1
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Kwon JH, Advani SD, Branch-Elliman W, Braun BI, Cheng VCC, Chiotos K, Douglas P, Gohil SK, Keller SC, Klein EY, Krein SL, Lofgren ET, Merrill K, Moehring RW, Monsees E, Perri L, Scaggs Huang F, Shelly MA, Skelton F, Spivak ES, Sreeramoju PV, Suda KJ, Ting JY, Weston GD, Yassin MH, Ziegler MJ, Mody L. A call to action: the SHEA research agenda to combat healthcare-associated infections. Infect Control Hosp Epidemiol 2024:1-18. [PMID: 39448369 DOI: 10.1017/ice.2024.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2024]
Affiliation(s)
- Jennie H Kwon
- Washington University School of Medicine in St. Louis, St. Louis, MI, USA
| | | | - Westyn Branch-Elliman
- VA Boston Healthcare System, VA National Artificial Intelligence Institute (NAII), Harvard Medical School, Boston, MA, USA
| | | | | | - Kathleen Chiotos
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Peggy Douglas
- Washington State Department of Health, Seattle, WA, USA
| | - Shruti K Gohil
- University of California Irvine School of Medicine, UCI Irvine Health, Irvine, CA, USA
| | - Sara C Keller
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Eili Y Klein
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Sarah L Krein
- VA Ann Arbor Healthcare System, University of Michigan, Ann Arbor, MI, USA
| | - Eric T Lofgren
- Paul G. Allen School for Global Health, Washington State University, Pullman, WA, USA
| | | | | | - Elizabeth Monsees
- Children's Mercy Kansas City, University of Missouri-Kansas City School of Medicine, Kansas City, MI, USA
| | - Luci Perri
- Infection Control Results, Wingate, NC, USA
| | - Felicia Scaggs Huang
- University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Mark A Shelly
- Geisinger Commonwealth School of Medicine, Danville, PA, USA
| | - Felicia Skelton
- Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX, USA
| | - Emily S Spivak
- University of Utah Health, Salt Lake City Veterans Affairs Healthcare System, Salt Lake City, UT, USA
| | | | - Katie J Suda
- University of Pittsburgh School of Medicine, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | | | | | - Mohamed H Yassin
- University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Matthew J Ziegler
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Lona Mody
- University of Michigan, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
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2
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Parkins MD, Lee BE, Acosta N, Bautista M, Hubert CRJ, Hrudey SE, Frankowski K, Pang XL. Wastewater-based surveillance as a tool for public health action: SARS-CoV-2 and beyond. Clin Microbiol Rev 2024; 37:e0010322. [PMID: 38095438 PMCID: PMC10938902 DOI: 10.1128/cmr.00103-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2024] Open
Abstract
Wastewater-based surveillance (WBS) has undergone dramatic advancement in the context of the coronavirus disease 2019 (COVID-19) pandemic. The power and potential of this platform technology were rapidly realized when it became evident that not only did WBS-measured SARS-CoV-2 RNA correlate strongly with COVID-19 clinical disease within monitored populations but also, in fact, it functioned as a leading indicator. Teams from across the globe rapidly innovated novel approaches by which wastewater could be collected from diverse sewersheds ranging from wastewater treatment plants (enabling community-level surveillance) to more granular locations including individual neighborhoods and high-risk buildings such as long-term care facilities (LTCF). Efficient processes enabled SARS-CoV-2 RNA extraction and concentration from the highly dilute wastewater matrix. Molecular and genomic tools to identify, quantify, and characterize SARS-CoV-2 and its various variants were adapted from clinical programs and applied to these mixed environmental systems. Novel data-sharing tools allowed this information to be mobilized and made immediately available to public health and government decision-makers and even the public, enabling evidence-informed decision-making based on local disease dynamics. WBS has since been recognized as a tool of transformative potential, providing near-real-time cost-effective, objective, comprehensive, and inclusive data on the changing prevalence of measured analytes across space and time in populations. However, as a consequence of rapid innovation from hundreds of teams simultaneously, tremendous heterogeneity currently exists in the SARS-CoV-2 WBS literature. This manuscript provides a state-of-the-art review of WBS as established with SARS-CoV-2 and details the current work underway expanding its scope to other infectious disease targets.
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Affiliation(s)
- Michael D. Parkins
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- O’Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Bonita E. Lee
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Nicole Acosta
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Maria Bautista
- Department of Biological Sciences, Faculty of Science, University of Calgary, Calgary, Alberta, Canada
| | - Casey R. J. Hubert
- Department of Biological Sciences, Faculty of Science, University of Calgary, Calgary, Alberta, Canada
| | - Steve E. Hrudey
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Kevin Frankowski
- Advancing Canadian Water Assets, University of Calgary, Calgary, Alberta, Canada
| | - Xiao-Li Pang
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
- Provincial Health Laboratory, Alberta Health Services, Calgary, Alberta, Canada
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3
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Haskell BR, Dhiyebi HA, Srikanthan N, Bragg LM, Parker WJ, Giesy JP, Servos MR. Implementing an adaptive, two-tiered SARS-CoV-2 wastewater surveillance program on a university campus using passive sampling. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:168998. [PMID: 38040360 DOI: 10.1016/j.scitotenv.2023.168998] [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: 10/13/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 12/03/2023]
Abstract
Building-level wastewater-based surveillance (WBS) has been increasingly applied upstream from wastewater treatment plants to conduct targeted monitoring for SARS-CoV-2. In this study, a two-tiered, trigger-based wastewater surveillance program was developed on a university campus to monitor dormitory wastewater. The objective was to determine if passive sampling with cotton gauze as a sampling medium could be used to support institution-level public health action. Two nucleocapsid gene targets (N1 and N2) of SARS-CoV-2 as well as the endogenous fecal indicator pepper mild mottle virus (PMMoV) were quantified using RT-qPCR. >500 samples were analyzed during two contrasting surveillance periods. In the Fall of 2021 community viral burden was low and a tiered sampling network was able to isolate individual clinical cases at the building-scale. In the Winter of 2022 wastewater signals were quickly elevated by the emergence of the highly transmissible SARS-CoV-2 Omicron (B.1.1.529) variant. Prevalence of SARS-CoV-2 shifted surveillance objectives from isolating cases to monitoring trends, revealing both the benefits and limitations of a tiered surveillance design under different public health situations. Normalization of SARS-CoV-2 by PMMoV was not reflective of upstream population differences, suggesting saturation of the material occurred during the exposure period. The passive sampling method detected nearly all known clinical cases and in one instance was able to identify one pre-symptomatic individual days prior to confirmation by clinical test. Comparisons between campus samplers and municipal wastewater influent suggests that the spread of COVID-19 on the campus was similar to that of the broader community. The results demonstrate that passive sampling is an effective tool that can produce semi-quantitative data capable of tracking temporal trends to guide targeted public health decision-making at an institutional level. Practitioners of WBS can utilize these results to inform surveillance program designs that prioritize efficient resource use and rapid reporting.
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Affiliation(s)
- Blake R Haskell
- Department of Biology, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada.
| | - Hadi A Dhiyebi
- Department of Biology, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada.
| | - Nivetha Srikanthan
- Department of Biology, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada
| | - Leslie M Bragg
- Department of Biology, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada.
| | - Wayne J Parker
- Department of Civil and Environmental Engineering, University of Waterloo, 200 University Ave. W, Waterloo, ON N2L 3G1, Canada.
| | - John P Giesy
- Toxicology Centre, University of Saskatchewan, 44 Campus Dr., Saskatoon, Saskatchewan S7N 5B3, Canada; Department of Environmental Science, Baylor University, 1 Bear Trail, Waco, TX 76798, USA
| | - Mark R Servos
- Department of Biology, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada.
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4
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Brighton K, Fisch S, Wu H, Vigil K, Aw TG. Targeted community wastewater surveillance for SARS-CoV-2 and Mpox virus during a festival mass-gathering event. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 906:167443. [PMID: 37793442 DOI: 10.1016/j.scitotenv.2023.167443] [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: 06/11/2023] [Revised: 08/24/2023] [Accepted: 09/26/2023] [Indexed: 10/06/2023]
Abstract
Wastewater surveillance has emerged recently as a powerful approach to understanding infectious disease dynamics in densely populated zones. Wastewater surveillance, while promising as a public health tool, is often hampered by slow turn-around times, complex analytical protocols, and resource-intensive techniques. In this study, we evaluated an affinity capture method and microfluidic digital PCR as a rapid approach to quantify severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), mpox (formerly known as monkeypox) virus, and fecal indicator, pepper mild mottle virus (PMMoV) in wastewater during a mass-gathering event. Wastewater samples (n = 131) were collected from residential and commercial manholes, pump stations, and a city's wastewater treatment plant. The use of Nanotrap® Microbiome Particles and microfluidic digital PCR produced comparable results to other established methodologies, with reduced process complexity and analytical times, providing same day results for public health preparedness and response. Using indigenous SARS-CoV-2 and PMMoV in wastewater, the average viral recovery efficiency was estimated at 10.1 %. Both SARS-CoV-2 N1 and N2 genes were consistently detected throughout the sampling period, with increased RNA concentrations mainly in wastewater samples collected from commercial area after festival mass gatherings. The mpox virus was sporadically detected in wastewater samples during the surveillance period, without distinct temporal trends. SARS-CoV-2 RNA concentrations in the city's wastewater mirrored the city's COVID-19 cases, confirming the predictive properties of wastewater surveillance. Wastewater surveillance continues to be beneficial for tracking diseases that display gastrointestinal symptoms, including SARS-CoV-2, and can be a powerful tool for sentinel surveillance. However, careful site selection and a thorough understanding of community dynamics are necessary when performing targeted surveillance during temporary mass-gathering events as potential confirmation bias may occur.
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Affiliation(s)
- Keegan Brighton
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Samuel Fisch
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Huiyun Wu
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Katie Vigil
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Tiong Gim Aw
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 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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Rusková M, Bučková M, Puškárová A, Cíchová M, Janská V, Achs A, Šubr Z, Kuchta T, Pangallo D. Comparison of ordinary reverse transcription real-time polymerase chain reaction (qRT-PCR) with a newly developed one-step single-tube nested real-time RT-PCR (OSN-qRT-PCR) for sensitive detection of SARS-CoV-2 in wastewater. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:95579-95589. [PMID: 37553492 PMCID: PMC10482794 DOI: 10.1007/s11356-023-29123-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/29/2023] [Indexed: 08/10/2023]
Abstract
Wastewater monitoring has proven to be an important approach to detecting and controlling the development of the SARS-CoV-2 pandemic. Various tests based on reverse transcription real-time PCR (qRT-PCR) have been developed and used for the detection of SARS-CoV-2 in wastewater samples. In this study, we attempted to increase the sensitivity of qRT-PCR by developing a one-step single-tube nested qRT-PCR assay (OSN-qRT-PCR). Two variants were developed, oriented to nucleocapsid phosphoprotein gene (N) and to spike protein gene (S), respectively. The performance of conventional qRT-PCR assays oriented to these genes with two novel OSN-qRT-PCR assays were firstly optimized using wastewater artificially contaminated with two encapsidated RNA mimic systems harboring a portion either N or S gene (ENRM and ESRM, respectively). The assays were coupled to a polyethylene glycol-based RNA precipitation/extraction method and applied to detect SARS-CoV-2 in wastewater samples from four cities in Slovakia. Both novel OSN-qRT-PCR assays demonstrated higher detection rates than the ordinary qRT-PCR counterparts. The virus levels in the analyzed wastewater samples had a high or very high relation with the numbers of clinical cases in the monitored regions. In fact, correlation with a 3-, 4-, or 5-day temporal offset was revealed. The OSN-qRT-PCR assays demonstrated robustness, mainly in samples with low viral loads.
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Affiliation(s)
- Magdaléna Rusková
- Institute of Molecular Biology, Slovak Academy of Sciences, Dúbravská Cesta 21, 845 51, Bratislava, Slovakia
| | - Mária Bučková
- Institute of Molecular Biology, Slovak Academy of Sciences, Dúbravská Cesta 21, 845 51, Bratislava, Slovakia
| | - Andrea Puškárová
- Institute of Molecular Biology, Slovak Academy of Sciences, Dúbravská Cesta 21, 845 51, Bratislava, Slovakia
| | - Marianna Cíchová
- Water Research Institute, Nábrežie Arm. Gen. L. Svobodu 5, 812 49, Bratislava, Slovakia
| | - Veronika Janská
- Water Research Institute, Nábrežie Arm. Gen. L. Svobodu 5, 812 49, Bratislava, Slovakia
| | - Adam Achs
- Biomedical Research Center, Slovak Academy of Sciences, Institute of Virology, Dúbravská Cesta 9, 845 05, Bratislava, Slovakia
| | - Zdeno Šubr
- Biomedical Research Center, Slovak Academy of Sciences, Institute of Virology, Dúbravská Cesta 9, 845 05, Bratislava, Slovakia
| | - Tomáš Kuchta
- Department of Microbiology, Molecular Biology and Biotechnology, Food Research Institute, National Agricultural and Food Centre, Priemyselná 4, 824 75, Bratislava, Slovakia
| | - Domenico Pangallo
- Institute of Molecular Biology, Slovak Academy of Sciences, Dúbravská Cesta 21, 845 51, Bratislava, Slovakia.
- Caravella, s.r.o., Tupolevova 2, 851 01, Bratislava, Slovakia.
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7
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Keck JW, Lindner J, Liversedge M, Mijatovic B, Olsson C, Strike W, Noble A, Adatorwovor R, Lacy P, Smith T, Berry SM. Wastewater Surveillance for SARS-CoV-2 at Long-Term Care Facilities: Mixed Methods Evaluation. JMIR Public Health Surveill 2023; 9:e44657. [PMID: 37643001 PMCID: PMC10467632 DOI: 10.2196/44657] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 04/26/2023] [Accepted: 07/18/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Wastewater surveillance provided early indication of COVID-19 in US municipalities. Residents of long-term care facilities (LTCFs) experienced disproportionate morbidity and mortality early in the COVID-19 pandemic. We implemented LTCF building-level wastewater surveillance for SARS-CoV-2 at 6 facilities in Kentucky to provide early warning of SARS-CoV-2 in populations considered vulnerable. OBJECTIVE This study aims to evaluate the performance of wastewater surveillance for SARS-CoV-2 at LTCFs in Kentucky. METHODS We conducted a mixed methods evaluation of wastewater surveillance following Centers for Disease Control and Prevention (CDC) guidelines for evaluating public health surveillance systems. Evaluation steps in the CDC guidelines were engaging stakeholders, describing the surveillance system, focusing the evaluation design, gathering credible evidence, and generating conclusions and recommendations. We purposively recruited stakeholders for semistructured interviews and undertook thematic content analysis of interview data. We integrated wastewater, clinical testing, and process data to characterize or calculate 7 surveillance system performance attributes (simplicity, flexibility, data quality, sensitivity and positive predictive value [PPV], timeliness, representativeness, and stability). RESULTS We conducted 8 stakeholder interviews. The surveillance system collected wastewater samples (N=811) 2 to 4 times weekly at 6 LTCFs in Kentucky from March 2021 to February 2022. Synthesis of credible evidence indicated variable surveillance performance. Regarding simplicity, surveillance implementation required moderate human resource and technical capacity. Regarding flexibility, the system efficiently adjusted surveillance frequency and demonstrated the ability to detect additional pathogens of interest. Regarding data quality, software identified errors in wastewater sample metadata entry (110/3120, 3.53% of fields), technicians identified polymerase chain reaction data issues (140/7734, 1.81% of reactions), and staff entered all data corrections into a log. Regarding sensitivity and PPV, using routine LTCF SARS-CoV-2 clinical testing results as the gold standard, a wastewater SARS-CoV-2 signal of >0 RNA copies/mL was 30.6% (95% CI 24.4%-36.8%) sensitive and 79.7% (95% CI 76.4%-82.9%) specific for a positive clinical test at the LTCF. The PPV of the wastewater signal was 34.8% (95% CI 27.9%-41.7%) at >0 RNA copies/mL and increased to 75% (95% CI 60%-90%) at >250 copies/mL. Regarding timeliness, stakeholders received surveillance data 24 to 72 hours after sample collection, with delayed reporting because of the lack of weekend laboratory staff. Regarding representativeness, stakeholders identified challenges delineating the population contributing to LTCF wastewater because of visitors, unknown staff toileting habits, and the use of adult briefs by some residents preventing their waste from entering the sewer system. Regarding stability, the reoccurring cost to conduct 1 day of wastewater surveillance at 1 facility was approximately US $144.50, which included transportation, labor, and materials expenses. CONCLUSIONS The LTCF wastewater surveillance system demonstrated mixed performance per CDC criteria. Stakeholders found surveillance feasible and expressed optimism regarding its potential while also recognizing challenges in interpreting and acting on surveillance data.
