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Ribeiro AVC, Mannarino CF, Novo SPC, Prado T, Lermontov A, de Paula BB, Fumian TM, Miagostovich MP. Assessment of crAssphage as a biological variable for SARS-CoV-2 data normalization in wastewater surveillance. J Appl Microbiol 2024; 135:lxae177. [PMID: 39013607 DOI: 10.1093/jambio/lxae177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 07/09/2024] [Accepted: 07/15/2024] [Indexed: 07/18/2024]
Abstract
AIMS This study aimed to assess the use of cross-assembled phage (crAssphage) as an endogenous control employing a multivariate normalization analysis and its application as a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) data normalizer. METHODS AND RESULTS A total of 188 twelve-hour composite raw sewage samples were obtained from eight wastewater treatment plants (WWTP) during a 1-year monitoring period. Employing the N1 and N2 target regions, SARS-CoV-2 RNA was detected in 94% (177) and 90% (170) of the samples, respectively, with a global median of 5 log10 genomic copies per liter (GC l-1). CrAssphage was detected in 100% of the samples, ranging from 8.29 to 10.43 log10 GC l-1, with a median of 9.46 ± 0.40 log10 GC l-1, presenting both spatial and temporal variabilities. CONCLUSIONS Although SARS-CoV-2 data normalization employing crAssphage revealed a correlation with clinical cases occurring during the study period, crAssphage normalization by the flow per capita per day of each WWTP increased this correlation, corroborating the importance of normalizing wastewater surveillance data in disease trend monitoring.
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Affiliation(s)
- André Vinicius Costa Ribeiro
- Department of Sanitation and Environmental Health, Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil
| | - Camille Ferreira Mannarino
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil
| | - Shênia Patrícia Corrêa Novo
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil
| | - Tatiana Prado
- Laboratory of Respiratory, Exanthematic, Enteroviruses and Viral Emergencies, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil
| | - André Lermontov
- Chemical and Biochemical Process Technology, School of Chemistry/Federal University of Rio de Janeiro - EQ/UFRJ, Rio de Janeiro 21941-909, Brazil
| | - Bruna Barbosa de Paula
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil
| | - Tulio Machado Fumian
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil
| | - Marize Pereira Miagostovich
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil
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Patiño LH, Ballesteros N, Muñoz M, Ramírez AL, Castañeda S, Galeano LA, Hidalgo A, Paniz-Mondolfi A, Ramírez JD. Global and genetic diversity of SARS-CoV-2 in wastewater. Heliyon 2024; 10:e27452. [PMID: 38463823 PMCID: PMC10923837 DOI: 10.1016/j.heliyon.2024.e27452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/03/2024] [Accepted: 02/28/2024] [Indexed: 03/12/2024] Open
Abstract
The analysis of SARS-CoV-2 in wastewater has enabled us to better understand the spread and evolution of the virus worldwide. To deepen our understanding of its epidemiological and genomic characteristics, we analyzed 10,147 SARS-CoV-2 sequences from 5 continents and 21 countries that were deposited in the GISAID database up until January 31, 2023. Our results revealed over 100 independent lineages of the virus circulating in water samples from March 2020 to January 2023, including variants of interest and concern. We observed four clearly defined periods of global distribution of these variants over time, with one variant being replaced by another. Interestingly, we found that SARS-CoV-2 water-borne sequences from different countries had a close phylogenetic relationship. Additionally, 40 SARS-CoV-2 water-borne sequences from Europe and the USA did not show any phylogenetic relationship with SARS-CoV-2 human sequences. We also identified a significant number of non-synonymous mutations, some of which were detected in previously reported cryptic lineages. Among the countries analyzed, France and the USA showed the highest degree of sequence diversity, while Austria reported the highest number of genomes (6,296). Our study provides valuable information about the epidemiological and genomic diversity of SARS-CoV-2 in wastewater, which can be employed to support public health initiatives and preparedness.
