Operational Constraints of Detecting SARS-CoV-2 on Passive Samplers using Electronegative Filters: A Kinetic and Equilibrium Analysis

Assessing Passive Sampling for the Monitoring of E. coli and Cryptosporidium spp. in Environmental Waters

Passive sampling has shown promise as an alternative approach for monitoring of pathogens in aquatic matrices. We conducted two controlled experiments to compare the efficacy of membrane passive sampling to composite sampling in both wastewater and surface water for the detection of Escherichia coli and Cryptosporidium. We also investigated the relative uptake of E. coli and Cryptosporidium onto membrane passive samplers over time. Both sampling methods returned positive detections of E. coli at all deployment times (4, 8, 24, 48, 72, and 96 h) in both water matrices. Passive sampling for Cryptosporidium showed similar detection rates as composite samples in surface water (31% passive; 41% composite) and wastewater (76% passive; 86% composite). We found significant linear uptake of E. coli onto passive samplers up to 96 h in surface water (R 2 = 0.932; p = 0.002). In wastewater, maximum passive sampler uptake of E. coli was reached after 24 h. For Cryptosporidium, linear uptake was observed up to 96 h for both surface water (R 2 = 0.805; p = 0.015) and wastewater (R 2 = 0.877; p = 0.006). Our results support that membrane passive samplers may be used for the detection of Cryptosporidium and E. coli in surface waters for up to 96 h.

Evaluating approach uncertainties of quantitative detection of SARS-CoV-2 in wastewater: Concentration, extraction and amplification

Substantial uncertainties pose challenges to the accuracy of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) quantification in wastewater. We conducted a comprehensive evaluation of two concentration methods, three nucleic acid extraction methods, and the amplification performance of eight primer-probe sets. Our results showed that the two concentration methods exhibited similar recovery rates. Specifically, using a 30 kDa cut-off ultrafilter and a centrifugal force of 2500 g achieved the highest virus recovery rates (27.32 ± 8.06 % and 26.37 ± 7.77 %, respectively), with lower corresponding quantification uncertainties of 29.51 % and 29.47 % in ultrafiltration methods. Similarly, a 15 % PEG concentration with 1.5 M NaCl markedly improved virus recovery (26.76 ± 5.92 % and 28.47 ± 6.74 %, respectively), and reducing variation to 22.16 % and 23.66 % in the PEG precipitation method. Additionally, employing a vigorous bead-beating approach at 6 m/s during viral RNA extraction significantly increased RNA yield, with an efficiency reaching up to 82.18 %. Among the evaluated eight primer-probe sets, the E_Sarbeco primer-probe set provided the most stable and consistent quantitative results across various sample matrices. These findings are crucial for establishing robust viral quantification protocols and enhancing methodological precision for effective wastewater surveillance, enabling sensitive and precise detection of SARS-CoV-2.

Improved passive sampling methods for wastewater to enable more sensitive detection of SARS-CoV-2 and its variants

Wastewater-based epidemiology (WBE) can be used as a part of a long-term strategy for detecting and responding rapidly to new outbreaks of infectious disease in the community. However, wastewater collected by grab samples may miss marker presence, and composite auto-sampling throughout a day is technically challenging and costly. Tampon swabs can be used as passive collectors of wastewater markers over hours, but recovery of the captured markers is a challenge. Our goal was to improve tampon elution methods for virus detection and variant analysis to increase the likelihood of detection near the Limit of Detection (LOD) and to potentially detect new or rare variants in a new outbreak. Counts of SARS-CoV-2 N1 and N2 markers in grab samples were compared to markers eluted from tampons that had been immersed in 3 sewersheds for 4-6 h during June to December 2023. We compared tampon elution methods that used different elution volumes, pressure, and amounts of Tween 20, evaluated after automated magnetic bead purification and RT-ddPCR of SARS-CoV-2 markers. Overall, method "SwabM2" in which tampons were eluted by high pressure squeeze in a 50 mL syringe after adding 2 mL of 0.5 X TE + 0.075 % Tween-20 yielded a median four-fold higher concentration of final purified SARS-CoV-2 markers than paired grab samples and significantly more than other tested tampon elution methods (p < 0.0001). Method SwabM2 was more likely to yield enough extracted nucleic acids for sequencing and also gave higher quality variant sequences than two other tampon elution methods. Variant analysis captured the Fall 2023 transition of variants from XBB to JN and "H" lineages. In summary, we demonstrated a tampon-based wastewater collecting and elution method that yielded higher counts, more detections near the LOD, and higher quality variant sequences compared to both grab samples and other tampon-based passive-collecting wastewater methods.

