Critical Needs for Integrated Surveillance: Wastewater-Based and Clinical Epidemiology in Evolving Scenarios with Lessons Learned from SARS-CoV-2

Food and Environmental Virology, Journal Year: 2024, Volume and Issue: 16(1), P. 38 - 49

Published: Jan. 2, 2024

Abstract During the COVID-19 pandemic, wastewater-based epidemiology (WBE) and clinical surveillance have been used as tools for analyzing circulation of SARS-CoV-2 in community, but both approaches can be strongly influenced by some sources variability. From challenging perspective integrating environmental data, we performed a correlation analysis between concentrations raw sewage incident cases areas served medium-size wastewater treatment plants (WWTPs) from 2021 to 2023. To this aim, datasets were adjusted several variability: WBE data factors including analytical protocol, flow, population size, while adjustments considered demographic composition population. Then, addressed impact on differences among sewerage networks variations frequency type swab tests due changes political regulatory scenarios. Wastewater significantly correlated when restrictive containment measures limited movements effect ( ρ = 0.50) confirmed exclusively through molecular testing 0.49). Moreover, positive (although weak) arose WWTPs located densely populated 0.37) with shorter lengths 0.28). This study provides methodological interpreting which could also useful other infections. Data evaluation possible bias need carefully integrated

Language: Английский

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A simple SEIR-V model to estimate COVID-19 prevalence and predict SARS-CoV-2 transmission using wastewater-based surveillance data

The Science of The Total Environment, Journal Year: 2022, Volume and Issue: 857, P. 159326 - 159326

Published: Oct. 8, 2022

Language: Английский

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Wastewater to clinical case (WC) ratio of COVID-19 identifies insufficient clinical testing, onset of new variants of concern and population immunity in urban communities

The Science of The Total Environment, Journal Year: 2022, Volume and Issue: 853, P. 158547 - 158547

Published: Sept. 5, 2022

Clinical testing has been the cornerstone of public health monitoring and infection control efforts in communities throughout COVID-19 pandemic. With anticipated reduction clinical as disease moves into an endemic state, SARS-CoV-2 wastewater surveillance (WWS) will have greater value important diagnostic tool. An in-depth analysis understanding metrics derived from WWS is required to interpret utilize WWS-acquired data effectively (McClary-Gutierrez et al., 2021; O'Keeffe, 2021). In this study, signal cases (WC) ratio was investigated across seven cities Canada over periods ranging 8 21 months. This work demonstrates that significant increases WC occurred when eligibility modified appointment-only testing, identifying a period insufficient (resulting access number daily tests) these communities, despite signal. Furthermore, decreased significantly 6 7 studied locations, serving potential emergence Alpha variant concern (VOC) relatively non-immunized community (40-60 % allelic proportion), while more muted decrease signaled Delta VOC well-immunized proportion). Finally, Omicron VOC, likely because variant's effectiveness at evading immunity, leading new reported cases, even immunity high. The ratio, used additional metric, could complement case counts signals individual its ability identify epidemiological occurrences, adding technology during pandemic for future pandemics.

Language: Английский

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Assessment of seasonality and normalization techniques for wastewater-based surveillance in Ontario, Canada

Frontiers in Public Health, Journal Year: 2023, Volume and Issue: 11

Published: Aug. 30, 2023

Introduction Wastewater-based surveillance is at the forefront of monitoring for community prevalence COVID-19, however, continued uncertainty exists regarding use fecal indicators normalization SARS-CoV-2 virus in wastewater. Using three communities Ontario, sampled from 2021–2023, seasonality a viral indicator (pepper mild mottle virus, PMMoV) and utility data to improve correlations with clinical cases was examined. Methods Wastewater samples Warden, Humber Air Management Facility (AMF), Kitchener were analyzed SARS-CoV-2, PMMoV, crAssphage. The PMMoV flow rates examined compared by Season-Trend-Loess decomposition analysis. effects using crAssphage, comparing episode date (CBED) during 2021. Results Seasonal analysis demonstrated that had similar trends AMF peaks January April 2022 low concentrations (troughs) summer months. Warden but more sporadic between troughs concentrations. Flow not correlated very weak ( r = 0.12). Despite differences among sewersheds, unnormalized (raw N1–N2) concentration wastewater n 99–191) strongly CBED 0.620–0.854) Additionally, did significantly reduced Kitchener. crAssphage 29–57) all sites different raw N1–N2 CBED. Discussion Differences seasonal biomarkers caused sewershed characteristics (flow, input, etc.) may play role determining how effective be improving (or not). This study highlights importance assessing influence on normalized or other viruses concern. Fecal used normalize target interest help hinder establishing outcomes wastewater-based needs considered carefully across seasons sites.