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Affiliation(s)
- Luz Helena Patiño
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, 111321, Colombia
| | - Nathalia Ballesteros
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, 111321, Colombia
| | - Marina Muñoz
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, 111321, Colombia
| | - Angie Lorena Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, 111321, Colombia
| | - Sergio Castañeda
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, 111321, Colombia
| | - Luis Alejandro Galeano
- Grupo de Investigación en Materiales Funcionales y Catálisis (GIMFC), Departamento de Química, Universidad de Nariño, Pasto, 52002, Colombia
| | - Arsenio Hidalgo
- Grupo de Investigación en Salud Pública, Departamento de Matemáticas, Universidad de Nariño, Pasto, 50002, Colombia
| | - Alberto Paniz-Mondolfi
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, 111321, Colombia
| | - Juan David Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, 111321, Colombia
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3
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Sweetapple C, Wade MJ, Melville-Shreeve P, Chen AS, Lilley C, Irving J, Grimsley JMS, Bunce JT. Dynamic population normalisation in wastewater-based epidemiology for improved understanding of the SARS-CoV-2 prevalence: a multi-site study. JOURNAL OF WATER AND HEALTH 2023; 21:625-642. [PMID: 37254910 PMCID: wh_2023_318 DOI: 10.2166/wh.2023.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Wastewater-based epidemiology (WBE) is a valuable tool for monitoring the circulation of COVID-19. However, while variations in population size are recognised as major sources of uncertainty, wastewater SARS-CoV-2 measurements are not routinely population-normalised. This paper aims to determine whether dynamic population normalisation significantly alters SARS-CoV-2 dynamics observed through wastewater monitoring, and whether it is beneficial or necessary to provide an understanding of COVID-19 epidemiology. Data from 394 sites in England are used, and normalisation is implemented based on ammoniacal nitrogen and orthophosphate concentrations. Raw and normalised wastewater SARS-CoV-2 metrics are evaluated at the site and spatially aggregated levels are compared against indicators of prevalence based on the Coronavirus Infection Survey and Test and Trace polymerase chain reaction test results. Normalisation is shown, on average, to have a limited impact on overall temporal trends. However, significant variability in the degree to which it affects local-level trends is observed. This is not evident from previous WBE studies focused on single sites and, critically, demonstrates that while the impact of normalisation on SARS-CoV-2 trends is small on average, this may not always be the case. When averaged across many sites, normalisation strengthens the correlation between wastewater SARS-CoV-2 data and prevalence indicators; however, confidence in the improvement is low.
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Affiliation(s)
- Chris Sweetapple
- UK Health Security Agency, Environmental Monitoring for Health Protection, Nobel House, London SW1P 3JR, United Kingdom E-mail: ; Centre for Water Systems, Faculty of Environment, Science and Economy, University of Exeter, Exeter EX4 4QF, United Kingdom
| | - Matthew J Wade
- UK Health Security Agency, Environmental Monitoring for Health Protection, Nobel House, London SW1P 3JR, United Kingdom E-mail: ; School of Engineering, Newcastle University, Newcastle-upon-Tyne NE1 7RU, United Kingdom
| | - Peter Melville-Shreeve
- Centre for Water Systems, Faculty of Environment, Science and Economy, University of Exeter, Exeter EX4 4QF, United Kingdom
| | - Albert S Chen
- Centre for Water Systems, Faculty of Environment, Science and Economy, University of Exeter, Exeter EX4 4QF, United Kingdom
| | - Chris Lilley
- UK Health Security Agency, Environmental Monitoring for Health Protection, Nobel House, London SW1P 3JR, United Kingdom E-mail:
| | - Jessica Irving
- UK Health Security Agency, Environmental Monitoring for Health Protection, Nobel House, London SW1P 3JR, United Kingdom E-mail:
| | - Jasmine M S Grimsley
- UK Health Security Agency, Environmental Monitoring for Health Protection, Nobel House, London SW1P 3JR, United Kingdom E-mail: ; The London Data Company, London EC2N 2AT, UK
| | - Joshua T Bunce
- UK Health Security Agency, Environmental Monitoring for Health Protection, Nobel House, London SW1P 3JR, United Kingdom E-mail: ; School of Engineering, Newcastle University, Newcastle-upon-Tyne NE1 7RU, United Kingdom; Department for Environment, Food and Rural Affairs, Seacole Building, London SW1P 4DF, United Kingdom
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4
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Rainey AL, Liang S, Bisesi JH, Sabo-Attwood T, Maurelli AT. A multistate assessment of population normalization factors for wastewater-based epidemiology of COVID-19. PLoS One 2023; 18:e0284370. [PMID: 37043469 PMCID: PMC10096268 DOI: 10.1371/journal.pone.0284370] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/29/2023] [Indexed: 04/13/2023] Open
Abstract
