Wastewater-based surveillance as a tool for public health action: SARS-CoV-2 and beyond

Clinical Microbiology Reviews, Journal Year: 2023, Volume and Issue: 37(1)

Published: Dec. 14, 2023

SUMMARY Wastewater-based surveillance (WBS) has undergone dramatic advancement in the context of coronavirus disease 2019 (COVID-19) pandemic. The power and potential 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 within monitored populations but also, fact, functioned as a leading indicator. Teams from across globe innovated novel approaches by which wastewater could be collected diverse sewersheds ranging treatment plants (enabling community-level surveillance) to more granular locations including individual neighborhoods high-risk buildings such long-term care facilities (LTCF). Efficient processes enabled extraction concentration highly dilute matrix. Molecular genomic tools identify, quantify, characterize its various variants adapted programs applied these mixed environmental systems. Novel data-sharing allowed information mobilized made immediately available public health government decision-makers even public, enabling evidence-informed decision-making based on local dynamics. WBS since been recognized tool transformative potential, providing near-real-time cost-effective, objective, comprehensive, inclusive data changing prevalence measured analytes space time populations. However, consequence rapid innovation hundreds teams simultaneously, tremendous heterogeneity currently exists literature. This manuscript provides state-of-the-art review established details current work underway expanding scope other infectious targets.

Language: Английский

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The National Wastewater Surveillance System (NWSS): From inception to widespread coverage, 2020–2022, United States

The Science of The Total Environment, Journal Year: 2024, Volume and Issue: 924, P. 171566 - 171566

Published: March 9, 2024

Wastewater surveillance is a valuable tool that can be used to track infectious diseases in community. In September 2020, the Centers for Disease Control and Prevention (CDC) established National Surveillance System (NWSS) coordinate build nation's capacity detect quantify concentrations of SARS-CoV-2 RNA U.S. wastewater. This first summary NWSS, covering 1, 2020 December 31, 2022. Through partnerships with state, tribal, local, territorial health departments, NWSS became national platform readily expanded adapted meet changing public needs. Beginning 209 sampling sites rapidly >1500 by 2022, ≈47 % population. As >152,000 unique wastewater samples have been collected partners, primarily from treatment plants (WWTPs). WWTPs participating tend larger than average WWTP serve more populated communities. ≈8 nearly 16,000 were NWSS. partners variety methods testing samples; however, progress being made standardize these methods. July 2021, started submitting genome sequencing data October monkeypox virus testing, plans include additional disease targets future. rapid implementation expansion important lessons learned. programs should consider both surge long-term capacities when developing an plan, early standardization facilitate comparisons across sites. has proven flexible sustainable system will continue useful complement case-based guiding action.

Language: Английский

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Key considerations for pathogen surveillance in wastewater

The Science of The Total Environment, Journal Year: 2024, Volume and Issue: 945, P. 173862 - 173862

Published: June 12, 2024

Wastewater surveillance (WWS) has received significant attention as a rapid, sensitive, and cost-effective tool for monitoring various pathogens in community. WWS is employed to assess the spatial temporal trends of diseases identify their early appearances reappearances, well detect novel mutated variants. However, shedding rates vary significantly depending on factors such disease severity, physiology affected individuals, characteristics pathogen. Furthermore, may exhibit differential fate decay kinetics sewerage system. Variable affect detection wastewater. This influence interpretation results conclusions studies. When selecting pathogen WWS, it essential consider it's specific characteristics. If data are not readily available, fate, decay, should be assessed before conducting surveillance. Alternatively, these can compared those similar which available.

Language: Английский

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Localised wastewater SARS-CoV-2 levels linked to COVID-19 cases: A long-term multisite study in England

The Science of The Total Environment, Journal Year: 2025, Volume and Issue: 962, P. 178455 - 178455

Published: Jan. 1, 2025

Wastewater-based surveillance (WBS) can monitor for the presence of human health pathogens in population. During COVID-19, WBS was widely used to determine wastewater SARS-CoV-2 RNA concentration (concentrations) providing information on community COVID-19 cases (cases). However, studies examining relationship between concentrations and tend be localised or focussed small-scale institutional settings. Few have examined this multiple settings, over long periods, with large sample numbers, nor attempted quantify detail how catchment characteristics affected these. This 18-month study (07/20-12/21) explored correlation quantitative using censored regression. Our analysis >94,000 samples collected from 452 diverse sampling sites (259 Sewage Treatment Works (STW) 193 Sewer Network Sites (SNS)) covering ~65 % English Wastewater were linked ~6 million diagnostically confirmed cases. High coefficients found (STW: median r = 0.66, IQR: 0.57-0.74; SNS: 0.65, 0.54-0.74). The (regression coefficient) variable catchments. Catchment (e.g. size population grab vs automated sampling) had significant but small effects regression coefficients. last six months reduced became highly coincided a shift towards younger cases, vaccinated rapid emergence variant Omicron. programme rapidly introduced at scale during COVID-19. Laboratory methods evolved catchments characteristics. Despite diversity, findings indicate that provides an effective proxy establishing dynamics across wide variety communities. While there is potential predicting concentration, may more smaller scales.

Language: Английский

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Wastewater surveillance for viral pathogens: A tool for public health

Heliyon, Journal Year: 2024, Volume and Issue: 10(13), P. e33873 - e33873

Published: June 29, 2024

A focus on water quality has intensified globally, considering its critical role in sustaining life and ecosystems. Wastewater, reflecting societal development, profoundly impacts public health. Wastewater-based epidemiology (WBE) emerged as a surveillance tool for detecting outbreaks early, monitoring infectious disease trends, providing real-time insights, particularly vulnerable communities. WBE aids tracking pathogens, including viruses, sewage, offering comprehensive understanding of community health lifestyle habits. With the rise global COVID-19 cases, gained prominence, aiding SARS-CoV-2 levels worldwide. Despite advancements treatment, poorly treated wastewater discharge remains threat, amplifying spread water-, sanitation-, hygiene (WaSH)-related diseases. WBE, serving complementary surveillance, is pivotal community-level viral infections. However, there untapped potential to expand surveillance. This review emphasizes importance link between health, highlighting need further integration into management.