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Affiliation(s)
- James W Keck
- Department of Family & Community Medicine, University of Kentucky, Lexington, KY, United States
| | - Jess Lindner
- College of Medicine - Northern Kentucky Campus, University of Kentucky, Highland Heights, KY, United States
| | - Matthew Liversedge
- Department of Family and Community Medicine, University of Kentucky, Lexington, KY, United States
| | - Blazan Mijatovic
- Department of Family and Community Medicine, University of Kentucky, Lexington, KY, United States
| | - Cullen Olsson
- Department of Family and Community Medicine, University of Kentucky, Lexington, KY, United States
| | - William Strike
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY, United States
| | - Anni Noble
- Department of Mechanical Engineering, University of Kentucky, Lexington, KY, United States
| | - Reuben Adatorwovor
- Department of Biostatistics, University of Kentucky, Lexington, KY, United States
| | - Parker Lacy
- Trilogy Health Services, Louisville, KY, United States
| | - Ted Smith
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, United States
| | - Scott M Berry
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY, United States
- Department of Mechanical Engineering, University of Kentucky, Lexington, KY, United States
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8
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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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9
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Corchis-Scott R, Geng Q, Al Riahi AM, Labak A, Podadera A, Ng KKS, Porter LA, Tong Y, Dixon JC, Menard SL, Seth R, McKay RM. Actionable wastewater surveillance: application to a university residence hall during the transition between Delta and Omicron resurgences of COVID-19. Front Public Health 2023; 11:1139423. [PMID: 37265515 PMCID: PMC10230041 DOI: 10.3389/fpubh.2023.1139423] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/28/2023] [Indexed: 06/03/2023] Open
Abstract
Wastewater surveillance has gained traction during the COVID-19 pandemic as an effective and non-biased means to track community infection. While most surveillance relies on samples collected at municipal wastewater treatment plants, surveillance is more actionable when samples are collected "upstream" where mitigation of transmission is tractable. This report describes the results of wastewater surveillance for SARS-CoV-2 at residence halls on a university campus aimed at preventing outbreak escalation by mitigating community spread. Another goal was to estimate fecal shedding rates of SARS-CoV-2 in a non-clinical setting. Passive sampling devices were deployed in sewer laterals originating from residence halls at a frequency of twice weekly during fall 2021 as the Delta variant of concern continued to circulate across North America. A positive detection as part of routine sampling in late November 2021 triggered daily monitoring and further isolated the signal to a single wing of one residence hall. Detection of SARS-CoV-2 within the wastewater over a period of 3 consecutive days led to a coordinated rapid antigen testing campaign targeting the residence hall occupants and the identification and isolation of infected individuals. With knowledge of the number of individuals testing positive for COVID-19, fecal shedding rates were estimated to range from 3.70 log10 gc ‧ g feces-1 to 5.94 log10 gc ‧ g feces-1. These results reinforce the efficacy of wastewater surveillance as an early indicator of infection in congregate living settings. Detections can trigger public health measures ranging from enhanced communications to targeted coordinated testing and quarantine.
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Affiliation(s)
- Ryland Corchis-Scott
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, ON, Canada
| | - Qiudi Geng
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, ON, Canada
| | - Abdul Monem Al Riahi
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, ON, Canada
| | - Amr Labak
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, ON, Canada
| | - Ana Podadera
- Department of Chemistry and Biochemistry, University of Windsor, Windsor, ON, Canada
| | - Kenneth K. S. Ng
- Department of Chemistry and Biochemistry, University of Windsor, Windsor, ON, Canada
| | - Lisa A. Porter
- Department of Biomedical Sciences, University of Windsor, Windsor, ON, Canada
| | - Yufeng Tong
- Department of Chemistry and Biochemistry, University of Windsor, Windsor, ON, Canada
| | - Jess C. Dixon
- Department of Kinesiology, University of Windsor, Windsor, ON, Canada
| | | | - Rajesh Seth
- Civil and Environmental Engineering, University of Windsor, Windsor, ON, Canada
| | - R. Michael McKay
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, ON, Canada
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10
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Lopez Marin MA, Zdenkova K, Bartackova J, Cermakova E, Dostalkova A, Demnerova K, Vavruskova L, Novakova Z, Sykora P, Rumlova M, Bartacek J. Monitoring COVID-19 spread in selected Prague's schools based on the presence of SARS-CoV-2 RNA in wastewater. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 871:161935. [PMID: 36731569 PMCID: PMC9886433 DOI: 10.1016/j.scitotenv.2023.161935] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 01/13/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic has demanded a broad range of techniques to better monitor its extent. Owing to its consistency, non-invasiveness, and cost effectiveness, wastewater-based epidemiology has emerged as a relevant approach to monitor the pandemic's course. In this work, we analyzed the extent of the COVID-19 pandemic in five primary schools in Prague, the Czech Republic, and how different preventive measures impact the presence of SARS-CoV-2 RNA copy numbers in wastewaters. Copy numbers were measured by reverse transcription-multiplex quantitative real-time PCR. These copy numbers were compared to the number of infected individuals in each school identified through regular clinical tests. Each school had a different monitoring regime and subsequent application of preventive measures to thwart the spread of COVID-19. The schools that constantly identified and swiftly quarantined infected individuals exhibited persistently low amounts of SARS-CoV-2 RNA copies in their wastewaters. In one school, a consistent monitoring of infected individuals, coupled with a delayed action to quarantine, allowed for the estimation of a linear model to predict the number of infected individuals based on the presence of SARS-CoV-2 RNA in the wastewater. The results show the importance of case detection and quarantining to stop the spread of the pandemic and its impact on the presence of SARS-CoV-2 RNA in wastewaters. This work also shows that wastewater-based epidemiological models can be reliably used even in small water catchments, but difficulties arise to fit models due to the nonconstant input of viral particles into the wastewater systems.
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Affiliation(s)
- Marco A Lopez Marin
- Department of Water Technology and Environmental Engineering, University of Chemistry and Technology Prague, Czechia
| | - K Zdenkova
- Department of Biochemistry and Microbiology, University of Chemistry and Technology Prague, Czechia.
| | - J Bartackova
- Department of Water Technology and Environmental Engineering, University of Chemistry and Technology Prague, Czechia
| | - E Cermakova
- Department of Biochemistry and Microbiology, University of Chemistry and Technology Prague, Czechia
| | - A Dostalkova
- Department of Biotechnology, University of Chemistry and Technology Prague, Czechia
| | - K Demnerova
- Department of Biochemistry and Microbiology, University of Chemistry and Technology Prague, Czechia
| | | | - Z Novakova
- Prazske vodovody a kanalizace, a.s., Czechia
| | - P Sykora
- Prazske vodovody a kanalizace, a.s., Czechia
| | - M Rumlova
- Department of Biotechnology, University of Chemistry and Technology Prague, Czechia
| | - J Bartacek
- Department of Water Technology and Environmental Engineering, University of Chemistry and Technology Prague, Czechia
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11
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Sharaby Y, Gilboa Y, Alfiya Y, Sabach S, Cheruti U, Friedler E. Whole campus wastewater surveillance of SARS-CoV-2 for COVID-19 outbreak management. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2023; 87:910-923. [PMID: 36853770 DOI: 10.2166/wst.2023.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
In this long-term study (eight months), a wastewater-based epidemiology program was initiated as a decision support tool for the detection and containment of COVID-19 spread in the Technion campus. The on-campus students' accommodations (∼3,300 residents) were divided into housing clusters and monitored through wastewater SARS-CoV-2 surveillance in 10 manholes. Results were used to create a 'traffic-light' scheme allowing the Technion's COVID-19 task force to track COVID-19 spatiotemporal spread on the campus, and consequently, contain it before high morbidity levels develop. Of the 523 sewage samples analysed, 87.4% were negative for SARS-CoV-2 while 11.5% were positive, corroborating morbidity information the COVID-19 task force had. For 7.6% of the SARS-CoV-2 positive samples, the task force had no information about positive resident/s. In these events, new cases were identified after the relevant residents were clinically surge tested for COVID-19. Hence, in these instances, wastewater surveillance provided early warning helping to secure the health of the campus residents by minimising COVID-19 spread. The inflammation biomarker ferritin levels in SARS-CoV-2 positive sewage samples were significantly higher than in negative ones. This may indicate that in the future, ferritin (and other biomarkers) concentrations in wastewater could serve as indicators of infectious and inflammatory disease outbreaks.
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Affiliation(s)
- Y Sharaby
- Faculty of Civil & Environmental Engineering, Technion-Israel Institute of Technology, Haifa, Israel E-mail: ; Current address: Department of Biology & Environment, University of Haifa, Oranim, Tivon, Israel
| | - Y Gilboa
- Faculty of Civil & Environmental Engineering, Technion-Israel Institute of Technology, Haifa, Israel E-mail:
| | - Y Alfiya
- Faculty of Civil & Environmental Engineering, Technion-Israel Institute of Technology, Haifa, Israel E-mail:
| | - S Sabach
- Faculty of Civil & Environmental Engineering, Technion-Israel Institute of Technology, Haifa, Israel E-mail:
| | - U Cheruti
- Faculty of Civil & Environmental Engineering, Technion-Israel Institute of Technology, Haifa, Israel E-mail:
| | - Eran Friedler
- Faculty of Civil & Environmental Engineering, Technion-Israel Institute of Technology, Haifa, Israel E-mail:
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12
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Rainey AL, Buschang K, O’Connor A, Love D, Wormington AM, Messcher RL, Loeb JC, Robinson SE, Ponder H, Waldo S, Williams R, Shapiro J, McAlister EB, Lauzardo M, Lednicky JA, Maurelli AT, Sabo-Attwood T, Bisesi J. Retrospective Analysis of Wastewater-Based Epidemiology of SARS-CoV-2 in Residences on a Large College Campus: Relationships between Wastewater Outcomes and COVID-19 Cases across Two Semesters with Different COVID-19 Mitigation Policies. ACS ES&T WATER 2023; 3:16-29. [PMID: 37552720 PMCID: PMC9762499 DOI: 10.1021/acsestwater.2c00275] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 06/18/2023]
Abstract
Wastewater-based epidemiology (WBE) has been utilized for outbreak monitoring and response efforts in university settings during the coronavirus disease 2019 (COVID-19) pandemic. However, few studies examined the impact of university policies on the effectiveness of WBE to identify cases and mitigate transmission. The objective of this study was to retrospectively assess relationships between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) wastewater outcomes and COVID-19 cases in residential buildings of a large university campus across two academic semesters (August 2020-May 2021) under different COVID-19 mitigation policies. Clinical case surveillance data of student residents were obtained from the university COVID-19 response program. We collected and processed building-level wastewater for detection and quantification of SARS-CoV-2 RNA by RT-qPCR. The odds of obtaining a positive wastewater sample increased with COVID-19 clinical cases in the fall semester (OR = 1.50, P value = 0.02), with higher odds in the spring semester (OR = 2.63, P value < 0.0001). We observed linear associations between SARS-CoV-2 wastewater concentrations and COVID-19 clinical cases (parameter estimate = 1.2, P value = 0.006). Our study demonstrated the effectiveness of WBE in the university setting, though it may be limited under different COVID-19 mitigation policies. As a complementary surveillance tool, WBE should be accompanied by robust administrative and clinical testing efforts for the COVID-19 pandemic response.
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Affiliation(s)
- Andrew L. Rainey
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Emerging Pathogens Institute, University
of Florida, Gainesville, Florida32610, United
States
| | - Katherine Buschang
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Emerging Pathogens Institute, University
of Florida, Gainesville, Florida32610, United
States
- Center for Environmental and Human Toxicology,
University of Florida, Gainesville, Florida32611,
United States
| | - Amber O’Connor
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Center for Environmental and Human Toxicology,
University of Florida, Gainesville, Florida32611,
United States
| | - Deirdre Love
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Center for Environmental and Human Toxicology,
University of Florida, Gainesville, Florida32611,
United States
| | - Alexis M. Wormington
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Center for Environmental and Human Toxicology,
University of Florida, Gainesville, Florida32611,
United States
| | - Rebeccah L. Messcher
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Emerging Pathogens Institute, University
of Florida, Gainesville, Florida32610, United
States
| | - Julia C. Loeb
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Emerging Pathogens Institute, University
of Florida, Gainesville, Florida32610, United
States
| | - Sarah E. Robinson
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Emerging Pathogens Institute, University
of Florida, Gainesville, Florida32610, United
States
- Center for Environmental and Human Toxicology,
University of Florida, Gainesville, Florida32611,
United States
| | - Hunter Ponder
- UF Health Screen, Test, and Protect,
University of Florida, Gainesville, Florida32611,
United States
- Florida Department of
Health, Alachua County, Gainesville, Florida32641, United
States
| | - Sarah Waldo
- UF Health Screen, Test, and Protect,
University of Florida, Gainesville, Florida32611,
United States
- Florida Department of
Health, Alachua County, Gainesville, Florida32641, United
States
| | - Roy Williams
- UF Health Screen, Test, and Protect,
University of Florida, Gainesville, Florida32611,
United States
- Florida Department of
Health, Alachua County, Gainesville, Florida32641, United
States
| | - Jerne Shapiro
- UF Health Screen, Test, and Protect,
University of Florida, Gainesville, Florida32611,
United States
- Florida Department of
Health, Alachua County, Gainesville, Florida32641, United
States
- Department of Epidemiology, College of Public
Health and Health Professions and College of Medicine, Gainesville,
Florida32611, United States
| | | | - Michael Lauzardo
- Emerging Pathogens Institute, University
of Florida, Gainesville, Florida32610, United
States
- UF Health Screen, Test, and Protect,
University of Florida, Gainesville, Florida32611,
United States
- Department of Medicine, College of Medicine,
University of Florida, Gainesville, Florida32611,
United States
| | - John A. Lednicky
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Emerging Pathogens Institute, University
of Florida, Gainesville, Florida32610, United
States
| | - Anthony T. Maurelli
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Emerging Pathogens Institute, University
of Florida, Gainesville, Florida32610, United
States
| | - Tara Sabo-Attwood
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Emerging Pathogens Institute, University
of Florida, Gainesville, Florida32610, United
States
- Center for Environmental and Human Toxicology,
University of Florida, Gainesville, Florida32611,
United States
| | - Joseph
H. Bisesi
- Department of Environmental and Global Health, College
of Public Health and Health Professions, University of Florida,
Gainesville, Florida32610, United States
- Emerging Pathogens Institute, University
of Florida, Gainesville, Florida32610, United
States
- Center for Environmental and Human Toxicology,
University of Florida, Gainesville, Florida32611,
United States
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13
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Maryam S, Ul Haq I, Yahya G, Ul Haq M, Algammal AM, Saber S, Cavalu S. COVID-19 surveillance in wastewater: An epidemiological tool for the monitoring of SARS-CoV-2. Front Cell Infect Microbiol 2023; 12:978643. [PMID: 36683701 PMCID: PMC9854263 DOI: 10.3389/fcimb.2022.978643] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 11/03/2022] [Indexed: 01/06/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has prompted a lot of questions globally regarding the range of information about the virus's possible routes of transmission, diagnostics, and therapeutic tools. Worldwide studies have pointed out the importance of monitoring and early surveillance techniques based on the identification of viral RNA in wastewater. These studies indicated the presence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in human feces, which is shed via excreta including mucus, feces, saliva, and sputum. Subsequently, they get dumped into wastewater, and their presence in wastewater provides a possibility of using it as a tool to help prevent and eradicate the virus. Its monitoring is still done in many regions worldwide and serves as an early "warning signal"; however, a lot of limitations of wastewater surveillance have also been identified.