Wastewater-based epidemiology (WBE) has become a valuable tool for monitoring SARS-CoV-2 infection trends throughout the COVID-19 pandemic. Population biomarkers that measure the relative human fecal contribution to normalize SARS-CoV-2 wastewater concentrations are needed for improved analysis and interpretation of community infection trends. The Centers for Disease Control and Prevention National Wastewater Surveillance System (CDC NWSS) recommends using the wastewater flow rate or human fecal indicators as population normalization factors. However, there is no consensus on which normalization factor performs best. In this study, we provided the first multistate assessment of the effects of flow rate and human fecal indicators (crAssphage, F+ Coliphage, and PMMoV) on the correlation of SARS-CoV-2 wastewater concentrations and COVID-19 cases using the CDC NWSS dataset of 182 communities across six U.S. states. Flow normalized SARS-CoV-2 wastewater concentrations produced the strongest correlation with COVID-19 cases. The correlation from the three human fecal indicators were significantly lower than flow rate. Additionally, using reverse transcription droplet digital polymerase chain reaction (RT-ddPCR) significantly improved correlation values over samples that were analyzed with real-time reverse transcription quantitative polymerase chain reaction (rRT-qPCR). Our assessment shows that utilizing flow normalization with RT-ddPCR generate the strongest correlation between SARS-CoV-2 wastewater concentrations and COVID-19 cases.
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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, Florida, United States of America
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
| | - Song Liang
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
| | - Joseph H. Bisesi
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Center for Environmental and Human Toxicology, University of Florida, Gainesville, Florida, United States of America
| | - Tara Sabo-Attwood
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
- Center for Environmental and Human Toxicology, University of Florida, Gainesville, Florida, United States of America
| | - Anthony T. Maurelli
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
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5
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Wade MJ, Bunce JT, Petterson S, Ferguson C, Del Campo NC, Gaddis E, Karanis P. Editorial: Wastewater-based epidemiology at the frontier of global public health. JOURNAL OF WATER AND HEALTH 2023; 21:iii-vi. [PMID: 37338311 PMCID: wh_2023_001 DOI: 10.2166/wh.2023.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Affiliation(s)
- Matthew J Wade
- Analytics & Data Science Directorate, UK Health Security Agency, Nobel House, Smith Square, London SW1P 3JR, United Kingdom
| | - Joshua T Bunce
- Department for Environment, Food and Rural Affairs, 2 Marsham Street, London SW1P 4DF, United Kingdom
| | - Susan Petterson
- School of Medicine, Griffith University, North Sydney, 2060, Australia
| | | | - Nohelia Castro Del Campo
- Centro de Investigación en Alimentación y Desarrollo, Carretera a Eldorado k.m. 5.5 Campo El Diez, C.P. 80110. Culiacán, Sinaloa, México
| | - Erica Gaddis
- SWCA Environmental Consultants, 257 East 200 South, Salt Lake City, Utah 84111, USA
| | - Panagiotos Karanis
- Unit of Anatomy and Morphology, University of Nicosia Medical School, 21 Ilia Papakyriakou, 2414 Engomi, CY-1700, Nicosia, Cyprus
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6
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Burnet JB, Cauchie HM, Walczak C, Goeders N, Ogorzaly L. Persistence of endogenous RNA biomarkers of SARS-CoV-2 and PMMoV in raw wastewater: Impact of temperature and implications for wastewater-based epidemiology. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 857:159401. [PMID: 36240930 PMCID: PMC9554201 DOI: 10.1016/j.scitotenv.2022.159401] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/21/2022] [Accepted: 10/08/2022] [Indexed: 05/28/2023]
Abstract
Understanding the persistence of SARS-CoV-2 biomarkers in wastewater should guide wastewater-based epidemiology users in selecting best RNA biomarkers for reliable detection of the virus during current and future waves of the pandemic. In the present study, the persistence of endogenous SARS-CoV-2 were assessed during one month for six different RNA biomarkers and for the pepper mild mottle virus (PMMoV) at three different temperatures (4, 12 and 20 °C) in one wastewater sample. All SARS-CoV-2 RNA biomarkers were consistently detected during 6 days at 4° and differences in signal persistence among RNA biomarkers were mostly observed at 20 °C with N biomarkers being globally more persistent than RdRP, E and ORF1ab ones. SARS-CoV-2 signal persistence further decreased in a temperature dependent manner. At 12 and 20 °C, RNA biomarker losses of 1-log10 occurred on average after 6 and 4 days, and led to a complete signal loss after 13 and 6 days, respectively. Besides the effect of temperature, SARS-CoV-2 RNA signals were more persistent in the particulate phase compared to the aqueous one. Finally, PMMoV RNA signal was highly persistent in both phases and significantly differed from that of SARS-CoV-2 biomarkers. We further provide a detailed overview of the latest literature on SARS-CoV-2 and PMMoV decay rates in sewage matrices.