Development of biomaterial composite hydrogel as a passive sampler with potential application in wastewater-based surveillance

Nowadays, the need to track fast-spreading infectious diseases has raised due to the recent COVID-19 disease pandemic. As a response, Wastewater-based Surveillance (WBS) has emerged as an early detection and disease tracking method for large populations that enables a comprehensive overview of public health allowing for a faster response from public health sector to prevent large outbreaks. The process to achieve WBS requires a highly intensive sampling strategy with either expensive equipment or trained personnel to continuously sample. The sampling problem can be addressed by passive sampler development. Chitosan-based hydrogels are recognized for their capability to sample and remove various contaminants from wastewater, including metals, dyes, pharmaceuticals, among others. However, chitosan-based hydrogels unique characteristics, can be exploited to develop passive samplers of genetic material that can be a very valuable tool for WBS. This study aimed to develop a novel chitosan hydrogel formulation with enhanced characteristics suitable for use as a passive sampler of genetic material and its application to detect disease-causing pathogens present in wastewater. The study evaluates the effect of the concentration of different components on the formulation of a Chitosan composite hydrogel (Chitosan, Glutaraldehyde, Microcrystalline cellulose (MCC), and Polyethylene glycol (PEG)) on the hydrogel properties using a Box Hunter & Hunter experimental matrix. Hydrogels' weight, thickness, swelling ratio, microscopic morphology (SEM), FTIR assay, and zeta potential were characterized. The resulting hydrogel formulations were shown to be highly porous, positively charged (Zeta potential up to 35.80 ± 1.44 mV at pH 3) and with high water swelling capacity (up to 703.89 ± 15.00 %). Based on the results, a formulation from experimental design was selected and then evaluated its capacity to adsorb genetic material from a control spiked water with Influenza A virus synthetic vector. The adsorption capacity of the selected formulation was 4157.04 ± 64.74 Gene Copies/mL of Influenza A virus synthetic vector. The developed hydrogel showed potential to be used as passive sampler for pathogen detection in wastewater. However, deeper research can be conducted to improve adsorption, desorption and extraction techniques of genetic material from chitosan-hydrogel matrices.

From capture to detection: A critical review of passive sampling techniques for pathogen surveillance in water and wastewater

Water quality, critical for human survival and well-being, necessitates rigorous control to mitigate contamination risks, particularly from pathogens amid expanding urbanization. Consequently, the necessity to maintain the microbiological safety of water supplies demands effective surveillance strategies, reliant on the collection of representative samples and precise measurement of contaminants. This review critically examines the advancements of passive sampling techniques for monitoring pathogens in various water systems, including wastewater, freshwater, and seawater. We explore the evolution from conventional materials to innovative adsorbents for pathogen capture and the shift from culture-based to molecular detection methods, underscoring the adaptation of this field to global health challenges. The comparison highlights passive sampling's efficacy over conventional techniques like grab sampling and its potential to overcome existing sampling challenges through the use of innovative materials such as granular activated carbon, thermoplastics, and polymer membranes. By critically evaluating the literature, this work identifies standardization gaps and proposes future research directions to augment passive sampling's efficiency, specificity, and utility in environmental and public health surveillance.

Diurnal changes in pathogenic and indicator virus concentrations in wastewater

Wastewater-based epidemiology (WBE) has been commonly used for monitoring SARS-CoV-2 outbreaks. As sampling times and methods (i.e. grab vs composite) may vary, diurnal changes of viral concentrations in sewage should be better understood. In this study, we collected untreated wastewater samples hourly for 4 days at two wastewater treatment plants in Wales to establish diurnal patterns in virus concentrations and the physico-chemical properties of the water. Simultaneously, we also trialled three absorbent materials as passive samples as a simple and cost-efficient alternative for the collection of composite samples. Ninety-six percent of all liquid samples (n = 74) and 88% of the passive samplers (n = 59) were positive for SARS-CoV-2, whereas 87% and 97% of the liquid and passive samples were positive for the faecal indicator virus crAssphage, respectively. We found no significant daily variations in the concentration of the target viruses, ammonium and orthophosphate, and the pH and electrical conductivity levels were also stable. Weak positive correlations were found between some physico-chemical properties and viral concentrations. More variation was observed in samples taken from the influent stream as opposed to those taken from the influent tank. Of the absorbent materials trialled as passive samples, we found that tampons provided higher viral recoveries than electronegative filter paper and cotton gauze swabs. For all materials tested, viral recovery was dependent on the virus type. Our results indicate that grab samples may provide representative alternatives to 24-h composite samples if taken from the influent tank, hence reducing the costs of sampling for WBE programmes. Tampons are also viable alternatives for cost-efficient sampling; however, viral recovery should be optimised prior to use.