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Affiliation(s)
- Sajida Maryam
- Department of Biosciences, The Commission on Science and Technology for Sustainable Development in the South (COMSATS) University Islamabad (CUI), Islamabad, Pakistan
| | - Ihtisham Ul Haq
- Department of Biosciences, The Commission on Science and Technology for Sustainable Development in the South (COMSATS) University Islamabad (CUI), Islamabad, Pakistan
- Department of Physical Chemistry and Polymers Technology, Silesian University of Technology, Gliwice, Poland
- Joint Doctoral School, Silesian University of Technology, Gliwice, Poland
| | - Galal Yahya
- Department of Microbiology and Immunology, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
| | - Mehboob Ul Haq
- Department of Biosciences, The Commission on Science and Technology for Sustainable Development in the South (COMSATS) University Islamabad (CUI), Islamabad, Pakistan
| | - Abdelazeem M. Algammal
- Department of Bacteriology, Immunology, and Mycology, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
| | - Sameh Saber
- Department of Pharmacology, Faculty of Pharmacy, Delta University for Science and Technology, Gamasa, Egypt
| | - Simona Cavalu
- Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
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14
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Bonanno Ferraro G, Veneri C, Mancini P, Iaconelli M, Suffredini E, Bonadonna L, Lucentini L, Bowo-Ngandji A, Kengne-Nde C, Mbaga DS, Mahamat G, Tazokong HR, Ebogo-Belobo JT, Njouom R, Kenmoe S, La Rosa G. A State-of-the-Art Scoping Review on SARS-CoV-2 in Sewage Focusing on the Potential of Wastewater Surveillance for the Monitoring of the COVID-19 Pandemic. FOOD AND ENVIRONMENTAL VIROLOGY 2022; 14:315-354. [PMID: 34727334 PMCID: PMC8561373 DOI: 10.1007/s12560-021-09498-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 09/21/2021] [Indexed: 05/07/2023]
Abstract
The outbreak of coronavirus infectious disease-2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has rapidly spread throughout the world. Several studies have shown that detecting SARS-CoV-2 in untreated wastewater can be a useful tool to identify new outbreaks, establish outbreak trends, and assess the prevalence of infections. On 06 May 2021, over a year into the pandemic, we conducted a scoping review aiming to summarize research data on SARS-CoV-2 in sewage. Papers dealing with raw sewage collected at wastewater treatment plants, sewer networks, septic tanks, and sludge treatment facilities were included in this review. We also reviewed studies on sewage collected in community settings such as private or municipal hospitals, healthcare facilities, nursing homes, dormitories, campuses, airports, aircraft, and cruise ships. The literature search was conducted using the electronic databases PubMed, EMBASE, and Web Science Core Collection. This comprehensive research yielded 1090 results, 66 of which met the inclusion criteria and are discussed in this review. Studies from 26 countries worldwide have investigated the occurrence of SARS-CoV-2 in sewage of different origin. The percentage of positive samples in sewage ranged from 11.6 to 100%, with viral concentrations ranging from ˂LOD to 4.6 × 108 genome copies/L. This review outlines the evidence currently available on wastewater surveillance: (i) as an early warning system capable of predicting COVID-19 outbreaks days or weeks before clinical cases; (ii) as a tool capable of establishing trends in current outbreaks; (iii) estimating the prevalence of infections; and (iv) studying SARS-CoV-2 genetic diversity. In conclusion, as a cost-effective, rapid, and reliable source of information on the spread of SARS-CoV-2 and its variants in the population, wastewater surveillance can enhance genomic and epidemiological surveillance with independent and complementary data to inform public health decision-making during the ongoing pandemic.
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Affiliation(s)
- G Bonanno Ferraro
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | | | - P Mancini
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - M Iaconelli
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - E Suffredini
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - L Bonadonna
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - L Lucentini
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - A Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon
| | - C Kengne-Nde
- Research Monitoring and Planning Unit, National Aids Control Committee, Douala, Cameroon
| | - D S Mbaga
- Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon
| | - G Mahamat
- Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon
| | - H R Tazokong
- Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon
| | - J T Ebogo-Belobo
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - R Njouom
- Virology Department, Centre Pasteur of Cameroon, Yaounde, Cameroon
| | - S Kenmoe
- Virology Department, Centre Pasteur of Cameroon, Yaounde, Cameroon
| | - G La Rosa
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy.
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15
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Rocha AY, Verbyla ME, Sant KE, Mladenov N. Detection, Quantification, and Simplified Wastewater Surveillance Model of SARS-CoV-2 RNA in the Tijuana River. ACS ES&T WATER 2022; 2:2134-2143. [PMID: 36398132 PMCID: PMC9063987 DOI: 10.1021/acsestwater.2c00062] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The COVID-19 pandemic and the detection of SARS-CoV-2 RNA in sewage has expanded global interest in wastewater surveillance. However, many underserved communities throughout the world lack improved sanitation and use informal combined sanitary and storm sewer systems. Sewage is transported via open channels, ditches, and rivers, where it mixes with surface water and/or stormwater. There is a need to develop better methods for the surveillance of pathogens such as SARS-CoV-2 RNA in this context. We developed a simplified surveillance system and monitored flow rates and concentrations of SARS-CoV-2 RNA in the Tijuana River at two locations downstream of the United States-Mexico border in California, United States. SARS-CoV-2 RNA was detected in the upstream location on six out of eight occasions, two of which were at concentrations as high as those reported in untreated wastewater from California sanitary sewer systems. The virus was not detected in any of the eight samples collected at the downstream (estuarine) sampling location, despite the consistent detection of PMMoV RNA. Synchrony was observed between the number of cases reported in Tijuana and the SARS-CoV-2 RNA concentrations measured with the CDC N1 assay when the latter were normalized by the reported flow rates in the river.
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Affiliation(s)
- Alma Y. Rocha
- Department
of Civil, Construction, and Environmental Engineering, San Diego State University, San Diego, California 92182, United States
| | - Matthew E. Verbyla
- Department
of Civil, Construction, and Environmental Engineering, San Diego State University, San Diego, California 92182, United States
| | - Karilyn E. Sant
- School
of Public Health, San Diego State University, San Diego, California 92182, United States
| | - Natalie Mladenov
- Department
of Civil, Construction, and Environmental Engineering, San Diego State University, San Diego, California 92182, United States
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16
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Nguyen Quoc B, Saingam P, RedCorn R, Carter JA, Jain T, Candry P, Gattuso M, Huang MLW, Greninger AL, Meschke JS, Bryan A, Winkler MKH. Case Study: Impact of Diurnal Variations and Stormwater Dilution on SARS-CoV-2 RNA Signal Intensity at Neighborhood Scale Wastewater Pumping Stations. ACS ES&T WATER 2022; 2:1964-1975. [PMID: 37552740 PMCID: PMC9261832 DOI: 10.1021/acsestwater.2c00016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 05/14/2023]
Abstract
Wastewater based epidemiology (WBE) has emerged as a tool to track the spread of SARS-CoV-2. However, sampling at wastewater treatment plants (WWTPs) cannot identify transmission hotspots within a city. Here, we sought to understand the diurnal variations (24 h) in SARS-CoV-2 RNA titers at the neighborhood level, using pump stations that serve vulnerable communities (e.g., essential workers, more diverse communities). Hourly composite samples were collected from wastewater pump stations located in (i) a residential area and (ii) a shopping district. In the residential area, SARS-CoV-2 RNA concentration (N1, N2, and E assays) varied by up to 42-fold within a 24 h period. The highest viral load was observed between 5 and 7 am, when viral RNA was not diluted by stormwater. Normalizing peak concentrations during this time window with nutrient concentrations (N and P) enabled correcting for rainfall to connect sewage to clinical cases reported in the sewershed. Data from the shopping district pump station were inconsistent, probably due to the fluctuation of customers shopping at the mall. This work indicates pump stations serving the residential area offer a narrow time period of high signal intensity that could improve the sensitivity of WBE, and tracer compounds (N, P concentration) can be used to normalize SARS-CoV-2 signals during rainfall.
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Affiliation(s)
- Bao Nguyen Quoc
- Department of Civil and Environmental Engineering,
University of Washington, Seattle, Washington 98105,
United States
| | - Prakit Saingam
- Department of Civil and Environmental Engineering,
University of Washington, Seattle, Washington 98105,
United States
| | - Raymond RedCorn
- Department of Civil and Environmental Engineering,
University of Washington, Seattle, Washington 98105,
United States
| | - John A. Carter
- Department of Civil and Environmental Engineering,
University of Washington, Seattle, Washington 98105,
United States
| | - Tanisha Jain
- Department of Civil and Environmental Engineering,
University of Washington, Seattle, Washington 98105,
United States
| | - Pieter Candry
- Department of Civil and Environmental Engineering,
University of Washington, Seattle, Washington 98105,
United States
| | - Meghan Gattuso
- Seattle Public Utilities,
Seattle, Washington 98124, United States
| | - Meei-Li W. Huang
- Dept of Laboratory Medicine and Pathology,
University of Washington, Seattle, Washington 98105,
United States
| | - Alexander L. Greninger
- Dept of Laboratory Medicine and Pathology,
University of Washington, Seattle, Washington 98105,
United States
| | - John Scott Meschke
- Department of Environmental & Occupational Health
Sciences, University of Washington, Seattle, Washington 98105,
United States
| | - Andrew Bryan
- Dept of Laboratory Medicine and Pathology,
University of Washington, Seattle, Washington 98105,
United States
| | - Mari K. H. Winkler
- Department of Civil and Environmental Engineering,
University of Washington, Seattle, Washington 98105,
United States
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17
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Zambrana W, Catoe D, Coffman MM, Kim S, Anand A, Solis D, Sahoo MK, Pinsky BA, Bhatt AS, Boehm AB, Wolfe MK. SARS-CoV-2 RNA and N Antigen Quantification via Wastewater at the Campus Level, Building Cluster Level, and Individual-Building Level. ACS ES&T WATER 2022; 2:2025-2033. [PMID: 37552722 PMCID: PMC9128006 DOI: 10.1021/acsestwater.2c00050] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/23/2022] [Accepted: 04/27/2022] [Indexed: 05/30/2023]
Abstract
Monitoring wastewater for SARS-CoV-2 from populations smaller than those served by wastewater treatment plants may help identify small spatial areas (subsewersheds) where COVID-19 infections are present. We sampled wastewater from three nested locations with different sized populations within the same sewer network at a university campus and quantified SARS-CoV-2 RNA using reverse transcriptase droplet digital polymerase chain reaction (PCR). SARS-CoV-2 RNA concentrations and/or concentrations normalized by PMMoV were positively associated with laboratory-confirmed COVID-19 cases for both the sewershed level and the subsewershed level. We also used an antigen-based assay to detect the nucleocapsid (N) antigen from SARS-CoV-2 in wastewater samples at the sewershed level. The N antigen was regularly detected at the sewershed level, but the results were not associated with either laboratory-confirmed COVID-19 cases or SARS-CoV-2 RNA concentrations. The results of this study indicate that wastewater monitoring based on quantification of SARS-CoV-2 RNA using PCR-based methods is associated with COVID-19 cases at multiple geographic scales within the subsewershed level and can serve to aid the public health response.
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Affiliation(s)
- Winnie Zambrana
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - David Catoe
- Joint Initiative for Metrology in Biology,
SLAC National Accelerator Laboratory, 2575 Sand Hill Road,
Menlo Park, California 94025, United States
| | - Mhara M. Coffman
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - Sooyeol Kim
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - Archana Anand
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - Daniel Solis
- Department of Pathology, Stanford
University School of Medicine, Stanford, California 94305, United
States
| | - Malaya K. Sahoo
- Department of Pathology, Stanford
University School of Medicine, Stanford, California 94305, United
States
| | - Benjamin A. Pinsky
- Department of Pathology, Stanford
University School of Medicine, Stanford, California 94305, United
States
- Department of Medicine, Division of Infectious
Diseases and Geographic Medicine, Stanford University School of
Medicine, Stanford, California 94305, United
States
| | - Ami S. Bhatt
- Department of Medicine (Hematology) and Department of
Genetics, Stanford University, Stanford, California 94305,
United States
| | - Alexandria B. Boehm
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - Marlene K. Wolfe
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
- Gangarosa Department of Environmental Health, Rollins School
of Public Health, Emory University, Atlanta, Georgia 30322,
United States
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18
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Pardo-Figueroa B, Mindreau-Ganoza E, Reyes-Calderon A, Yufra SP, Solorzano-Ortiz IM, Donayre-Torres AJ, Antonini C, Renom JM, Quispe AM, Mota CR, Chernicharo CAL, Carbajal MA, Santa-María M. Spatiotemporal Surveillance of SARS-CoV-2 in the Sewage of Three Major Urban Areas in Peru: Generating Valuable Data Where Clinical Testing Is Extremely Limited. ACS ES&T WATER 2022; 2:2144-2157. [PMID: 37552743 PMCID: PMC9159516 DOI: 10.1021/acsestwater.2c00065] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/06/2022] [Accepted: 05/09/2022] [Indexed: 05/29/2023]
Abstract
Peru has been severely affected by the COVID-19 pandemic. By January 2022, Peru had surpassed 200 000 COVID-19 deaths, constituting the highest death rate per capita worldwide. Peru has had several limitations during the pandemic: insufficient testing access, limited contact tracing, a strained medical infrastructure, and many economic hurdles. These limitations hindered the gathering of accurate information about infected individuals with spatial resolution in real time, a critical aspect of effectively controlling the pandemic. Wastewater monitoring for SARS-CoV-2 RNA offered a promising alternative for providing needed population-wide information to complement health care indicators. In this study, we demonstrate the feasibility and value of implementing a decentralized SARS-CoV-2 RNA wastewater monitoring system to assess the spatiotemporal distribution of COVID-19 in three major cities in Peru: Lima, Callao, and Arequipa. Our data on viral loads showed the same trends as health indicators such as incidence and mortality. Furthermore, we were able to identify hot spots of contagion within the surveyed urban areas to guide the efforts of health authorities. Viral decay in the sewage network of the cities studied was found to be negligible (<2%). Overall, our results support wastewater monitoring for SARS-CoV-2 as a valuable and cost-effective tool for monitoring the COVID-19 pandemic in the Peruvian context.