Language: Английский

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Patterns of SARS-CoV-2 circulation revealed by a nationwide sewage surveillance programme, the Netherlands, August 2020 to February 2022

Eurosurveillance, Journal Year: 2023, Volume and Issue: 28(25)

Published: June 22, 2023

Background Surveillance of SARS-CoV-2 in wastewater offers a near real-time tool to track circulation at local scale. However, individual measurements sewage are noisy, inherently variable and can be left-censored. Aim We aimed infer latent virus loads comprehensive surveillance programme that includes all treatment plants (STPs) the Netherlands covers 99.6% Dutch population. Methods applied multilevel Bayesian penalised spline model estimate time- STP-specific based on water flow-adjusted qRT-PCR data for one four samples per week each more than 300 STPs. Results The captured epidemic upsurges downturns Netherlands, despite substantial day-to-day variation measurements. Estimated STP varied by two orders magnitude, from ca 10 12 particles 100,000 persons day trough August 2020 almost 15 many STPs January 2022. timing epidemics level was slightly shifted between municipalities, which resulted less pronounced peaks troughs national level. Conclusion Although is observed load measurements, wastewater-based performed high sampling frequency long-term progression an scale real time.

Language: Английский

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Predicting COVID-19 Incidence Using Wastewater Surveillance Data, Denmark, October 2021–June 2022

Emerging infectious diseases, Journal Year: 2023, Volume and Issue: 29(8)

Published: July 13, 2023

Analysis of wastewater is used in many settings for surveillance SARS-CoV-2, but it remains unclear how well testing results reflect incidence. Denmark has had an extensive analysis system that conducts 3 weekly tests ≈200 sites and 85% population coverage; the country also offers free SARS-CoV-2 PCR to all residents. Using time series modeling, we found data, combined with information on circulating variants number human performed, closely fitted incidence curve persons positive. The were consistent at a regional level among subpopulation frequently tested healthcare personnel. We data estimate after was reduced minimum March 2022. These imply from large-scale can serve as good proxy COVID-19 epidemic control.

Language: Английский

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Results from the SARS-CoV-2 wastewater-based surveillance system in Denmark, July 2021 to June 2022

Water Research, Journal Year: 2024, Volume and Issue: 252, P. 121223 - 121223

Published: Jan. 29, 2024

The microbiological analysis of wastewater samples is increasingly used for the surveillance SARS-CoV-2 globally. We described setup process national wastewater-based system in Denmark, presented its main results during first year activities, from July 2021 to June 2022, and discussed their operational significance. Danish was designed cover 85 % population Denmark it entailed taking three weekly 230 sites. Samples were RT-qPCR tested RNA, targeting genetic markers N1, N2 RdRp, two faecal indicators, Pepper Mild Mottle Virus crAssphage. calculated RNA concentration each sampling site monitored view individual testing, at regional levels. attempted use identify potential local outbreaks, we sequenced positive using Nanopore sequencing monitor circulation viral variants Denmark. reached full implementation by October covered up 86.4 population. allowed monitoring trends infections However, contribution identification outbreaks limited extensive information available clinical testing. identified relevant concern, line with human samples. Amidst COVID-19 pandemic, implemented a nationwide that integrated routine Today, while testing community level has been discontinued, on frontline occurrence spread

Language: Английский

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Tracking SARS-CoV-2 variants of concern in wastewater: an assessment of nine computational tools using simulated genomic data

Microbial Genomics, Journal Year: 2024, Volume and Issue: 10(5)

Published: May 24, 2024

Wastewater-based surveillance (WBS) is an important epidemiological and public health tool for tracking pathogens across the scale of a building, neighbourhood, city, or region. WBS gained widespread adoption globally during SARS-CoV-2 pandemic estimating community infection levels by qPCR. Sequencing pathogen genes genomes from wastewater adds information about genetic diversity, which can be used to identify viral lineages (including variants concern) that are circulating in local population. Capturing diversity sequencing not trivial, as samples often contain diverse mixture with real mutations errors, must deconvoluted computationally short reads. In this study we assess nine different computational tools have recently been developed address challenge. We simulated 100 sequence consisting BA.1, BA.2, Delta lineages, various mixtures, well Delta–Omicron recombinant synthetic ‘novel’ lineage. Most performed identifying true present their relative abundances were generally robust variation depth read length. While many identified down 1 % frequency, results more reliable above 5 threshold. The presence unknown lineage, represents unclassified increases error abundance estimates other but magnitude effect was small most tools. also varied how they labelled novel recombinants. our dataset just one possible use cases these methods, hope it helps users understand potential sources bias analysis appreciate commonalities differences methods.

Language: Английский

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Wastewater based epidemiology as a public health resource in low- and middle-income settings.

Environmental Pollution, Journal Year: 2024, Volume and Issue: 351, P. 124045 - 124045

Published: April 25, 2024

In the face of emerging and re-emerging diseases, novel innovative approaches to population scale surveillance are necessary for early detection quantification pathogens. The last decade has seen rapid development wastewater environmental (WES) address public health challenges, which led establishment wastewater-based epidemiology (WBE) being deployed monitor a range hazards. WBE exploits fact that excretions secretions from urine, gut discharged in wastewater, particularly sewage, such sampling sewage systems provides an warning system disease outbreaks by providing indication pathogen circulation. While been mainly used locations with networked systems, here we consider its value less connected populations typical lower-income settings, assess opportunity afforded pit latrines sample communities localities. We propose where struggle access diagnostic facilities, despite several additional unconnected remains important means large relatively cost-effective manner.

Language: Английский

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Cross-continental comparative experiences of wastewater surveillance and a vision for the 21st century

The Science of The Total Environment, Journal Year: 2024, Volume and Issue: 919, P. 170842 - 170842

Published: Feb. 8, 2024

Language: Английский

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