Enhanced detection of viruses for improved water safety

Human viruses pose a significant health risk in freshwater environments, but current monitoring methods are inadequate for detecting viral presence efficiently. We evaluated a novel passive in-situ concentration method using granular activated carbon (GAC). This study detected and quantified eight enteric and non-enteric, pathogenic viruses in a freshwater recreational lake in paired grab and GAC passive samples. The results found that GAC passive sampling had a higher detection rate for all viruses compared to grab samples, with adenovirus found to be the most prevalent virus, followed by respiratory syncytial virus, norovirus, enterovirus, influenza A, SARS-CoV-2, and rotavirus. GAC in-situ concentration allowed for the capture and recovery of viral gene copy targets that ranged from one to three orders of magnitude higher than conventional ex-situ concentration methods used in viral monitoring. This simple and affordable sampling method may have far-reaching implications for reducing barriers associated with viral monitoring across various environmental contexts.

Adsorption of Respiratory Syncytial Virus, Rhinovirus, SARS-CoV-2, and F+ Bacteriophage MS2 RNA onto Wastewater Solids from Raw Wastewater

Despite the widespread adoption of wastewater surveillance, more research is needed to understand the fate and transport of viral genetic markers in wastewater. This information is essential for optimizing monitoring strategies and interpreting wastewater surveillance data. In this study, we examined the solid-liquid partitioning behavior of four viruses in wastewater: SARS-CoV-2, respiratory syncytial virus (RSV), rhinovirus (RV), and F+ coliphage/MS2. We used two approaches: (1) laboratory partitioning experiments using lab-grown viruses and (2) distribution experiments using endogenous viruses in raw wastewater. Partition experiments were conducted at 4 and 22 °C. Wastewater samples were spiked with varying concentrations of each virus, solids and liquids were separated via centrifugation, and viral RNA concentrations were quantified using reverse-transcription-digital droplet PCR (RT-ddPCR). For the distribution experiments, wastewater samples were collected from six wastewater treatment plants and processed without spiking exogenous viruses; viral RNA concentrations were measured in wastewater solids and liquids. In both experiments, RNA concentrations were higher in the solid fraction than the liquid fraction by approximately 3-4 orders of magnitude. Partition coefficients (KF) ranged from 2000-270,000 mL·g-1 across viruses and temperature conditions. Distribution coefficients (Kd) were consistent with results from partitioning experiments. Further research is needed to understand how virus and wastewater characteristics might influence the partitioning of viral genetic markers in wastewater.

Surveillance of SARS-CoV-2 in sewage from buildings housing residents with different vulnerability levels

During the last three years, various restrictions have been set up to limit the transmission of the Coronavirus Disease (COVID-19). While these rules apply at a large scale (e.g., country-wide level) human-to-human transmission of the virus that causes COVID-19, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), occurs at a small scale. Different preventive policies and testing protocols were implemented in buildings where COVID-19 poses a threat (e.g., elderly residences) or constitutes a disruptive force (e.g., schools). In this study, we sampled sewage from different buildings (a school, a university campus, a university residence, and an elderly residence) that host residents of different levels of vulnerability. Our main goal was to assess the agreement between the SARS-CoV-2 concentration in wastewater and the policies applied in these buildings. All buildings were sampled using passive samplers while 24 h composite samples were also collected from the elderly residence. Results showed that passive samplers performed comparably well to composite samples while being cost-effective to keep track of COVID-19 prevalence. In the elderly residence, the comparison of sampling protocols (passive vs. active) combined with the strict clinical testing allowed us to compare the sensitivities of the two methods. Active sampling was more sensitive than passive sampling, as the former was able to detect a COVID-19 prevalence of 0.4 %, compared to a prevalence of 2.2 % for passive sampling. The number of COVID-19-positive individuals was tracked clinically in all the monitored buildings. More frequent detection of SARS-CoV-2 in wastewater was observed in residential buildings than in non-residential buildings using passive samplers. In all buildings, sewage surveillance can be used to complement COVID-19 clinical testing regimes, as the detection of SARS-CoV-2 in wastewater remained positive even when no COVID-19-positive individuals were reported. Passive sampling is useful for building managers to adapt their COVID-19 mitigation policies.