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Affiliation(s)
- Braulio Pardo-Figueroa
- Universidad de Ingenieria y Tecnologia
(UTEC), Centro de Investigación y Tecnología del Agua
(CITA), Jr. Medrano Silva 165, Lima 15063, Peru
| | - Elias Mindreau-Ganoza
- Universidad Nacional Mayor de San Marcos,
Facultad de Ciencias Biológicas, Av. Germán Amézaga
s/n, Lima 15081, Peru
| | - Alonso Reyes-Calderon
- Universidad de Ingenieria y Tecnologia
(UTEC), Centro de Investigación y Tecnología del Agua
(CITA), Jr. Medrano Silva 165, Lima 15063, Peru
| | - Sonia P. Yufra
- Universidad Nacional de San Agustin de
Arequipa, Departamento de Ingeniería Metalúrgica e
Ingeniería Ambiental, Av. Independencia s/n, Arequipa 04001,
Peru
| | - Isabel M. Solorzano-Ortiz
- Universidad de Ingenieria y Tecnologia
(UTEC), Departamento de Ingeniería Ambiental, Jr. Medrano Silva
165, Lima 15063, Peru
| | - Alberto J. Donayre-Torres
- Universidad de Ingenieria y Tecnologia
(UTEC), Departamento de Bioingeniería, Jr. Medrano Silva 165, Lima
15063, Peru
| | - Claudia Antonini
- Universidad de Ingenieria y Tecnologia
(UTEC), Departamento de Ingeniería Industrial, Jr. Medrano Silva
165, Lima 15063, Peru
| | - Jose Miguel Renom
- Universidad de Ingenieria y Tecnologia
(UTEC), Departamento de Ciencias, Jr. Medrano Silva 165, Lima 15063,
Peru
| | - Antonio Marty Quispe
- Universidad de Ingenieria y Tecnologia
(UTEC), Departamento de Bioingeniería, Jr. Medrano Silva 165, Lima
15063, Peru
- Universidad Continental,
Escuela de Posgrado, Av. San Carlos 1980, Huancayo 12001, Peru
| | - Cesar R. Mota
- Universidade Federal de Minas
Gerais, Departamento de Engenharia Sanitária e Ambiental, Escola de
Engenharia, Av. Antonio Carlos, 6.627, 31270-901 Belo Horizonte,
Brazil
| | - Carlos A. L. Chernicharo
- Universidade Federal de Minas
Gerais, Departamento de Engenharia Sanitária e Ambiental, Escola de
Engenharia, Av. Antonio Carlos, 6.627, 31270-901 Belo Horizonte,
Brazil
| | - Max A. Carbajal
- Ministerio de Vivienda
Construcción y Saneamiento, Dirección de Saneamiento, Av.
República de Panamá 3650, Lima 15073, Peru
| | - Mónica
C. Santa-María
- Universidad de Ingenieria y Tecnologia
(UTEC), Centro de Investigación y Tecnología del Agua
(CITA), Jr. Medrano Silva 165, Lima 15063, Peru
- Universidad de Ingenieria y Tecnologia
(UTEC), Departamento de Ingeniería Ambiental, Jr. Medrano Silva
165, Lima 15063, Peru
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19
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Kotay SM, Tanabe KO, Colosi LM, Poulter MD, Barry KE, Holstege CP, Mathers AJ, Porter MD. Building-Level Wastewater Surveillance for SARS-CoV-2 in Occupied University Dormitories as an Outbreak Forecasting Tool: One Year Case Study. ACS ES&T WATER 2022; 2:2094-2104. [PMID: 37552737 PMCID: PMC9212191 DOI: 10.1021/acsestwater.2c00057] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 06/03/2023]
Abstract
Congregate living poses one of the highest risk situations for the transmission of respiratory viruses including SARS-CoV-2. University dormitories exemplify such high-risk settings. We demonstrate the value of using building-level SARS-CoV-2 wastewater surveillance as an early warning system to inform when prevalence testing of all building occupants is warranted. Coordinated daily testing of composite wastewater samples and clinical testing in dormitories was used to prompt the screening of otherwise unrecognized infected occupants. We overlay the detection patterns in the context of regular scheduled occupant testing to validate a wastewater detection model. The trend of wastewater positivity largely aligned well with the clinical positivity and epidemiology of dormitory occupants. However, the predictive ability of wastewater-surveillance to detect new positive cases is hampered by convalescent shedding in recovered/noncontagious individuals as they return to the building. Building-level pooled wastewater-surveillance and forecasting is most productive for predicting new cases in low-prevalence instances at the community level. For higher-education facilities and other congregate living settings to remain in operation during a pandemic, a thorough surveillance-based decision-making system is vital. Building-level wastewater monitoring on a daily basis paired with regular testing of individual dormitory occupants is an effective and efficient approach for mitigating outbreaks on university campuses.
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Affiliation(s)
- Shireen M. Kotay
- Division of Infectious Diseases, School of Medicine,
University of Virginia Health System, Charlottesville,
Virginia 22908, United States
| | - Kawai O. Tanabe
- Department of Student Health & Wellness, Division
of Student Affairs, University of Virginia, Charlottesville,
Virginia 22903, United States
| | - Lisa M. Colosi
- Department of Engineering Systems & Environment,
University of Virginia, Charlottesville, Virginia 22903,
United States
| | - Melinda D. Poulter
- Clinical Microbiology Laboratory, Department of
Pathology, University of Virginia Health System,
Charlottesville, Virginia 22908, United States
| | - Katherine E. Barry
- Division of Infectious Diseases, School of Medicine,
University of Virginia Health System, Charlottesville,
Virginia 22908, United States
| | - Christopher P. Holstege
- Department of Student Health & Wellness, Division
of Student Affairs, University of Virginia, Charlottesville,
Virginia 22903, United States
- Departments of Emergency Medicine & Pediatrics,
School of Medicine, University of Virginia, Charlottesville,
Virginia 22903, United States
| | - Amy J. Mathers
- Division of Infectious Diseases, School of Medicine,
University of Virginia Health System, Charlottesville,
Virginia 22908, United States
- Clinical Microbiology Laboratory, Department of
Pathology, University of Virginia Health System,
Charlottesville, Virginia 22908, United States
| | - Michael D. Porter
- Department of Engineering Systems & Environment,
University of Virginia, Charlottesville, Virginia 22903,
United States
- School of Data Science, University of
Virginia, Charlottesville, Virginia 22903, United
States
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20
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Islam A, Hossen F, Rahman A, Sultana KF, Hasan MN, Haque A, Sosa-Hernández JE, Oyervides-Muñoz MA, Parra-Saldívar R, Ahmed T, Islam T, Dhama K, Sangkham S, Bahadur NM, Reza HM, Jakariya, Al Marzan A, Bhattacharya P, Sonne C, Ahmed F. An opinion on Wastewater-Based Epidemiological Monitoring (WBEM) with Clinical Diagnostic Test (CDT) for detecting high-prevalence areas of community COVID-19 Infections. CURRENT OPINION IN ENVIRONMENTAL SCIENCE & HEALTH 2022; 31:100396. [PMID: 36320818 PMCID: PMC9612100 DOI: 10.1016/j.coesh.2022.100396] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 02/17/2024]
Abstract
Wastewater-Based Epidemiological Monitoring (WBEM) is an efficient surveillance tool during the COVID-19 pandemic as it meets all requirements of a complete monitoring system including early warning, tracking the current trend, prevalence of the disease, detection of genetic diversity as well asthe up-surging SARS-CoV-2 new variants with mutations from the wastewater samples. Subsequently, Clinical Diagnostic Test is widely acknowledged as the global gold standard method for disease monitoring, despite several drawbacks such as high diagnosis cost, reporting bias, and the difficulty of tracking asymptomatic patients (silent spreaders of the COVID-19 infection who manifest nosymptoms of the disease). In this current reviewand opinion-based study, we first propose a combined approach) for detecting COVID-19 infection in communities using wastewater and clinical sample testing, which may be feasible and effective as an emerging public health tool for the long-term nationwide surveillance system. The viral concentrations in wastewater samples can be used as indicatorsto monitor ongoing SARS-CoV-2 trends, predict asymptomatic carriers, and detect COVID-19 hotspot areas, while clinical sampleshelp in detecting mostlysymptomaticindividuals for isolating positive cases in communities and validate WBEM protocol for mass vaccination including booster doses for COVID-19.
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Affiliation(s)
- Aminul Islam
- COVID-19 Diagnostic Lab, Department of Microbiology, Noakhali Science and Technology University, Noakhali-3814, Bangladesh
- Advanced Molecular Lab, Department of Microbiology, President Abdul Hamid Medical College, Karimganj, Kishoreganj, Bangladesh
| | - Foysal Hossen
- COVID-19 Diagnostic Lab, Department of Microbiology, Noakhali Science and Technology University, Noakhali-3814, Bangladesh
| | - Arifur Rahman
- COVID-19 Diagnostic Lab, Department of Microbiology, Noakhali Science and Technology University, Noakhali-3814, Bangladesh
| | - Khandokar Fahmida Sultana
- COVID-19 Diagnostic Lab, Department of Microbiology, Noakhali Science and Technology University, Noakhali-3814, Bangladesh
| | - Mohammad Nayeem Hasan
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
- Joint Rohingya Response Program, Food for the Hungry, Cox's Bazar, Bangladesh
| | - Atiqul Haque
- Key Lab of Animal Epidemiology and Zoonoses of Ministry of Agriculture and Rural Affairs, College of Veterinary Medicine, China Agricultural University, Beijing, China
- Department of Microbiology, Faculty of Veterinary and Animal Science, Hajee Mohammad Danesh Science and Technology University, Dinajpur-5200, Bangladesh
| | | | | | | | - Tanvir Ahmed
- Department of Civil Engineering, Bangladesh University of Engineering and Technology, Dhaka-1000, Bangladesh
| | | | - Kuldeep Dhama
- Indian Veterinary Research Institute, Izzatnagar-243 122, Bareilly, Uttar Pradesh, India
| | - Sarawut Sangkham
- Department of Environmental Health, School of Public Health, University of Phayao, Muang District, 56000, Phayao, Thailand
| | - Newaz Mohammed Bahadur
- Department of Applied Chemistry and Chemical Engineering, Noakhali Science and TechnologyUniversity, Noakhali-3814, Bangladesh
| | - Hasan Mahmud Reza
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | - Jakariya
- Department of Environmental Science and Management, North South University, Bashundhara, Dhaka-1229, Bangladesh
| | - Abdullah Al Marzan
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh
| | - Prosun Bhattacharya
- COVID-19 Research@KTH, Department of Sustainable Development, Environmental Science and Engineering, KTH Royal Institute of Technology, Teknikringen 10B, SE 114 28 Stockholm, Sweden
| | - Christian Sonne
- Department of Bioscience, Arctic Research Centre (ARC), Faculty of Science and Technology, Aarhus University, Frederiksborgvej 399, PO Box 358, 4000 Roskilde, Denmark
| | - Firoz Ahmed
- COVID-19 Diagnostic Lab, Department of Microbiology, Noakhali Science and Technology University, Noakhali-3814, Bangladesh
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21
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Castro GB, Bernegossi AC, Sousa BJDO, De Lima E Silva MR, Silva FRD, Freitas BLS, Ogura AP, Corbi JJ. Global occurrence of SARS-CoV-2 in environmental aquatic matrices and its implications for sanitation and vulnerabilities in Brazil and developing countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:2160-2199. [PMID: 34310248 DOI: 10.1080/09603123.2021.1949437] [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: 10/27/2020] [Accepted: 06/23/2021] [Indexed: 06/13/2023]
Abstract
This paper includes a systematic review of the SARS-CoV-2 occurrence in environmental aquatic matrices and a critical sanitation analysis. We discussed the interconnection of sanitation services (wastewater, water supply, solid waste, and stormwater drainage) functioning as an important network for controlling the spread of SARS-CoV-2 in waters. We collected 98 studies containing data of the SARS-CoV-2 occurrence in aquatic matrices around the world, of which 40% were from developing countries. Alongside a significant number of people infected by the virus, developing countries face socioeconomic deficiencies and insufficient public investment in infrastructure. Therefore, our study focused on highlighting solutions to provide sanitation in developing countries, considering the virus control in waters by disinfection techniques and sanitary measures, including alternatives for the vulnerable communities. The need for multilateral efforts to improve the universal coverage of sanitation services demands urgent attention in a pandemic scenario.
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Affiliation(s)
- Gleyson B Castro
- Department of Hydraulic and Sanitation, São Carlos School of Engineering, University of São Paulo, São Carlos, SP, Brazil
| | - Aline C Bernegossi
- Department of Hydraulic and Sanitation, São Carlos School of Engineering, University of São Paulo, São Carlos, SP, Brazil
| | - Bruno José de O Sousa
- Department of Hydraulic and Sanitation, São Carlos School of Engineering, University of São Paulo, São Carlos, SP, Brazil
| | | | - Fernando R Da Silva
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Bárbara Luíza S Freitas
- Department of Hydraulic and Sanitation, São Carlos School of Engineering, University of São Paulo, São Carlos, SP, Brazil
| | - Allan P Ogura
- Department of Hydraulic and Sanitation, São Carlos School of Engineering, University of São Paulo, São Carlos, SP, Brazil
- PPG-SEA and CRHEA/SHS, São Carlos School of Engineering, University of São Paulo, São Carlos, SP, Brazil
| | - Juliano J Corbi
- Department of Hydraulic and Sanitation, São Carlos School of Engineering, University of São Paulo, São Carlos, SP, Brazil
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22
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Hill DT, Cousins H, Dandaraw B, Faruolo C, Godinez A, Run S, Smith S, Willkens M, Zirath S, Larsen DA. Wastewater treatment plant operators report high capacity to support wastewater surveillance for COVID-19 across New York State, USA. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 837:155664. [PMID: 35526635 PMCID: PMC9072752 DOI: 10.1016/j.scitotenv.2022.155664] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 05/28/2023]
Abstract
Wastewater surveillance for infectious disease expanded greatly during the COVID-19 pandemic. As a collaboration between sanitation engineers and scientists, the most cost-effective deployment of wastewater surveillance routinely tests wastewater samples from wastewater treatment plants. To evaluate the capacity of treatment plants of different sizes and characteristics to participate in surveillance efforts, we developed and distributed a survey to New York State municipal treatment plant supervisors in the summer and fall of 2021. The goal of the survey was to assess the knowledge, capacity, and attitudes toward wastewater surveillance as a public health tool. Our objectives were to: (1) determine what treatment plant operators know about wastewater surveillance for public health; (2) assess how plant operators feel about the affordability and benefits of wastewater surveillance; and (3) determine how frequently plant personnel can take and ship samples using existing resources. Results show that 62% of respondents report capacity to take grab samples twice weekly. Knowledge about wastewater surveillance was mixed with most supervisors knowing that COVID-19 can be tracked via wastewater but having less knowledge about surveillance for other public health issues such as opioids. We found that attitudes toward wastewater testing for public health were directly associated with differences in self-reported capacity of the plant to take samples. Further, findings suggest a diverse capacity for sampling across sewer systems with larger treatment plants reporting greater capacity for more frequent sampling. Findings provide guidance for outreach activities as well as important insight into treatment plant sampling capacity as it is connected to internal factors such as size and resource availability. These may help public health departments understand the limitations and ability of wastewater surveillance for public health benefit.
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Affiliation(s)
- Dustin T Hill
- Department of Public Health, Syracuse University, Syracuse, NY 13244, United States of America.
| | - Hannah Cousins
- Department of Biology, Case Western Reserve University, Cleveland, OH 44106, United States of America
| | - Bryan Dandaraw
- Department of Environmental Science, SUNY College of Environmental Science and Forestry, Syracuse, NY 13210, United States of America
| | - Catherine Faruolo
- Department of Public Health, Syracuse University, Syracuse, NY 13244, United States of America
| | - Alex Godinez
- Department of Public Health, Syracuse University, Syracuse, NY 13244, United States of America
| | - Sythong Run
- Department of Public Health, Syracuse University, Syracuse, NY 13244, United States of America
| | - Simon Smith
- Department of Public Health, Syracuse University, Syracuse, NY 13244, United States of America
| | - Megan Willkens
- Department of Public Health, Syracuse University, Syracuse, NY 13244, United States of America
| | - Shruti Zirath
- Department of Environmental Science, SUNY College of Environmental Science and Forestry, Syracuse, NY 13210, United States of America
| | - David A Larsen
- Department of Public Health, Syracuse University, Syracuse, NY 13244, United States of America
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23
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Welling CM, Singleton DR, Haase SB, Browning CH, Stoner BR, Gunsch CK, Grego S. Predictive values of time-dense SARS-CoV-2 wastewater analysis in university campus buildings. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 835:155401. [PMID: 35469858 PMCID: PMC9026951 DOI: 10.1016/j.scitotenv.2022.155401] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/15/2022] [Accepted: 04/16/2022] [Indexed: 05/14/2023]
Abstract
Wastewater-based SARS-CoV-2 surveillance on college campuses has the ability to detect individual clinical COVID-19 cases at the building-level. High concordance of wastewater results and clinical cases has been observed when calculated over a time window of four days or longer and in settings with high incidence of infection. At Duke University, twice a week clinical surveillance of all resident undergraduates was carried out in the spring 2021 semester. We conducted simultaneous wastewater surveillance with daily frequency on selected residence halls to assess wastewater as an early warning tool during times of low transmission with the hope of scaling down clinical test frequency. We evaluated the temporal relationship of the two time-dense data sets, wastewater and clinical, and sought a strategy to achieve the highest wastewater predictive values using the shortest time window to enable timely intervention. There were 11 days with clinical cases in the residence halls (80-120 occupants) under wastewater surveillance with 5 instances of a single clinical case and 3 instances of two clinical cases which also corresponded to a positive wastewater SARS-CoV-2 signal. While the majority (71%) of our wastewater samples were negative for SARS-CoV-2, 29% resulted in at least one positive PCR signal, some of which did not correlate with an identified clinical case. Using a criteria of two consecutive days of positive wastewater signals, we obtained a positive predictive value (PPV) of 75% and a negative predictive value of 87% using a short 2 day time window for agreement. A conventional concordance over a much longer 4 day time window resulted in PPV of only 60%. Our data indicated that daily wastewater collection and using a criteria of two consecutive days of positive wastewater signals was the most predictive approach to timely early warning of COVID-19 cases at the building level.