Language: Английский

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Developing wastewater-based surveillance schemes for multiple pathogens: The WastPan project in Finland

The Science of The Total Environment, Journal Year: 2024, Volume and Issue: 926, P. 171401 - 171401

Published: March 11, 2024

Wastewater comprises multiple pathogens and offers a potential for wastewater-based surveillance (WBS) to track the prevalence of communicable diseases. The Finnish WastPan project aimed establish pandemic preparedness (viruses, bacteria, parasites, fungi), including antimicrobial resistance (AMR). This article outlines WastPan's experiences in this project, criteria target selection, sampling locations, frequency, analysis methods results communication. Target selection relied on epidemiological microbiological evidence practical feasibility. Within framework, wastewater samples were collected between 2021 2023 from 10 treatment plants (WWTPs) covering 40 % Finland's population. WWTP was validated reported cases Extended Spectrum Beta-lactamase-producing bacterial (Escherichia coli Klebsiella pneumoniae) National Infectious Disease Register. workflow included 24-h composite influent samples, with one fraction culture-based (bacteria fungi) rest sample reserved molecular antibiotic genes, parasites). reproducibility monitoring assessed SARS-CoV-2 through inter-laboratory comparisons using N2 N1 assays. Identical protocols applied same-day yielding similar positivity trends two laboratories, but assay achieved significantly higher detection rate (Laboratory 1: 91.5 %; Laboratory 2: 87.4 %) than (76.6 monitored only 2 (McNemar, p < 0.001 Lab 1, = 0.006 2). result indicates that primers assays may impact sensitivity WBS. Overall, current study recommends frequencies population coverage should be based pathogen-specific characteristics. For example, are stable over time need less frequent annual sampling, while those occurring across regions require reduced coverage. Here, successfully piloted WBS pathogens, highlighting significance one-litre community assessing health. infrastructure established COVID-19 is valuable various pathogens. Prioritizing targets optimizes resource utilization, legislative support determination sustained funding advisable future.

Language: Английский

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Wastewater Surveillance for Influenza A Virus and H5 Subtype Concurrent with the Highly Pathogenic Avian Influenza A(H5N1) Virus Outbreak in Cattle and Poultry and Associated Human Cases — United States, May 12–July 13, 2024

MMWR Morbidity and Mortality Weekly Report, Journal Year: 2024, Volume and Issue: 73(37), P. 804 - 809

Published: Sept. 19, 2024

As part of the response to highly pathogenic avian influenza A(H5N1) virus outbreak in U.S. cattle and poultry associated human cases, CDC partners are monitoring A levels detection H5 subtype wastewater. Among 48 states District Columbia that performed testing wastewater during May 12-July 13, 2024, a weekly average 309 sites 38 had sufficient data for analysis, 11 four reported high virus. was conducted at 203 41 states, with detections 24 nine states. For each or level, state local health departments evaluated from other surveillance systems partnered utilities agriculture investigate potential sources. detected wastewater, three corresponding evidence activity systems. detections, 15 identified animal sources within sewershed adjacent county, including eight milk-processing inputs. Data these early investigations can help officials optimize use upcoming respiratory illness season.

Language: Английский

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A broad wastewater screening and clinical data surveillance for virus-related diseases in the metropolitan Detroit area in Michigan

Human Genomics, Journal Year: 2024, Volume and Issue: 18(1)

Published: Feb. 6, 2024

Abstract Background Periodic bioinformatics-based screening of wastewater for assessing the diversity potential human viral pathogens circulating in a given community may help to identify novel or potentially emerging infectious diseases. Any identified contigs related viruses should be confirmed with targeted and clinical testing. Results During COVID-19 pandemic, untreated samples were collected 1-year period from Great Lakes Water Authority Wastewater Treatment Facility Detroit, MI, USA, population both centralized interceptor sites localized neighborhood sewersheds was investigated. Clinical cases diseases caused by tabulated compared data monitoring. In addition Betacoronavirus , comparison using assembled against custom Swiss-Prot virus database indicated prevalence other pathogenic genera, including: Orthopoxvirus Rhadinovirus, Parapoxvirus Varicellovirus, Hepatovirus, Simplexvirus, Bocaparvovirus, Molluscipoxvirus, Parechovirus, Roseolovirus, Lymphocryptovirus, Alphavirus, Spumavirus, Lentivirus, Deltaretrovirus, Enterovirus, Kobuvirus, Gammaretrovirus, Cardiovirus, Erythroparvovirus, Salivirus, Rubivirus, Orthohepevirus, Cytomegalovirus, Norovirus, Mamastrovirus . Four nearly complete genomes recovered Astrovirus, Norovirus Betapolyomavirus genera species identified. Conclusions The presented findings are primarily at genus level can serve as preliminary “screening” tool that indication initiate further testing confirmation presence associated disease. Integrating innovative environmental microbiology technologies like metagenomic sequencing epidemiology offers significant opportunity improve monitoring of, predictive intelligence for, viruses, wastewater.

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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Interpretation of indoor air surveillance for respiratory infections: a prospective longitudinal observational study in a childcare setting

EBioMedicine, Journal Year: 2025, Volume and Issue: 112, P. 105512 - 105512

Published: Jan. 30, 2025

Language: Английский

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