapest, Hungary
| | - Zoltán Kis
- Department of Virology, National Public Health Centre, Albert Flórián út 2-6, H-1097 Budapest, Hungary
| | - Luca Bella Kovács
- Department of Public Health Laboratory, National Public Health Centre, Albert Flórián út 2-6, H-1097 Budapest, Hungary
| | - Eszter Schuler
- Department of Public Health Laboratory, National Public Health Centre, Albert Flórián út 2-6, H-1097 Budapest, Hungary
| | - Nóra Magyar
- Department of Virology, National Public Health Centre, Albert Flórián út 2-6, H-1097 Budapest, Hungary
| | - Tibor Málnási
- Department of Public Health Laboratory, National Public Health Centre, Albert Flórián út 2-6, H-1097 Budapest, Hungary
| | - Orsolya Oravecz
- Department of Public Health Laboratory, National Public Health Centre, Albert Flórián út 2-6, H-1097 Budapest, Hungary
| | - Bernadett Pályi
- Department of Virology, National Public Health Centre, Albert Flórián út 2-6, H-1097 Budapest, Hungary
| | - Tamás Pándics
- Department of Public Health Laboratory, National Public Health Centre, Albert Flórián út 2-6, H-1097 Budapest, Hungary
| | - Márta Vargha
- Department of Public Health Laboratory, National Public Health Centre, Albert Flórián út 2-6, H-1097 Budapest, Hungary.
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