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Affiliation(s)
- Claire M Welling
- Center for Water, Sanitation, Hygiene and Infectious Disease (WASH-AID), Department of Electrical and Computer Engineering, Duke University, Durham, NC, United States of America
| | - David R Singleton
- Department of Civil and Environmental Engineering, Duke University, Durham, NC, United States of America
| | - Steven B Haase
- Departments of Biology and Medicine, Duke University, Durham, NC, United States of America
| | - Christian H Browning
- Office of Information Technology, Duke University, Durham, NC, United States of America
| | - Brian R Stoner
- Center for Water, Sanitation, Hygiene and Infectious Disease (WASH-AID), Department of Electrical and Computer Engineering, Duke University, Durham, NC, United States of America
| | - Claudia K Gunsch
- Department of Civil and Environmental Engineering, Duke University, Durham, NC, United States of America
| | - Sonia Grego
- Center for Water, Sanitation, Hygiene and Infectious Disease (WASH-AID), Department of Electrical and Computer Engineering, Duke University, Durham, NC, United States of America.
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Hyllestad S, Myrmel M, Lomba JAB, Jordhøy F, Schipper SK, Amato E. Effectiveness of environmental surveillance of SARS-CoV-2 as an early warning system during the first year of the COVID-19 pandemic: a systematic review. JOURNAL OF WATER AND HEALTH 2022; 20:1223-1242. [PMID: 36044191 DOI: 10.2166/wh.2022.115] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Since infected persons shed SARS-CoV-2 in faeces before symptoms appear, environmental surveillance (ES) may serve as an early warning system (EWS) for COVID-19 and new variants of concern. The ES of SARS-CoV-2 has been widely reviewed; however, its effectiveness as an EWS for SARS-CoV-2 in terms of timeliness, sensitivity and specificity has not been systematically assessed. We conducted a systematic review to identify and synthesise evidence on the ES of SARS-CoV-2 as an EWS to evaluate the added value for public health. Of 1,014 studies identified, we considered 29 for a qualitative synthesis of the timeliness of ES as an EWS for COVID-19, while six studies were assessed for the ability to detect new variants and two for both aims. The synthesis indicates ES may serve as an EWS of 1-2 weeks. ES could complement clinical surveillance for SARS-CoV-2; however, its cost-benefit value for public health decisions needs to be assessed based on the stage of the pandemic and resources available. Studies focusing methodological knowledge gaps as well as how to use and interpret ES signals for public health actions are needed, as is the sharing of knowledge within countries/areas with long experience of such surveillance.
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Affiliation(s)
- Susanne Hyllestad
- Department for Infection Control and Preparedness, Norwegian Institute of Public Health (NIPH), Oslo, Norway E-mail:
| | - Mette Myrmel
- Faculty of Veterinary Medicine, Virology Unit, Norwegian University of Life Science (NMBU), Oslo, Norway
| | - Jose Antonio Baz Lomba
- Department of Environmental Chemistry and Technology, Norwegian Institute for Water Research (NIVA), Oslo, Norway
| | - Fredrik Jordhøy
- Department for Infection Control and Preparedness, Norwegian Institute of Public Health (NIPH), Oslo, Norway E-mail:
| | - Svanhild Kjørsvik Schipper
- Department for Infection Control and Preparedness, Norwegian Institute of Public Health (NIPH), Oslo, Norway E-mail:
| | - Ettore Amato
- Department for Infection Control and Preparedness, Norwegian Institute of Public Health (NIPH), Oslo, Norway E-mail:
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25
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Canh VD, Liu M, Sangsanont J, Katayama H. Capsid integrity detection of pathogenic viruses in waters: Recent progress and potential future applications. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 827:154258. [PMID: 35248642 DOI: 10.1016/j.scitotenv.2022.154258] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/26/2022] [Accepted: 02/27/2022] [Indexed: 06/14/2023]
Abstract
Waterborne diseases caused by pathogenic human viruses are a major public health concern. To control the potential risk of viral infection through contaminated waters, a rapid, reliable tool to assess the infectivity of pathogenic viruses is required. Recently, an advanced approach (i.e., capsid integrity (RT-)qPCR) was developed to discriminate intact viruses (potentially infectious) from inactivated viruses. In this approach, samples were pretreated with capsid integrity reagents (e.g., monoazide dyes or metal compounds) before (RT -)qPCR. These reagents can only penetrate inactivated viruses with compromised capsids to bind to viral genomes and prevent their amplification, but they cannot enter viruses with intact capsids. Therefore, only viral genomes of intact viruses were amplified or detected by (RT-)qPCR after capsid integrity treatment. In this study, we reviewed recent progress in the development and application of capsid integrity (RT-)qPCR to assess the potential infectivity of viruses (including non-enveloped and enveloped viruses with different genome structures [RNA and DNA]) in water. The efficiency of capsid integrity (RT-)qPCR has been shown to depend on various factors, such as conditions of integrity reagent treatment, types of viruses, environmental matrices, and the capsid structure of viruses after disinfection treatments (e.g., UV, heat, and chlorine). For the application of capsid integrity (RT-)qPCR in real-world samples, the use of suitable virus concentration methods and process controls is important to control the efficiency of capsid integrity (RT-)qPCR. In addition, potential future applications of capsid integrity (RT-)qPCR for determining the mechanism of disinfection treatment on viral structure (e.g., capsid or genome) and a combination of capsid integrity treatment and next-generation sequencing (NGS) (capsid integrity NGS) for monitoring the community of intact pathogenic viruses in water are also discussed. This review provides essential information on the application of capsid integrity (RT-)qPCR as an efficient tool for monitoring the presence of pathogenic viruses with intact capsids in water.
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Affiliation(s)
- Vu Duc Canh
- Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan.
| | - Miaomiao Liu
- Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Jatuwat Sangsanont
- Department of Environmental Science, Faculty of Science, Chulalongkorn University, Bangkok 10330, Thailand; Water Science and Technology for Sustainable Environmental Research Group, Chulalongkorn University, Bangkok 10330, Thailand
| | - Hiroyuki Katayama
- Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan.
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26
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Beattie RE, Blackwood AD, Clerkin T, Dinga C, Noble RT. Evaluating the impact of sample storage, handling, and technical ability on the decay and recovery of SARS-CoV-2 in wastewater. PLoS One 2022; 17:e0270659. [PMID: 35749532 PMCID: PMC9232146 DOI: 10.1371/journal.pone.0270659] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/14/2022] [Indexed: 11/19/2022] Open
Abstract
Wastewater based epidemiology (WBE) is useful for tracking and monitoring the level of disease prevalence in a community and has been used extensively to complement clinical testing during the current COVID-19 pandemic. Despite the numerous benefits, sources of variability in sample storage, handling, and processing methods can make WBE data difficult to generalize. We performed an experiment to determine sources of variability in WBE data including the impact of storage time, handling, and processing techniques on the concentration of SARS-CoV-2 in wastewater influent from three wastewater treatment plants (WWTP) in North Carolina over 19 days. The SARS-CoV-2 concentration in influent samples held at 4°C did not degrade significantly over the 19-day experiment. Heat pasteurization did not significantly impact the concentration of SARS-CoV-2 at two of the three WWTP but did reduce viral recovery at the WWTP with the smallest population size served. On each processing date, one filter from each sample was processed immediately while a replicate filter was frozen at -80°C. Once processed, filters previously frozen were found to contain slightly higher concentrations (<0.2 log copies/L) than their immediately processed counterparts, indicating freezing filters is a viable method for delayed quantification and may even improve recovery at WWTP with low viral concentrations. Investigation of factors contributing to variability during sample processing indicated that analyst experience level contributed significantly (p<0.001) to accepted droplet generation while extraction efficiency and reverse transcription efficiency contributed significantly (p<0.05) to day-to-day SARS-CoV-2 variability. This study provides valuable practical information for minimizing decay and/or loss of SARS CoV-2 in wastewater influent while adhering to safety procedures, promoting efficient laboratory workflows, and accounting for sources of variability.
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Affiliation(s)
- Rachelle E. Beattie
- Department of Earth, Marine, and Environmental Sciences, Institute of Marine Science, University of North Carolina at Chapel Hill, Morehead City, North Carolina, United States of America
| | - A. Denene Blackwood
- Department of Earth, Marine, and Environmental Sciences, Institute of Marine Science, University of North Carolina at Chapel Hill, Morehead City, North Carolina, United States of America
| | - Thomas Clerkin
- Department of Earth, Marine, and Environmental Sciences, Institute of Marine Science, University of North Carolina at Chapel Hill, Morehead City, North Carolina, United States of America
| | - Carly Dinga
- Department of Earth, Marine, and Environmental Sciences, Institute of Marine Science, University of North Carolina at Chapel Hill, Morehead City, North Carolina, United States of America
| | - Rachel T. Noble
- Department of Earth, Marine, and Environmental Sciences, Institute of Marine Science, University of North Carolina at Chapel Hill, Morehead City, North Carolina, United States of America
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Jiang AZ, Nian F, Chen H, McBean EA. Passive Samplers, an Important Tool for Continuous Monitoring of the COVID-19 Pandemic. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:32326-32334. [PMID: 35137317 PMCID: PMC9072756 DOI: 10.1007/s11356-022-19073-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/02/2022] [Indexed: 05/05/2023]
Abstract
The global pandemic caused by COVID-19 has resulted in major costs around the world, costs with dimensions in every aspect, from peoples' daily living to the global economy. As the pandemic progresses, the virus evolves, and more vaccines become available, and the 'battle against the virus' continues. As part of the battle, Wastewater-Based Epidemiology (WBE) technologies are being widely deployed in essential roles for SARS-CoV-2 detection and monitoring. While focusing on demonstrating the advantages of passive samplers as a tool in WBE, this review provides a holistic view of the current WBE applications in monitoring SARS-CoV-2 with the integration of the most up-to-date data. A novel scenario example based on a recent Nanjing (China) outbreak in July 2021 is used to illustrate the potential benefits of using passive samplers to monitor COVID-19 and to facilitate effective control of future major outbreaks. The presented contents and how the application of passive samplers indicates that this technology can be beneficial at different levels, varying from building to community to regional. Countries and regions that have the pandemic well under control or have low positive case occurrences have the potential to significantly benefit from deploying passive samplers as a measure to identify and suppress outbreaks.
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Affiliation(s)
- Albert Z. Jiang
- School of Engineering, University of Guelph, 50 Stone Rd. E, Guelph, N1G 2W1 Canada
| | - Fulin Nian
- Department of Digestive, Shanghai Pudong Hospital, Fudan University Affiliated Pudong Medical Center, 2800 Gongwei Road, Shanghai, 201399 China
| | - Han Chen
- College of Environmental Science and Engineering/Sino-Canada Joint R&D Centre for Water and Environmental Safety, Nankai University, Tianjin, 300071 China
| | - Edward A. McBean
- School of Engineering, University of Guelph, 50 Stone Rd. E, Guelph, N1G 2W1 Canada
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28
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Godinez A, Hill D, Dandaraw B, Green H, Kilaru P, Middleton F, Run S, Kmush BL, Larsen DA. High Sensitivity and Specificity of Dormitory-Level Wastewater Surveillance for COVID-19 during Fall Semester 2020 at Syracuse University, New York. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4851. [PMID: 35457720 PMCID: PMC9030442 DOI: 10.3390/ijerph19084851] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/12/2022] [Accepted: 04/12/2022] [Indexed: 01/27/2023]
Abstract
A residential building's wastewater presents a potential non-invasive method of surveilling numerous infectious diseases, including SARS-CoV-2. We analyzed wastewater from 16 different residential locations at Syracuse University (Syracuse, NY, USA) during fall semester 2020, testing for SARS-CoV-2 RNA twice weekly and compared the presence of clinical COVID-19 cases to detection of the viral RNA in wastewater. The sensitivity of wastewater surveillance to correctly identify dormitories with a case of COVID-19 ranged from 95% (95% confidence interval [CI] = 76-100%) on the same day as the case was diagnosed to 73% (95% CI = 53-92%), with 7 days lead time of wastewater. The positive predictive value ranged from 20% (95% CI = 13-30%) on the same day as the case was diagnosed to 50% (95% CI = 40-60%) with 7 days lead time. The specificity of wastewater surveillance to correctly identify dormitories without a case of COVID-19 ranged from 60% (95% CI = 52-67%) on the day of the wastewater sample to 67% (95% CI = 58-74%) with 7 days lead time. The negative predictive value ranged from 99% (95% CI = 95-100%) on the day of the wastewater sample to 84% (95% CI = 77-91%) with 7 days lead time. Wastewater surveillance for SARS-CoV-2 at the building level is highly accurate in determining if residents have a COVID-19 infection. Particular benefit is derived from negative wastewater results that can confirm a building is COVID-19 free.
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Affiliation(s)
- Alex Godinez
- David B. Falk College of Sports and Human Dynamics, Syracuse University, Syracuse, NY 13244, USA; (A.G.); (D.H.); (P.K.); (S.R.); (B.L.K.)
| | - Dustin Hill
- David B. Falk College of Sports and Human Dynamics, Syracuse University, Syracuse, NY 13244, USA; (A.G.); (D.H.); (P.K.); (S.R.); (B.L.K.)
| | - Bryan Dandaraw
- Department of Environmental Sciences, College of Environmental Sciences and Forestry, State University of New York, Syracuse, NY 13210, USA;
| | - Hyatt Green
- Department of Environmental Biology, College of Environmental Sciences and Forestry, State University of New York, Syracuse, NY 13210, USA;
| | - Pruthvi Kilaru
- David B. Falk College of Sports and Human Dynamics, Syracuse University, Syracuse, NY 13244, USA; (A.G.); (D.H.); (P.K.); (S.R.); (B.L.K.)
- College of Osteopathic Medicine, Des Moines University, Des Moines, IA 50312, USA
| | - Frank Middleton
- Department of Biochemistry and Molecular Biology, SUNY Upstate Medical University, Syracuse, NY 13210, USA;
| | - Sythong Run
- David B. Falk College of Sports and Human Dynamics, Syracuse University, Syracuse, NY 13244, USA; (A.G.); (D.H.); (P.K.); (S.R.); (B.L.K.)
| | - Brittany L. Kmush
- David B. Falk College of Sports and Human Dynamics, Syracuse University, Syracuse, NY 13244, USA; (A.G.); (D.H.); (P.K.); (S.R.); (B.L.K.)
| | - David A. Larsen
- David B. Falk College of Sports and Human Dynamics, Syracuse University, Syracuse, NY 13244, USA; (A.G.); (D.H.); (P.K.); (S.R.); (B.L.K.)
