1
|
Keck JW, Adatorwovor R, Liversedge M, Mijotavich B, Olsson C, Strike WD, Amirsoleimani A, Noble A, Torabi S, Rockward A, Banadaki MD, Smith T, Lacy P, Berry SM. Wastewater Surveillance for Identifying SARS-CoV-2 Infections in Long-Term Care Facilities, Kentucky, USA, 2021-2022. Emerg Infect Dis 2024; 30:530-538. [PMID: 38407144 PMCID: PMC10902530 DOI: 10.3201/eid3003.230888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
Persons living in long-term care facilities (LTCFs) were disproportionately affected by COVID-19. We used wastewater surveillance to detect SARS-CoV-2 infection in this setting by collecting and testing 24-hour composite wastewater samples 2-4 times weekly at 6 LTCFs in Kentucky, USA, during March 2021-February 2022. The LTCFs routinely tested staff and symptomatic and exposed residents for SARS-CoV-2 using rapid antigen tests. Of 780 wastewater samples analyzed, 22% (n = 173) had detectable SARS-CoV-2 RNA. The LTCFs reported 161 positive (of 16,905) SARS-CoV-2 clinical tests. The wastewater SARS-CoV-2 signal showed variable correlation with clinical test data; we observed the strongest correlations in the LTCFs with the most positive clinical tests (n = 45 and n = 58). Wastewater surveillance was 48% sensitive and 80% specific in identifying SARS-CoV-2 infections found on clinical testing, which was limited by frequency, coverage, and rapid antigen test performance.
Collapse
Affiliation(s)
| | - Reuben Adatorwovor
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | | | - Blazan Mijotavich
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | - Cullen Olsson
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | - William D. Strike
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | - Atena Amirsoleimani
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | - Ann Noble
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | - Soroosh Torabi
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | - Alexus Rockward
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | - Mohammad Dehghan Banadaki
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | - Ted Smith
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | - Parker Lacy
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | - Scott M. Berry
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| |
Collapse
|
2
|
Dehghan Banadaki M, Torabi S, Rockward A, Strike WD, Noble A, Keck JW, Berry SM. Simple SARS-CoV-2 concentration methods for wastewater surveillance in low resource settings. Sci Total Environ 2024; 912:168782. [PMID: 38000737 PMCID: PMC10842712 DOI: 10.1016/j.scitotenv.2023.168782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 11/26/2023]
Abstract
Wastewater-based epidemiology (WBE) measures pathogens in wastewater to monitor infectious disease prevalence in communities. Due to the high dilution of pathogens in sewage, a concentration method is often required to achieve reliable biomarker signals. However, most of the current concentration methods rely on expensive equipment and labor-intensive processes, which limits the application of WBE in low-resource settings. Here, we compared the performance of four inexpensive and simple concentration methods to detect SARS-CoV-2 in wastewater samples: Solid Fraction, Porcine Gastric Mucin-conjugated Magnetic Beads, Calcium Flocculation-Citrate Dissolution (CFCD), and Nanotrap® Magnetic Beads (NMBs). The NMBs and CFCD methods yielded the highest concentration performance for SARS-CoV-2 (∼16-fold concentration and ∼ 41 % recovery) and require <45 min processing time. CFCD has a relatively low consumable cost (<$2 per four sample replicates). All methods can be performed with basic laboratory equipment and minimal electricity usage which enables further application of WBE in remote areas and low resource settings.
Collapse
Affiliation(s)
| | - Soroosh Torabi
- Department of Mechanical Engineering, College of Engineering, University of Kentucky, United States
| | - Alexus Rockward
- Department of Biomedical Engineering, College of Engineering, University of Kentucky, United States
| | - William D Strike
- Department of Biomedical Engineering, College of Engineering, University of Kentucky, United States
| | - Ann Noble
- Department of Mechanical Engineering, College of Engineering, University of Kentucky, United States
| | - James W Keck
- WWAMI School of Medicine, University of Alaska Anchorage, United States
| | - Scott M Berry
- Department of Mechanical Engineering, College of Engineering, University of Kentucky, United States; Department of Biomedical Engineering, College of Engineering, University of Kentucky, United States.
| |
Collapse
|
3
|
Torabi S, Amirsoleimani A, Dehghan Banadaki M, Strike WD, Rockward A, Noble A, Liversedge M, Keck JW, Berry SM. Stabilization of SARS-CoV-2 RNA in wastewater via rapid RNA extraction. Sci Total Environ 2023; 878:162992. [PMID: 36948314 PMCID: PMC10028336 DOI: 10.1016/j.scitotenv.2023.162992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/21/2022] [Accepted: 03/17/2023] [Indexed: 05/13/2023]
Abstract
Wastewater-based Epidemiology (WBE) has contributed to surveillance of SARS-CoV-2 in communities across the world. Both symptomatic and asymptomatic patients with COVID-19 can shed the virus through the gastrointestinal tract, enabling the quantification of the virus in stool and ultimately in wastewater (WW). Unfortunately, instability of SARS-CoV-2 RNA in wastewater limits the utility of WBE programs, particularly in remote/rural regions where reliable cold storage and/or rapid shipping may be unavailable. This study examined whether rapid SARS-CoV-2 RNA extraction on the day of sample collection could minimize degradation. Importantly, the extraction technology used in these experiments, termed exclusion-based sample preparation (ESP), is lightweight, portable, and electricity-free, making it suitable for implementation in remote settings. We demonstrated that immediate RNA extraction followed by ambient storage significantly increased the RNA half-life compared to raw wastewater samples stored at both 4 °C or ambient temperature. Given that RNA degradation negatively impacts both the sensitivity and precision of WBE measurements, efforts must be made to mitigate degradation in order to maximize the potential impact of WBE on public health.