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Affiliation(s)
- Jean-Baptiste Burnet
- Luxembourg Institute of Science and Technology (LIST), Environmental Research & Innovation Department, 41 rue du Brill, L-4422 Belvaux, Luxembourg
| | - Henry-Michel Cauchie
- Luxembourg Institute of Science and Technology (LIST), Environmental Research & Innovation Department, 41 rue du Brill, L-4422 Belvaux, Luxembourg
| | - Cécile Walczak
- Luxembourg Institute of Science and Technology (LIST), Environmental Research & Innovation Department, 41 rue du Brill, L-4422 Belvaux, Luxembourg
| | - Nathalie Goeders
- Luxembourg Institute of Science and Technology (LIST), Environmental Research & Innovation Department, 41 rue du Brill, L-4422 Belvaux, Luxembourg
| | - Leslie Ogorzaly
- Luxembourg Institute of Science and Technology (LIST), Environmental Research & Innovation Department, 41 rue du Brill, L-4422 Belvaux, Luxembourg.
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7
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Markt R, Stillebacher F, Nägele F, Kammerer A, Peer N, Payr M, Scheffknecht C, Dria S, Draxl-Weiskopf S, Mayr M, Rauch W, Kreuzinger N, Rainer L, Bachner F, Zuba M, Ostermann H, Lackner N, Insam H, Wagner AO. Expanding the Pathogen Panel in Wastewater Epidemiology to Influenza and Norovirus. Viruses 2023; 15:263. [PMID: 36851479 PMCID: PMC9966704 DOI: 10.3390/v15020263] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/01/2023] [Accepted: 01/12/2023] [Indexed: 01/18/2023] Open
Abstract
Since the start of the 2019 pandemic, wastewater-based epidemiology (WBE) has proven to be a valuable tool for monitoring the prevalence of SARS-CoV-2. With methods and infrastructure being settled, it is time to expand the potential of this tool to a wider range of pathogens. We used over 500 archived RNA extracts from a WBE program for SARS-CoV-2 surveillance to monitor wastewater from 11 treatment plants for the presence of influenza and norovirus twice a week during the winter season of 2021/2022. Extracts were analyzed via digital PCR for influenza A, influenza B, norovirus GI, and norovirus GII. Resulting viral loads were normalized on the basis of NH4-N. Our results show a good applicability of ammonia-normalization to compare different wastewater treatment plants. Extracts originally prepared for SARS-CoV-2 surveillance contained sufficient genomic material to monitor influenza A, norovirus GI, and GII. Viral loads of influenza A and norovirus GII in wastewater correlated with numbers from infected inpatients. Further, SARS-CoV-2 related non-pharmaceutical interventions affected subsequent changes in viral loads of both pathogens. In conclusion, the expansion of existing WBE surveillance programs to include additional pathogens besides SARS-CoV-2 offers a valuable and cost-efficient possibility to gain public health information.