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29
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Fahrenfeld NL, Morales Medina WR, D'Elia S, Modica M, Ruiz A, McLane M. Comparison of residential dormitory COVID-19 monitoring via weekly saliva testing and sewage monitoring. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 814:151947. [PMID: 34838560 PMCID: PMC8611854 DOI: 10.1016/j.scitotenv.2021.151947] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/05/2021] [Accepted: 11/20/2021] [Indexed: 05/09/2023]
Abstract
Wastewater surveillance has been used as a tool for COVID-19 outbreak detection particularly where there was not capability in place for routine and robust individual testing. Given clinical reports that earlier detection is possible following infection from throat/nasal samples compared to fecal samples for COVID-19 patients, the utility of wastewater testing where robust individual testing is possible is less clear. The objective of this study was to compare the results of weekly required COVID-19 saliva tests to weekly wastewater monitoring for residential buildings (i.e., dormitories) located across three college campuses capturing wastewater from 80 to 441 occupants per sampling location. Sampling occurred during the spring semester of the 2021 academic year which captured the third wave of SARS-CoV-2 cases in the study region. Comparison of the saliva and wastewater testing results indicated that the wastewater SARS-CoV-2 concentrations had a strong linear correlation with the previous week's percentage of positive saliva test results and a weak linear correlation with the saliva testing results surrounding the wastewater sampling (four days before and 3 days after). Given that no correlation was observed between the wastewater and the saliva testing from the following week, the weekly saliva testing captured spikes in COVID-19 cases earlier than the weekly wastewater sampling. Interestingly, the N1 gene was observed in buildings on all campuses, but N2 was observed in wastewater on only one of the campuses. N1 and N2 were also observed in sewer biofilm. The campus-specific challenges associated with implementation of wastewater surveillance are discussed. Overall, these results can help inform design of surveillance for early detection of SARS-CoV-2 in residential settings thereby informing mitigation strategies to slow or prevent the spread of the virus among residents in congregate living.
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Affiliation(s)
- N L Fahrenfeld
- Civil & Environmental Engineering, Rutgers, The State University of New Jersey, 500 Bartholomew Dr, Piscataway, NJ 08854, USA.
| | | | - Stephanie D'Elia
- Biochemistry and Microbiology, Rutgers, The State University of New Jersey, USA
| | - Maureen Modica
- Environmental Health and Safety, Rutgers, The State University of New Jersey, USA
| | - Alejandro Ruiz
- Environmental Health and Safety, Rutgers, The State University of New Jersey, USA
| | - Mark McLane
- Environmental Health and Safety, Rutgers, The State University of New Jersey, USA
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30
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Sangsanont J, Rattanakul S, Kongprajug A, Chyerochana N, Sresung M, Sriporatana N, Wanlapakorn N, Poovorawan Y, Mongkolsuk S, Sirikanchana K. SARS-CoV-2 RNA surveillance in large to small centralized wastewater treatment plants preceding the third COVID-19 resurgence in Bangkok, Thailand. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 809:151169. [PMID: 34699826 PMCID: PMC8540006 DOI: 10.1016/j.scitotenv.2021.151169] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/17/2021] [Accepted: 10/19/2021] [Indexed: 05/07/2023]
Abstract
Wastewater surveillance for SARS-CoV-2 RNA has been a successful indicator of COVID-19 outbreaks in populations prior to clinical testing. However, this has been mostly conducted in high-income countries, which means there is a dearth of performance investigations in low- and middle-income countries with different socio-economic settings. This study evaluated the applicability of SARS-CoV-2 RNA monitoring in wastewater (n = 132) to inform COVID-19 infection in the city of Bangkok, Thailand using CDC N1 and N2 RT-qPCR assays. Wastewater influents (n = 112) and effluents (n = 20) were collected from 19 centralized wastewater treatment plants (WWTPs) comprising four large, four medium, and 11 small WWTPs during seven sampling events from January to April 2021 prior to the third COVID-19 resurgence that was officially declared in April 2021. The CDC N1 assay showed higher detection rates and mostly lower Ct values than the CDC N2. SARS-CoV-2 RNA was first detected at the first event when new reported cases were low. Increased positive detection rates preceded an increase in the number of newly reported cases and increased over time with the reported infection incidence. Wastewater surveillance (both positive rates and viral loads) showed strongest correlation with daily new COVID-19 cases at 22-24 days lag (Spearman's Rho = 0.85-1.00). Large WWTPs (serving 432,000-580,000 of the population) exhibited similar trends of viral loads and new cases to those from all 19 WWTPs, emphasizing that routine monitoring of the four large WWTPs could provide sufficient information for the city-scale dynamics. Higher sampling frequency at fewer sites, i.e., at the four representative WWTPs, is therefore suggested especially during the subsiding period of the outbreak to indicate the prevalence of COVID-19 infection, acting as an early warning of COVID-19 resurgence.
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Affiliation(s)
- Jatuwat Sangsanont
- Department of Environmental Science, Faculty of Science, Chulalongkorn University, Bangkok 10330, Thailand; Water Science and Technology for Sustainable Environmental Research Group, Chulalongkorn University, Bangkok 10330, Thailand
| | - Surapong Rattanakul
- Department of Environmental Engineering, Faculty of Engineering, King Mongkut's University of Technology Thonburi, Bangkok 10140, Thailand
| | - Akechai Kongprajug
- Research Laboratory of Biotechnology, Chulabhorn Research Institute, Bangkok 10210, Thailand
| | - Natcha Chyerochana
- Research Laboratory of Biotechnology, Chulabhorn Research Institute, Bangkok 10210, Thailand
| | - Montakarn Sresung
- Research Laboratory of Biotechnology, Chulabhorn Research Institute, Bangkok 10210, Thailand
| | - Nonnarit Sriporatana
- Department of Environmental Science, Faculty of Science, Chulalongkorn University, Bangkok 10330, Thailand
| | - Nasamon Wanlapakorn
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Thailand
| | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Thailand
| | - Skorn Mongkolsuk
- Research Laboratory of Biotechnology, Chulabhorn Research Institute, Bangkok 10210, Thailand; Center of Excellence on Environmental Health and Toxicology (EHT), Ministry of Education, Bangkok 10400, Thailand
| | - Kwanrawee Sirikanchana
- Research Laboratory of Biotechnology, Chulabhorn Research Institute, Bangkok 10210, Thailand; Center of Excellence on Environmental Health and Toxicology (EHT), Ministry of Education, Bangkok 10400, Thailand.
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31
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Kaya D, Niemeier D, Ahmed W, Kjellerup BV. Evaluation of multiple analytical methods for SARS-CoV-2 surveillance in wastewater samples. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 808:152033. [PMID: 34883175 PMCID: PMC8648376 DOI: 10.1016/j.scitotenv.2021.152033] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/21/2021] [Accepted: 11/24/2021] [Indexed: 05/06/2023]
Abstract
In this study, 14 virus concentration protocols based on centrifugation, filtration, polyethylene glycol (PEG) precipitation and ultrafiltration were tested for their efficacy for the quantification of SARS-CoV-2 in wastewater samples. These protocols were paired with four RNA extraction procedures resulting in a combination of 50 unique approaches. Bovine respiratory syncytial virus (BRSV) was used as a process control and seeded in each wastewater sample subjected to all 50 protocols. The recovery of BRSV obtained through the application of 50 unique approaches ranged from <0.03 to 64.7% (±1.6%). Combination of centrifugation as the solid removal step, ultrafiltration (Amicon-UF-15; 100 kDa cut-off; protocol 9) as the primary virus concentration method, and Zymo Quick-RNA extraction kit provided the highest BRSV recovery (64.7 ± 1.6%). To determine the impact of prolonged storage of large wastewater sample volume (900 mL) at -20 °C on enveloped virus decay, the BRSV seeded wastewaters samples were stored at -20 °C up to 110 days and analyzed using the most efficient concentration (protocol 9) and extraction (Zymo Quick-RNA kit) methods. BRSV RNA followed a first-order decay rate (k = 0.04/h with r2 = 0.99) in wastewater. Finally, 21 wastewater influent samples from five wastewater treatment plants (WWTPs) in southern Maryland, USA were analyzed between May to August 2020 to determine SARS-CoV-2 RNA concentrations. SARS-CoV-2 RNA was quantifiable in 17/21 (81%) of the influent wastewater samples with concentration ranging from 1.10 (±0.10) × 104 to 2.38 (±0.16) × 106 gene copies/L. Among the RT-qPCR assays tested, US CDC N1 assay was the most sensitive followed by US CDC N2, E_Sarbeco, and RdRp assays. Data presented in this study may enhance our understanding on the effective concentration and extraction of SARS-CoV-2 from wastewater.
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Affiliation(s)
- Devrim Kaya
- Department of Civil and Environmental Engineering, 1147 Glenn L. Martin Hall, USA.
| | - Debra Niemeier
- Department of Civil and Environmental Engineering, 1147 Glenn L. Martin Hall, USA; Maryland Transportation Institute, 3244 Jeong H. Kim Engineering Bldng, University of Maryland, College Park, MD 20742, USA
| | - Warish Ahmed
- CSIRO Land and Water, Ecosciences Precinct, 41 Boggo Road, Dutton Park 4102, QLD, Australia
| | - Birthe V Kjellerup
- Department of Civil and Environmental Engineering, 1147 Glenn L. Martin Hall, USA.
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32
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George AD, Kaya D, Layton BA, Bailey K, Mansell S, Kelly C, Williamson KJ, Radniecki TS. Impact of Sampling Type, Frequency, and Scale of the Collection System on SARS-CoV-2 Quantification Fidelity. ENVIRONMENTAL SCIENCE & TECHNOLOGY LETTERS 2022; 9:160-165. [PMID: 37566370 PMCID: PMC8791033 DOI: 10.1021/acs.estlett.1c00882] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 05/05/2023]
Abstract
With the rapid onset of the COVID-19 pandemic, wastewater-based epidemiology sampling methodologies for SARS-CoV-2 were often implemented quickly and may not have considered the unique drainage catchment characteristics. This study assessed the impact of grab versus composite sampling on the detection and quantification of SARS-CoV-2 in four different catchment scales with flow rates ranging from high flow (wastewater treatment plant influent) to medium flow (neighborhood scale) to low-flow (city block scale) to ultralow flow (building scale). At the high-flow site, grab samples were comparable to 24 h composite samples with SARS-CoV-2 detected in all samples and differed in concentration from the composite by <1 log 10 unit. However, as the size of the catchment decreased, the percentage of negative grab samples increased despite all respective composites being positive, and the SARS-CoV-2 concentrations of grab samples varied from those of the composites by up to almost 2 log 10 units. At the ultra-low-flow site, increased sampling frequencies generated composite samples with higher fidelity to the 5 min composite, which is the closest estimate of the true SARS-CoV-2 composite concentration that could be measured. Thus, composite sampling is more likely to compensate for temporal signal variability while grab samples do not, especially as the catchment basin size decreases.
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Affiliation(s)
- Andrea D. George
- Department of Research & Innovation,
Clean Water Services, Hillsboro, Oregon 97123,
United States
- School of Chemical, Biological, and Environmental
Engineering, Oregon State University, Corvallis, Oregon 97331,
United States
| | - Devrim Kaya
- School of Chemical, Biological, and Environmental
Engineering, Oregon State University, Corvallis, Oregon 97331,
United States
| | - Blythe A. Layton
- Department of Research & Innovation,
Clean Water Services, Hillsboro, Oregon 97123,
United States
| | - Kestrel Bailey
- Department of Research & Innovation,
Clean Water Services, Hillsboro, Oregon 97123,
United States
| | - Scott Mansell
- Department of Research & Innovation,
Clean Water Services, Hillsboro, Oregon 97123,
United States
| | - Christine Kelly
- School of Chemical, Biological, and Environmental
Engineering, Oregon State University, Corvallis, Oregon 97331,
United States
| | - Kenneth J. Williamson
- Department of Research & Innovation,
Clean Water Services, Hillsboro, Oregon 97123,
United States
| | - Tyler S. Radniecki
- School of Chemical, Biological, and Environmental
Engineering, Oregon State University, Corvallis, Oregon 97331,
United States
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33
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Shah S, Gwee SXW, Ng JQX, Lau N, Koh J, Pang J. Wastewater surveillance to infer COVID-19 transmission: A systematic review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 804:150060. [PMID: 34798721 PMCID: PMC8423771 DOI: 10.1016/j.scitotenv.2021.150060] [Citation(s) in RCA: 113] [Impact Index Per Article: 56.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/27/2021] [Accepted: 08/27/2021] [Indexed: 05/18/2023]
Abstract
Successful detection of SARS-COV-2 in wastewater suggests the potential utility of wastewater-based epidemiology (WBE) for COVID-19 community surveillance. This systematic review aims to assess the performance of wastewater surveillance as early warning system of COVID-19 community transmission. A systematic search was conducted in PubMed, Medline, Embase and the WBE Consortium Registry according to PRISMA guidelines for relevant articles published until 31st July 2021. Relevant data were extracted and summarized. Quality of each paper was assessed using an assessment tool adapted from Bilotta et al.'s tool for environmental science. Of 763 studies identified, 92 studies distributed across 34 countries were shortlisted for qualitative synthesis. A total of 26,197 samples were collected between January 2020 and May 2021 from various locations serving population ranging from 321 to 11,400,000 inhabitants. Overall sample positivity was moderate at 29.2% in all examined settings with the spike (S) gene having maximum rate of positive detections and nucleocapsid (N) gene being the most targeted. Wastewater signals preceded confirmed cases by up to 63 days, with 13 studies reporting sample positivity before the first cases were detected in the community. At least 50 studies reported an association of viral load with community cases. While wastewater surveillance cannot replace large-scale diagnostic testing, it can complement clinical surveillance by providing early signs of potential transmission for more active public health responses. However, more studies using standardized and validated methods are required along with risk analysis and modelling to understand the dynamics of viral outbreaks.
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Affiliation(s)
- Shimoni Shah
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore 117549, Singapore.
| | - Sylvia Xiao Wei Gwee
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore 117549, Singapore.
| | - Jamie Qiao Xin Ng
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore 117549, Singapore.
| | - Nicholas Lau
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore 117549, Singapore.
| | - Jiayun Koh
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore 117549, Singapore.
| | - Junxiong Pang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore 117549, Singapore.
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34
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Hrudey SE, Bischel HN, Charrois J, Chik AHS, Conant B, Delatolla R, Dorner S, Graber TE, Hubert C, Isaac-Renton J, Pons W, Safford H, Servos M, Sikora C. Wastewater Surveillance for SARS-CoV-2 RNA in Canada. Facets (Ott) 2022. [DOI: 10.1139/facets-2022-0148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Wastewater surveillance for SARS-CoV-2 RNA is a relatively recent adaptation of long-standing wastewater surveillance for infectious and other harmful agents. Individuals infected with COVID-19 were found to shed SARS-CoV-2 in their faeces. Researchers around the world confirmed that SARS-CoV-2 RNA fragments could be detected and quantified in community wastewater. Canadian academic researchers, largely as volunteer initiatives, reported proof-of-concept by April 2020. National collaboration was initially facilitated by the Canadian Water Network. Many public health officials were initially skeptical about actionable information being provided by wastewater surveillance even though experience has shown that public health surveillance for a pandemic has no single, perfect approach. Rather, different approaches provide different insights, each with its own strengths and limitations. Public health science must triangulate among different forms of evidence to maximize understanding of what is happening or may be expected. Well-conceived, resourced, and implemented wastewater-based platforms can provide a cost-effective approach to support other conventional lines of evidence. Sustaining wastewater monitoring platforms for future surveillance of other disease targets and health states is a challenge. Canada can benefit from taking lessons learned from the COVID-19 pandemic to develop forward-looking interpretive frameworks and capacity to implement, adapt, and expand such public health surveillance capabilities.