Collapse
Affiliation(s)
- Soroosh Torabi
- Department of Mechanical Engineering, College of Engineering, University of Kentucky, United States of America
| | - Atena Amirsoleimani
- Department of Mechanical Engineering, College of Engineering, University of Kentucky, United States of America
| | - Mohammad Dehghan Banadaki
- Department of Mechanical Engineering, College of Engineering, University of Kentucky, United States of America
| | - William Dalton Strike
- Department of Biomedical Engineering, College of Engineering, University of Kentucky, United States of America
| | - Alexus Rockward
- Department of Biomedical Engineering, College of Engineering, University of Kentucky, United States of America
| | - Ann Noble
- Department of Mechanical Engineering, College of Engineering, University of Kentucky, United States of America
| | - Matthew Liversedge
- Department of Family and Community Medicine, College of Medicine, University of Kentucky, United States of America
| | - James W Keck
- Department of Family and Community Medicine, College of Medicine, University of Kentucky, United States of America
| | - Scott M Berry
- Department of Mechanical Engineering, College of Engineering, University of Kentucky, United States of America; Department of Biomedical Engineering, College of Engineering, University of Kentucky, United States of America.
| |
Collapse
|
4
|
Strike W, Amirsoleimani A, Olaleye A, Noble A, Lewis K, Faulkner L, Backus S, Lindeman S, Eterovich K, Fraley M, Banadaki MD, Torabi S, Rockward A, Zeitlow E, Liversedge M, Keck J, Berry S. Development and Validation of a Simplified Method for Analysis of SARS-CoV-2 RNA in University Dormitories. ACS ES T Water 2022; 2:1984-1991. [PMID: 37552725 PMCID: PMC9115885 DOI: 10.1021/acsestwater.2c00044] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/26/2022] [Accepted: 05/02/2022] [Indexed: 05/26/2023]
Abstract
Over the course of the COVID-19 pandemic, wastewater surveillance has become a useful tool for describing SARS-CoV-2 prevalence in populations of varying size, from individual facilities (e.g., university residence halls, nursing homes, prisons) to entire municipalities. Wastewater analysis for SARS-CoV-2 RNA requires specialized equipment, expensive consumables, and expert staff, limiting its feasibility and scalability. Further, the extremely labile nature of viral RNA complicates sample transportation, especially in regions with limited access to reliable cold chains. Here, we present a new method for wastewater analysis, termed exclusion-based sample preparation (ESP), that substantially simplifies workflow (at least 70% decrease in time; 40% decrease in consumable usage compared with traditional techniques) by targeting the labor-intensive processing steps of RNA purification and concentration. To optimize and validate this method, we analyzed wastewater samples from residence halls at the University of Kentucky, of which 34% (44/129) contained detectible SARS-CoV-2 RNA. Although concurrent clinical testing was not comprehensive, student infections were identified in the 7 days following a positive wastewater detection in 68% of samples. This pilot study among university residence halls validated the performance and utility of the ESP method, laying the foundation for future studies in regions of the world where wastewater testing is not currently feasible.
Collapse
Affiliation(s)
- William Strike
- Departments of Biomedical Engineering, University of Kentucky, 151 Ralph G. Anderson Building Lexington, KY 40506-0503
| | - Atena Amirsoleimani
- Mechanical Engineering, University of Kentucky, 151 Ralph G. Anderson Building Lexington, KY 40506-0503
| | - Abisola Olaleye
- Mechanical Engineering, University of Kentucky, 151 Ralph G. Anderson Building Lexington, KY 40506-0503
| | - Ann Noble
- Mechanical Engineering, University of Kentucky, 151 Ralph G. Anderson Building Lexington, KY 40506-0503
| | - Kevin Lewis
- Environmental Quality Management, University of Kentucky, 355 Cooper Drive, Lexington, KY 40508
| | - Lee Faulkner
- Environmental Quality Management, University of Kentucky, 355 Cooper Drive, Lexington, KY 40508
| | - Spencer Backus
- Mechanical Engineering, University of Kentucky, 151 Ralph G. Anderson Building Lexington, KY 40506-0503
| | - Sierra Lindeman
- Mechanical Engineering, University of Kentucky, 151 Ralph G. Anderson Building Lexington, KY 40506-0503
| | - Katrina Eterovich
- Mechanical Engineering, University of Kentucky, 151 Ralph G. Anderson Building Lexington, KY 40506-0503
| | - Melicity Fraley
- Mechanical Engineering, University of Kentucky, 151 Ralph G. Anderson Building Lexington, KY 40506-0503
| | - Mohammad Dehghan Banadaki
- Mechanical Engineering, University of Kentucky, 151 Ralph G. Anderson Building Lexington, KY 40506-0503
| | - Soroosh Torabi
- Mechanical Engineering, University of Kentucky, 151 Ralph G. Anderson Building Lexington, KY 40506-0503
| | - Alexus Rockward
- Departments of Biomedical Engineering, University of Kentucky, 151 Ralph G. Anderson Building Lexington, KY 40506-0503
| | - Eli Zeitlow
- Department of Mechanical Engineering, University of Wisconsin-Platteville, 1 University Plaza, Platteville, WI 53818
| | - Matthew Liversedge
- Family and Community Medicine, University of Kentucky 2195 Harrodsburg Rd, Ste 125, Lexington, KY 40504
| | - James Keck
- Family and Community Medicine, University of Kentucky 2195 Harrodsburg Rd, Ste 125, Lexington, KY 40504
| | - Scott Berry
- Departments of Biomedical Engineering, University of Kentucky, 151 Ralph G. Anderson Building Lexington, KY 40506-0503
- Mechanical Engineering, University of Kentucky, 151 Ralph G. Anderson Building Lexington, KY 40506-0503
| |
Collapse
|