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Affiliation(s)
- Rudolf Markt
- Department of Microbiology, Universität Innsbruck, 6020 Innsbruck, Austria
- Department of Health Sciences and Social Work, Carinthia University of Applied Sciences, 9020 Klagenfurt, Austria
| | | | - Fabiana Nägele
- Department of Microbiology, Universität Innsbruck, 6020 Innsbruck, Austria
| | - Anna Kammerer
- Department of Microbiology, Universität Innsbruck, 6020 Innsbruck, Austria
| | - Nico Peer
- Department of Microbiology, Universität Innsbruck, 6020 Innsbruck, Austria
| | - Maria Payr
- Department of Microbiology, Universität Innsbruck, 6020 Innsbruck, Austria
| | - Christoph Scheffknecht
- Institut für Umwelt und Lebensmittelsicherheit des Landes Vorarlberg, 6900 Bregenz, Austria
| | - Silvina Dria
- Institut für Umwelt und Lebensmittelsicherheit des Landes Vorarlberg, 6900 Bregenz, Austria
| | | | - Markus Mayr
- Department of Microbiology, Universität Innsbruck, 6020 Innsbruck, Austria
| | - Wolfgang Rauch
- Department of Infrastructure, Universität Innsbruck, 6020 Innsbruck, Austria
| | - Norbert Kreuzinger
- Institute for Water Quality and Resource Management, Technische Universität Wien, 1040 Vienna, Austria
| | - Lukas Rainer
- Austrian National Public Health Institute, 1010 Vienna, Austria
| | - Florian Bachner
- Austrian National Public Health Institute, 1010 Vienna, Austria
| | - Martin Zuba
- Austrian National Public Health Institute, 1010 Vienna, Austria
| | | | - Nina Lackner
- Department of Health Sciences and Social Work, Carinthia University of Applied Sciences, 9020 Klagenfurt, Austria
| | - Heribert Insam
- Department of Microbiology, Universität Innsbruck, 6020 Innsbruck, Austria
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8
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Maal-Bared R, Qiu Y, Li Q, Gao T, Hrudey SE, Bhavanam S, Ruecker NJ, Ellehoj E, Lee BE, Pang X. Does normalization of SARS-CoV-2 concentrations by Pepper Mild Mottle Virus improve correlations and lead time between wastewater surveillance and clinical data in Alberta (Canada): comparing twelve SARS-CoV-2 normalization approaches. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 856:158964. [PMID: 36167131 PMCID: PMC9508694 DOI: 10.1016/j.scitotenv.2022.158964] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/13/2022] [Accepted: 09/19/2022] [Indexed: 05/02/2023]
Abstract
Wastewater-based surveillance (WBS) data normalization is an analyte measurement correction that addresses variations resulting from dilution of fecal discharge by non-sanitary sewage, stormwater or groundwater infiltration. No consensus exists on what WBS normalization parameters result in the strongest correlations and lead time between SARS-CoV-2 WBS data and COVID-19 cases. This study compared flow, population size and biomarker normalization impacts on the correlations and lead times for ten communities in twelve sewersheds in Alberta (Canada) between September 2020 and October 2021 (n = 1024) to determine if normalization by Pepper Mild Mottle Virus (PMMoV) provides any advantages compared to other normalization parameters (e.g., flow, reported and dynamic population sizes, BOD, TSS, NH3, TP). PMMoV concentrations (GC/mL) corresponded with plant influent flows and were highest in the urban centres. SARS-CoV-2 target genes E, N1 and N2 were all negatively associated with wastewater influent pH, while PMMoV was positively associated with temperature. Pooled data analysis showed that normalization increased ρ-values by almost 0.1 and was highest for ammonia, TKN and TP followed by PMMoV. Normalization by other parameters weakened associations. None of the differences were statistically significant. Site-specific correlations showed that normalization of SARS-CoV-2 data by PMMoV only improved correlations significantly in two of the twelve systems; neither were large sewersheds or combined sewer systems. In five systems, normalization by traditional wastewater strength parameters and dynamic population estimates improved correlations. Lead time ranged between 1 and 4 days in both pooled and site-specific comparisons. We recommend that WBS researchers and health departments: a) Investigate WWTP influent properties (e.g., pH) in the WBS planning phase and use at least two parallel approaches for normalization only if shown to provide value; b) Explore normalization by wastewater strength parameters and dynamic population size estimates further; and c) Evaluate purchasing an influent flow meter in small communities to support long-term WBS efforts and WWTP management.
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Affiliation(s)
- Rasha Maal-Bared
- Quality Assurance and Environment, EPCOR Water, Edmonton, Alberta, Canada.
| | - Yuanyuan Qiu
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Qiaozhi Li
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Tiejun Gao
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Steve E Hrudey
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Sudha Bhavanam
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Norma J Ruecker
- Water Quality Services, City of Calgary, Calgary, Alberta, Canada
| | - Erik Ellehoj
- Ellehoj Redmond Consulting, Edmonton, Alberta, Canada
| | - Bonita E Lee
- Department of Paediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Xiaoli Pang
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada; Public Health Laboratories (ProvLab), Alberta Precision Laboratories (APL), Edmonton, Alberta, Canada
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