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Affiliation(s)
- Steve E. Hrudey
- Professor Emeritus, Analytical & Environmental Toxicology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2G3 Canada
| | - Heather N. Bischel
- Associate Professor, Department of Civil & Environmental Engineering, University of California, Davis, Davis, CA 95616 USA
| | - Jeff Charrois
- Senior Manager, Analytical Operations and Process Development Teams, EPCOR Water Services Inc, Edmonton, AB T5K 0A5 Canada
| | - Alex H. S. Chik
- Project Manager, Wastewater Surveillance Initiative, Ontario Clean Water Agency, Mississauga, ON L5A 4G1 Canada
| | - Bernadette Conant
- Past Chief Executive Officer, Canadian Water Network, Waterloo, ON N2L 3G1 Canada
| | - Rob Delatolla
- Professor, Civil Engineering, University of Ottawa, Ottawa, ON K1N 6N5 Canada
| | - Sarah Dorner
- Professor, Civil, Geological & Mining Engineering, Polytechnique Montréal, Montréal, PQ H3T 1J4 Canada
| | - Tyson E. Graber
- Associate Scientist, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, K1H 8L1 Canada
| | - Casey Hubert
- Professor, Campus Alberta Innovates Program Chair in Geomicrobiology, Department of Biological Sciences, University of Calgary, Calgary, AB T2N 1N4 Canada
| | - Judy Isaac-Renton
- Professor Emerita, Dept. Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Calgary, AB, T2N 3V9 Canada
| | - Wendy Pons
- Professor, Bachelor of Environmental Health Program Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON N2P 2N6 Canada
| | - Hannah Safford
- Associate Director of Science Policy, Federation of American Scientists, Arlington, VA 22205 USA
| | - Mark Servos
- Professor & Canada Research Chair, Department of Biology, University of Waterloo, Waterloo, ON N2L 3G1 Canada
| | - Christopher Sikora
- Medical Officer of Health, Edmonton Region, Alberta Health Services, Edmonton, AB T5J 3E4 Canada
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35
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Corchis-Scott R, Geng Q, Seth R, Ray R, Beg M, Biswas N, Charron L, Drouillard KD, D'Souza R, Heath DD, Houser C, Lawal F, McGinlay J, Menard SL, Porter LA, Rawlings D, Scholl ML, Siu KWM, Tong Y, Weisener CG, Wilhelm SW, McKay RML. Averting an Outbreak of SARS-CoV-2 in a University Residence Hall through Wastewater Surveillance. Microbiol Spectr 2021; 9:e0079221. [PMID: 34612693 DOI: 10.1101/2021.06.23.21259176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
A wastewater surveillance program targeting a university residence hall was implemented during the spring semester 2021 as a proactive measure to avoid an outbreak of COVID-19 on campus. Over a period of 7 weeks from early February through late March 2021, wastewater originating from the residence hall was collected as grab samples 3 times per week. During this time, there was no detection of SARS-CoV-2 by reverse transcriptase quantitative PCR (RT-qPCR) in the residence hall wastewater stream. Aiming to obtain a sample more representative of the residence hall community, a decision was made to use passive samplers beginning in late March onwards. Adopting a Moore swab approach, SARS-CoV-2 was detected in wastewater samples just 2 days after passive samplers were deployed. These samples also tested positive for the B.1.1.7 (Alpha) variant of concern (VOC) using RT-qPCR. The positive result triggered a public health case-finding response, including a mobile testing unit deployed to the residence hall the following day, with testing of nearly 200 students and staff, which identified two laboratory-confirmed cases of Alpha variant COVID-19. These individuals were relocated to a separate quarantine facility, averting an outbreak on campus. Aggregating wastewater and clinical data, the campus wastewater surveillance program has yielded the first estimates of fecal shedding rates of the Alpha VOC of SARS-CoV-2 in individuals from a nonclinical setting. IMPORTANCE Among early adopters of wastewater monitoring for SARS-CoV-2 have been colleges and universities throughout North America, many of whom are using this approach to monitor congregate living facilities for early evidence of COVID-19 infection as an integral component of campus screening programs. Yet, while there have been numerous examples where wastewater monitoring on a university campus has detected evidence for infection among community members, there are few examples where this monitoring triggered a public health response that may have averted an actual outbreak. This report details a wastewater-testing program targeting a residence hall on a university campus during spring 2021, when there was mounting concern globally over the emergence of SARS-CoV-2 variants of concern, reported to be more transmissible than the wild-type Wuhan strain. In this communication, we present a clear example of how wastewater monitoring resulted in actionable responses by university administration and public health, which averted an outbreak of COVID-19 on a university campus.
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Affiliation(s)
- Ryland Corchis-Scott
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Qiudi Geng
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Rajesh Seth
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- Civil and Environmental Engineering, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Rajan Ray
- Civil and Environmental Engineering, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Mohsan Beg
- Student Counselling Centre, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Nihar Biswas
- Civil and Environmental Engineering, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Lynn Charron
- Residence Services, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Kenneth D Drouillard
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- School of the Environment, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Ramsey D'Souza
- Windsor-Essex County Health Unit, Windsor, Ontario, Canada
| | - Daniel D Heath
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- Department of Integrative Biology, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Chris Houser
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- School of the Environment, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Felicia Lawal
- Windsor-Essex County Health Unit, Windsor, Ontario, Canada
| | - James McGinlay
- Residence Services, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Sherri Lynne Menard
- Environmental Health and Safety, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Lisa A Porter
- Department of Biomedical Sciences, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Diane Rawlings
- Residence Services, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Matthew L Scholl
- Student Health Services, University of Windsorgrid.267455.7University of Windsor, grid.267455.7, Windsor, Ontario, Canada
| | - K W Michael Siu
- Department of Chemistry and Biochemistry, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Yufeng Tong
- Department of Chemistry and Biochemistry, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Christopher G Weisener
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- School of the Environment, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Steven W Wilhelm
- Department of Microbiology, The University of Tennessee, Knoxville, Tennessee, USA
- Great Lakes Center for Fresh Waters and Human Health, Bowling Green State University, Bowling Green, Ohio, USA
| | - R Michael L McKay
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- School of the Environment, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- Great Lakes Center for Fresh Waters and Human Health, Bowling Green State University, Bowling Green, Ohio, USA
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36
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Corchis-Scott R, Geng Q, Seth R, Ray R, Beg M, Biswas N, Charron L, Drouillard KD, D’Souza R, Heath DD, Houser C, Lawal F, McGinlay J, Menard SL, Porter LA, Rawlings D, Scholl ML, Siu KWM, Tong Y, Weisener CG, Wilhelm SW, McKay RML. Averting an Outbreak of SARS-CoV-2 in a University Residence Hall through Wastewater Surveillance. Microbiol Spectr 2021; 9:e0079221. [PMID: 34612693 PMCID: PMC8510253 DOI: 10.1128/spectrum.00792-21] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/06/2021] [Indexed: 12/23/2022] Open
Abstract
A wastewater surveillance program targeting a university residence hall was implemented during the spring semester 2021 as a proactive measure to avoid an outbreak of COVID-19 on campus. Over a period of 7 weeks from early February through late March 2021, wastewater originating from the residence hall was collected as grab samples 3 times per week. During this time, there was no detection of SARS-CoV-2 by reverse transcriptase quantitative PCR (RT-qPCR) in the residence hall wastewater stream. Aiming to obtain a sample more representative of the residence hall community, a decision was made to use passive samplers beginning in late March onwards. Adopting a Moore swab approach, SARS-CoV-2 was detected in wastewater samples just 2 days after passive samplers were deployed. These samples also tested positive for the B.1.1.7 (Alpha) variant of concern (VOC) using RT-qPCR. The positive result triggered a public health case-finding response, including a mobile testing unit deployed to the residence hall the following day, with testing of nearly 200 students and staff, which identified two laboratory-confirmed cases of Alpha variant COVID-19. These individuals were relocated to a separate quarantine facility, averting an outbreak on campus. Aggregating wastewater and clinical data, the campus wastewater surveillance program has yielded the first estimates of fecal shedding rates of the Alpha VOC of SARS-CoV-2 in individuals from a nonclinical setting. IMPORTANCE Among early adopters of wastewater monitoring for SARS-CoV-2 have been colleges and universities throughout North America, many of whom are using this approach to monitor congregate living facilities for early evidence of COVID-19 infection as an integral component of campus screening programs. Yet, while there have been numerous examples where wastewater monitoring on a university campus has detected evidence for infection among community members, there are few examples where this monitoring triggered a public health response that may have averted an actual outbreak. This report details a wastewater-testing program targeting a residence hall on a university campus during spring 2021, when there was mounting concern globally over the emergence of SARS-CoV-2 variants of concern, reported to be more transmissible than the wild-type Wuhan strain. In this communication, we present a clear example of how wastewater monitoring resulted in actionable responses by university administration and public health, which averted an outbreak of COVID-19 on a university campus.
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Affiliation(s)
- Ryland Corchis-Scott
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
| | - Qiudi Geng
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
| | - Rajesh Seth
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
- Civil and Environmental Engineering, University of Windsor, Windsor, Ontario, Canada
| | - Rajan Ray
- Civil and Environmental Engineering, University of Windsor, Windsor, Ontario, Canada
| | - Mohsan Beg
- Student Counselling Centre, University of Windsor, Windsor, Ontario, Canada
| | - Nihar Biswas
- Civil and Environmental Engineering, University of Windsor, Windsor, Ontario, Canada
| | - Lynn Charron
- Residence Services, University of Windsor, Windsor, Ontario, Canada
| | - Kenneth D. Drouillard
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
- School of the Environment, University of Windsor, Windsor, Ontario, Canada
| | - Ramsey D’Souza
- Windsor-Essex County Health Unit, Windsor, Ontario, Canada
| | - Daniel D. Heath
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
- Department of Integrative Biology, University of Windsor, Windsor, Ontario, Canada
| | - Chris Houser
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
- School of the Environment, University of Windsor, Windsor, Ontario, Canada
| | - Felicia Lawal
- Windsor-Essex County Health Unit, Windsor, Ontario, Canada
| | - James McGinlay
- Residence Services, University of Windsor, Windsor, Ontario, Canada
| | - Sherri Lynne Menard
- Environmental Health and Safety, University of Windsor, Windsor, Ontario, Canada
| | - Lisa A. Porter
- Department of Biomedical Sciences, University of Windsor, Windsor, Ontario, Canada
| | - Diane Rawlings
- Residence Services, University of Windsor, Windsor, Ontario, Canada
| | - Matthew L. Scholl
- Student Health Services, University of Windsor, Windsor, Ontario, Canada
| | - K. W. Michael Siu
- Department of Chemistry and Biochemistry, University of Windsor, Windsor, Ontario, Canada
| | - Yufeng Tong
- Department of Chemistry and Biochemistry, University of Windsor, Windsor, Ontario, Canada
| | - Christopher G. Weisener
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
- School of the Environment, University of Windsor, Windsor, Ontario, Canada
| | - Steven W. Wilhelm
- Department of Microbiology, The University of Tennessee, Knoxville, Tennessee, USA
- Great Lakes Center for Fresh Waters and Human Health, Bowling Green State University, Bowling Green, Ohio, USA
| | - R. Michael L. McKay
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
- School of the Environment, University of Windsor, Windsor, Ontario, Canada
- Great Lakes Center for Fresh Waters and Human Health, Bowling Green State University, Bowling Green, Ohio, USA
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Wolfe MK, Topol A, Knudson A, Simpson A, White B, Vugia DJ, Yu AT, Li L, Balliet M, Stoddard P, Han GS, Wigginton KR, Boehm AB. High-Frequency, High-Throughput Quantification of SARS-CoV-2 RNA in Wastewater Settled Solids at Eight Publicly Owned Treatment Works in Northern California Shows Strong Association with COVID-19 Incidence. mSystems 2021; 6:e0082921. [PMID: 34519528 PMCID: PMC8547422 DOI: 10.1128/msystems.00829-21] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/30/2021] [Indexed: 01/19/2023] Open
Abstract
A number of recent retrospective studies have demonstrated that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA concentrations in wastewater are associated with coronavirus disease 2019 (COVID-19) cases in the corresponding sewersheds. Implementing high-resolution, prospective efforts across multiple plants depends on sensitive measurements that are representative of COVID-19 cases, scalable for high-throughput analysis, and comparable across laboratories. We conducted a prospective study across eight publicly owned treatment works (POTWs). A focus on SARS-CoV-2 RNA in solids enabled us to scale up our measurements with a commercial lab partner. Samples were collected daily, and results were posted to a website within 24 h. SARS-CoV-2 RNA in daily samples correlated with the incidence of COVID-19 cases in the sewersheds; a 1 log10 increase in SARS-CoV-2 RNA in settled solids corresponds to a 0.58 log10 (4×) increase in sewershed incidence rate. SARS-CoV-2 RNA signals measured with the commercial laboratory partner were comparable across plants and comparable to measurements conducted in a university laboratory when normalized by pepper mild mottle virus (PMMoV) RNA. Results suggest that SARS-CoV-2 RNA should be detectable in settled solids for COVID-19 incidence rates of >1/100,000 (range, 0.8 to 2.3 cases per 100,000). These sensitive, representative, scalable, and comparable methods will be valuable for future efforts to scale up wastewater-based epidemiology. IMPORTANCE Access to reliable, rapid monitoring data is critical to guide response to an infectious disease outbreak. For pathogens that are shed in feces or urine, monitoring wastewater can provide a cost-effective snapshot of transmission in an entire community via a single sample. In order for a method to be useful for ongoing COVID-19 monitoring, it should be sensitive for detection of low concentrations of SARS-CoV-2, representative of incidence rates in the community, scalable to generate data quickly, and comparable across laboratories. This paper presents a method utilizing wastewater solids to meet these goals, producing measurements of SARS-CoV-2 RNA strongly associated with COVID-19 cases in the sewershed of a publicly owned treatment work. Results, provided within 24 h, can be used to detect incidence rates as low as approximately 1/100,000 cases and can be normalized for comparison across locations generating data using different methods.
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Affiliation(s)
- Marlene K. Wolfe
- Department of Civil & Environmental Engineering, Stanford University, Stanford, California, USA
| | - Aaron Topol
- Verily Life Sciences, South San Francisco, California, USA
| | - Alisha Knudson
- Verily Life Sciences, South San Francisco, California, USA
| | - Adrian Simpson
- Verily Life Sciences, South San Francisco, California, USA
| | - Bradley White
- Verily Life Sciences, South San Francisco, California, USA
| | - Duc J. Vugia
- California Department of Public Health, Infectious Diseases Branch, Richmond, California, USA
| | - Alexander T. Yu
- California Department of Public Health, Infectious Diseases Branch, Richmond, California, USA
| | - Linlin Li
- County of Santa Clara Public Health Department, San Jose, California, USA
| | - Michael Balliet
- County of Santa Clara Department of Environmental Health, San Jose, California, USA
| | - Pamela Stoddard
- County of Santa Clara Public Health Department, San Jose, California, USA
| | - George S. Han
- County of Santa Clara Public Health Department, San Jose, California, USA
| | - Krista R. Wigginton
- Department of Civil & Environmental Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Alexandria B. Boehm
- Department of Civil & Environmental Engineering, Stanford University, Stanford, California, USA
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Wolfe MK, Topol A, Knudson A, Simpson A, White B, Vugia DJ, Yu AT, Li L, Balliet M, Stoddard P, Han GS, Wigginton KR, Boehm AB. High-Frequency, High-Throughput Quantification of SARS-CoV-2 RNA in Wastewater Settled Solids at Eight Publicly Owned Treatment Works in Northern California Shows Strong Association with COVID-19 Incidence. mSystems 2021; 6:e0082921. [PMID: 34519528 DOI: 10.1101/2021.07.16.21260627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
A number of recent retrospective studies have demonstrated that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA concentrations in wastewater are associated with coronavirus disease 2019 (COVID-19) cases in the corresponding sewersheds. Implementing high-resolution, prospective efforts across multiple plants depends on sensitive measurements that are representative of COVID-19 cases, scalable for high-throughput analysis, and comparable across laboratories. We conducted a prospective study across eight publicly owned treatment works (POTWs). A focus on SARS-CoV-2 RNA in solids enabled us to scale up our measurements with a commercial lab partner. Samples were collected daily, and results were posted to a website within 24 h. SARS-CoV-2 RNA in daily samples correlated with the incidence of COVID-19 cases in the sewersheds; a 1 log10 increase in SARS-CoV-2 RNA in settled solids corresponds to a 0.58 log10 (4×) increase in sewershed incidence rate. SARS-CoV-2 RNA signals measured with the commercial laboratory partner were comparable across plants and comparable to measurements conducted in a university laboratory when normalized by pepper mild mottle virus (PMMoV) RNA. Results suggest that SARS-CoV-2 RNA should be detectable in settled solids for COVID-19 incidence rates of >1/100,000 (range, 0.8 to 2.3 cases per 100,000). These sensitive, representative, scalable, and comparable methods will be valuable for future efforts to scale up wastewater-based epidemiology. IMPORTANCE Access to reliable, rapid monitoring data is critical to guide response to an infectious disease outbreak. For pathogens that are shed in feces or urine, monitoring wastewater can provide a cost-effective snapshot of transmission in an entire community via a single sample. In order for a method to be useful for ongoing COVID-19 monitoring, it should be sensitive for detection of low concentrations of SARS-CoV-2, representative of incidence rates in the community, scalable to generate data quickly, and comparable across laboratories. This paper presents a method utilizing wastewater solids to meet these goals, producing measurements of SARS-CoV-2 RNA strongly associated with COVID-19 cases in the sewershed of a publicly owned treatment work. Results, provided within 24 h, can be used to detect incidence rates as low as approximately 1/100,000 cases and can be normalized for comparison across locations generating data using different methods.
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Affiliation(s)
- Marlene K Wolfe
- Department of Civil & Environmental Engineering, Stanford Universitygrid.168010.e, Stanford, California, USA
| | - Aaron Topol
- Verily Life Sciences, South San Francisco, California, USA
| | - Alisha Knudson
- Verily Life Sciences, South San Francisco, California, USA
| | - Adrian Simpson
- Verily Life Sciences, South San Francisco, California, USA
| | - Bradley White
- Verily Life Sciences, South San Francisco, California, USA
| | - Duc J Vugia
- California Department of Public Health, Infectious Diseases Branch, Richmond, California, USA
| | - Alexander T Yu
- California Department of Public Health, Infectious Diseases Branch, Richmond, California, USA
| | - Linlin Li
- County of Santa Clara Public Health Department, San Jose, California, USA
| | - Michael Balliet
- County of Santa Clara Department of Environmental Health, San Jose, California, USA
| | - Pamela Stoddard
- County of Santa Clara Public Health Department, San Jose, California, USA
| | - George S Han
- County of Santa Clara Public Health Department, San Jose, California, USA
| | - Krista R Wigginton
- Department of Civil & Environmental Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Alexandria B Boehm
- Department of Civil & Environmental Engineering, Stanford Universitygrid.168010.e, Stanford, California, USA
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Sanchez-Galan JE, Ureña G, Escovar LF, Fabrega-Duque JR, Coles A, Kurt Z. Challenges to detect SARS-CoV-2 on environmental media, the need and strategies to implement the detection methodologies in wastewaters. JOURNAL OF ENVIRONMENTAL CHEMICAL ENGINEERING 2021; 9:105881. [PMID: 34221893 PMCID: PMC8239206 DOI: 10.1016/j.jece.2021.105881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/15/2021] [Accepted: 06/13/2021] [Indexed: 06/13/2023]
Abstract
Understanding risks, putting in place preventative methods to seamlessly continue daily activities are essential tools to fight a pandemic. All social, commercial and leisure activities have an impact on the environmental media. Therefore, to accurately predict the fate and behavior of viruses in the environment, it is necessary to understand and analyze available detection methods, possible transmission pathways and preventative techniques. The aim of this review is to critically analyze and summarize the research done regarding SARS-COV-2 virus detection, focusing on sampling and laboratory detection methods in environmental media. Special attention will be given to wastewater and sewage sludge. This review has summarized the survival of the virus on surfaces to estimate the risk carried by different environmental media (water, wastewater, air and soil) in order to explain which communities are under higher risk. The critical analysis concludes that the detection of SARS-CoV-2 with current technologies and sampling strategies would reveal the presence of the virus. This information could be used to design systematic sampling points throughout the sewage systems when available, taking into account peak flows and more importantly economic factors on when to sample. Such approaches will provide clues for potential future viral outbreak, saving financial resources by reducing testing necessities for viral detection, hence contributing for more appropriate confinement policies by governments and could be further used to define more precisely post-pandemic or additional waves measures if/ when needed.
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Affiliation(s)
- Javier E Sanchez-Galan
- Facultad de Ingeniería de Sistemas Computacionales (FISC), Universidad Tecnológica de Panamá, Panama
- Grupo de Investigación en Biotecnología, Bioinformática y Biología de Sistemas (GIBBS), Universidad Tecnológica de Panamá, Panama
- Institute of Scientific Research and High Technology Services, Panama City, Panama
| | - Grimaldo Ureña
- Grupo de Investigación en Biotecnología, Bioinformática y Biología de Sistemas (GIBBS), Universidad Tecnológica de Panamá, Panama
- Theoretical Evolutionary Genetics Laboratory, University of Houston, Houston, TX, USA
| | | | - Jose R Fabrega-Duque
- Centro de Investigaciones Hidráulicas e Hidrotécnicas (CIHH), Universidad Tecnologica de Panama, Panama
| | - Alexander Coles
- Centro de Investigaciones Hidráulicas e Hidrotécnicas (CIHH), Universidad Tecnologica de Panama, Panama
| | - Zohre Kurt
- Grupo de Investigación en Biotecnología, Bioinformática y Biología de Sistemas (GIBBS), Universidad Tecnológica de Panamá, Panama
- Urban Risk Center, Florida State University-Panama, Panama
- Institute of Scientific Research and High Technology Services, Panama City, Panama
- Department of Environmental Engineering, Middle East Technical University, Ankara, Turkey
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Rouchka EC, Chariker JH, Saurabh K, Waigel S, Zacharias W, Zhang M, Talley D, Santisteban I, Puccio M, Moyer S, Holm RH, Yeager RA, Sokoloski KJ, Fuqua J, Bhatnagar A, Smith T. The Rapid Assessment of Aggregated Wastewater Samples for Genomic Surveillance of SARS-CoV-2 on a City-Wide Scale. Pathogens 2021; 10:1271. [PMID: 34684220 PMCID: PMC8541652 DOI: 10.3390/pathogens10101271] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/03/2021] [Accepted: 09/28/2021] [Indexed: 01/08/2023] Open
Abstract
Throughout the course of the ongoing SARS-CoV-2 pandemic there has been a need for approaches that enable rapid monitoring of public health using an unbiased and minimally invasive means. A major way this has been accomplished is through the regular assessment of wastewater samples by qRT-PCR to detect the prevalence of viral nucleic acid with respect to time and location. Further expansion of SARS-CoV-2 wastewater monitoring efforts to include the detection of variants of interest/concern through next-generation sequencing has enhanced the understanding of the SARS-CoV-2 outbreak. In this report, we detail the results of a collaborative effort between public health and metropolitan wastewater management authorities and the University of Louisville to monitor the SARS-CoV-2 pandemic through the monitoring of aggregate wastewater samples over a period of 28 weeks. Through the use of next-generation sequencing approaches the polymorphism signatures of Variants of Concern/Interest were evaluated to determine the likelihood of their prevalence within the community on the basis of their relative dominance within sequence datasets. Our data indicate that wastewater monitoring of water quality treatment centers and smaller neighborhood-scale catchment areas is a viable means by which the prevalence and genetic variation of SARS-CoV-2 within a metropolitan community of approximately one million individuals may be monitored, as our efforts detected the introduction and emergence of variants of concern in the city of Louisville. Importantly, these efforts confirm that regional emergence and spread of variants of interest/concern may be detected as readily in aggregate wastewater samples as compared to the individual wastewater sheds. Furthermore, the information gained from these efforts enabled targeted public health efforts including increased outreach to at-risk communities and the deployment of mobile or community-focused vaccination campaigns.
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Affiliation(s)
- Eric C. Rouchka
- Department of Biochemistry and Molecular Genetics, University of Louisville, 323 E. Chestnut St., Louisville, KY 40202, USA;
- KY INBRE Bioinformatics Core, University of Louisville, 522 E. Gray St., Louisville, KY 40202, USA;
| | - Julia H. Chariker
- KY INBRE Bioinformatics Core, University of Louisville, 522 E. Gray St., Louisville, KY 40202, USA;
| | - Kumar Saurabh
- Brown Cancer Center, University of Louisville, 530 S. Jackson St., Louisville, KY 40202, USA;
| | - Sabine Waigel
- Department of Medicine, University of Louisville, 530 S. Jackson St., Louisville, KY 40402, USA; (S.W.); (W.Z.)
| | - Wolfgang Zacharias
- Department of Medicine, University of Louisville, 530 S. Jackson St., Louisville, KY 40402, USA; (S.W.); (W.Z.)
| | - Mei Zhang
- Department of Neuroscience, University of Louisville, 505 S. Hancock St., Louisville, KY 40202, USA;
| | - Daymond Talley
- Louisville/Jefferson County Metropolitan Sewer District, Morris Forman Water Quality Treatment Center, 4522 Algonquin Parkway, Louisville, KY 40211, USA;
| | - Ian Santisteban
- Department of Pharmacology and Toxicology, University of Louisville, 505 S. Hancock St., Louisville, KY 40202, USA;
- Center for Predictive Medicine, University of Louisville, 505 S. Hancock St., Louisville, KY 40202, USA
| | - Madeline Puccio
- Christina Lee Brown Envirome Institute, University of Louisville, 302 E. Muhammad Ali Blvd., Louisville, KY 40202, USA; (M.P.); (R.H.H.); (R.A.Y.); (A.B.); (T.S.)
| | - Sarah Moyer
- Department of Health Management and System Sciences, School of Public Health and Information Sciences, University of Louisville, 485 E. Gray St., Louisville, KY 40202, USA;
- Department of Public Health and Wellness, Louisville Metro Government, 400 E. Gray St., Louisville, KY 40202, USA
| | - Rochelle H. Holm
- Christina Lee Brown Envirome Institute, University of Louisville, 302 E. Muhammad Ali Blvd., Louisville, KY 40202, USA; (M.P.); (R.H.H.); (R.A.Y.); (A.B.); (T.S.)
| | - Ray A. Yeager
- Christina Lee Brown Envirome Institute, University of Louisville, 302 E. Muhammad Ali Blvd., Louisville, KY 40202, USA; (M.P.); (R.H.H.); (R.A.Y.); (A.B.); (T.S.)
- Department of Environmental and Occupational Health Sciences, School of Public Health and Information Sciences, University of Louisville, 485 E. Gray St., Louisville, KY 40202, USA
| | - Kevin J. Sokoloski
- Center for Predictive Medicine, University of Louisville, 505 S. Hancock St., Louisville, KY 40202, USA
- Department of Microbiology and Immunology, University of Louisville, 505 S. Hancock St., Louisville, KY 40202, USA
| | - Joshua Fuqua
- Department of Pharmacology and Toxicology, University of Louisville, 505 S. Hancock St., Louisville, KY 40202, USA;
- Center for Predictive Medicine, University of Louisville, 505 S. Hancock St., Louisville, KY 40202, USA
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute, University of Louisville, 302 E. Muhammad Ali Blvd., Louisville, KY 40202, USA; (M.P.); (R.H.H.); (R.A.Y.); (A.B.); (T.S.)
| | - Ted Smith
- Christina Lee Brown Envirome Institute, University of Louisville, 302 E. Muhammad Ali Blvd., Louisville, KY 40202, USA; (M.P.); (R.H.H.); (R.A.Y.); (A.B.); (T.S.)
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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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Wilder ML, Middleton F, Larsen DA, Du Q, Fenty A, Zeng T, Insaf T, Kilaru P, Collins M, Kmush B, Green HC. Co-quantification of crAssphage increases confidence in wastewater-based epidemiology for SARS-CoV-2 in low prevalence areas. WATER RESEARCH X 2021; 11:100100. [PMID: 33842875 PMCID: PMC8021452 DOI: 10.1016/j.wroa.2021.100100] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/16/2021] [Accepted: 04/01/2021] [Indexed: 05/17/2023]
Abstract
Wastewater surveillance of SARS-CoV-2 RNA is increasingly being incorporated into public health efforts to respond to the COVID-19 pandemic. In order to obtain the maximum benefit from these efforts, approaches to wastewater monitoring need to be rapid, sensitive, and relatable to relevant epidemiological parameters. In this study, we present an ultracentrifugation-based method for the concentration of SARS-CoV-2 wastewater RNA and use crAssphage, a bacteriophage specific to the human gut, to help account for RNA loss during transit in the wastewater system and sample processing. With these methods, we were able to detect, and sometimes quantify, SARS-CoV-2 RNA from 20 mL wastewater samples within as little as 4.5 hours. Using known concentrations of bovine coronavirus RNA and deactivated SARS-CoV-2, we estimate recovery rates of approximately 7-12% of viral RNA using our method. Results from 24 sewersheds across Upstate New York during the spring and summer of 2020 suggested that stronger signals of SARS-CoV-2 RNA from wastewater may be indicative of greater COVID-19 incidence in the represented service area approximately one week in advance. SARS-CoV-2 wastewater RNA was quantifiable in some service areas with daily positives tests of less than 1 per 10,000 people or when weekly positive test rates within a sewershed were as low as 1.7%. crAssphage DNA concentrations were significantly lower during periods of high flow in almost all areas studied. After accounting for flow rate and population served, crAssphage levels per capita were estimated to be about 1.35 × 1011 and 2.42 × 108 genome copies per day for DNA and RNA, respectively. A negative relationship between per capita crAssphage RNA and service area size was also observed likely reflecting degradation of RNA over long transit times. Our results reinforce the potential for wastewater surveillance to be used as a tool to supplement understanding of infectious disease transmission obtained by traditional testing and highlight the potential for crAssphage co-detection to improve interpretations of wastewater surveillance data.
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Affiliation(s)
- Maxwell L. Wilder
- Department of Environmental and Forest Biology, SUNY-ESF, Syracuse, NY 13210
| | - Frank Middleton
- Department of Neuroscience and Physiology, Upstate Medical University, Syracuse, NY 13210
| | - David A. Larsen
- Department of Public Health, Syracuse University, Syracuse, NY 13244
| | - Qian Du
- Quadrant Biosciences, Syracuse, NY 13210
| | - Ariana Fenty
- Department of Environmental and Forest Biology, SUNY-ESF, Syracuse, NY 13210
| | - Teng Zeng
- Department of Civil & Environmental Engineering, Syracuse University, Syracuse, NY 13244
| | - Tabassum Insaf
- Bureau of Environmental and Occupational Epidemiology, New York State Department of Health, Albany, NY 12337
- Department of Epidemiology and Biostatistics, University at Albany, Rensselaer, NY 12144
| | - Pruthvi Kilaru
- Department of Public Health, Syracuse University, Syracuse, NY 13244
| | - Mary Collins
- Department of Environmental Studies, SUNY-ESF, Syracuse, NY 13210
| | - Brittany Kmush
- Department of Public Health, Syracuse University, Syracuse, NY 13244
| | - Hyatt C. Green
- Department of Environmental and Forest Biology, SUNY-ESF, Syracuse, NY 13210
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