Parallel deployment of passive and composite samplers for surveillance and variant profiling of SARS-CoV-2 in sewage

Wastewater-based epidemiology during the COVID-19 pandemic has proven useful for public health decision-making but is often hampered by sampling methodology constraints, particularly at the building- or neighborhood-level. Time-weighted composite samples are commonly used; however, autosamplers are expensive and can be affected by intermittent flows in sub-sewershed contexts. In this study, we compared time-weighted composite, grab, and passive sampling via Moore swabs, at four locations across a college campus to understand the utility of passive sampling. After optimizing the methods for sample handling and processing for viral RNA extraction, we quantified SARS-CoV-2 N1 and N2, as well as a fecal strength indicator, PMMoV, by ddRT-PCR and applied tiled amplicon sequencing of the SARS-CoV-2 genome. Passive samples compared favorably with composite samples in our study area: for samples collected concurrently, 42 % of the samples agreed between Moore swab and composite samples and 58 % of the samples were positive for SARS-CoV-2 using Moore swabs while composite samples were below the limit of detection. Variant profiles from Moore swabs showed a shift from variant BA.1 to BA.2, consistent with in-person saliva samples. These data have implications for the broader implementation of sewage surveillance without advanced sampling technologies and for the utilization of passive sampling approaches for other emerging pathogens.

Sewage surveillance of SARS-CoV-2 at student campus residences in the Western Cape, South Africa

The current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnostic capacity is limited in defined communities, posing a challenge in tracking and tracing new infections. Monitoring student residences, which are considered infection hotspots, with targeted wastewater surveillance is crucial. This study evaluated the efficacy of SARS-CoV-2 targeted wastewater surveillance for outbreak mitigation at Stellenbosch University's student residences in South Africa. Using torpedo-style passive sampling devices, wastewater samples were collected biweekly from manholes at twelve Stellenbosch University Tygerberg (SUT) campus and Stellenbosch University-Main (SUM) campus student residences. The surveillance led to an early warning detection of SARS-CoV-2 presence on campus, followed by an informed management strategy leading to restriction of student activities on campus and a delay in the onset of the third wave that was experienced throughout the country. Moreover, the study highlighted the extent of possible infections at defined locations even when a low number of confirmed coronavirus disease 2019 (COVID-19) cases were reported. The study also tracked the surge of the Delta and Omicron variants in the student residences using the Thermo Fisher TaqMan® RT-qPCR genotyping assay.

Looking Forward: The Role of Academic Researchers in Building Sustainable Wastewater Surveillance Programs

BACKGROUND

In just over 2 years, tracking the COVID-19 pandemic through wastewater surveillance advanced from early reports of successful SARS-CoV-2 RNA detection in untreated wastewater to implementation of programs in at least 60 countries. Early wastewater monitoring efforts primarily originated in research laboratories and are now transitioning into more formal surveillance programs run in commercial and public health laboratories. A major challenge in this progression has been to simultaneously optimize methods and build scientific consensus while implementing surveillance programs, particularly during the rapidly changing landscape of the pandemic. Translating wastewater surveillance results for effective use by public health agencies also remains a key objective for the field.

OBJECTIVES

We examined the evolution of wastewater surveillance to identify model collaborations and effective partnerships that have created rapid and sustained success. We propose needed areas of research and key roles academic researchers can play in the framework of wastewater surveillance to aid in the transition from early monitoring efforts to more formalized programs within the public health system.

DISCUSSION

Although wastewater surveillance has rapidly developed as a useful public health tool for tracking COVID-19, there remain technical challenges and open scientific questions that academic researchers are equipped to address. This includes validating methodology and backfilling important knowledge gaps, such as fate and transport of surveillance targets and epidemiological links to wastewater concentrations. Our experience in initiating and implementing wastewater surveillance programs in the United States has allowed us to reflect on key barriers and draw useful lessons on how to promote synergy between different areas of expertise. As wastewater surveillance programs are formalized, the working relationships developed between academic researchers, commercial and public health laboratories, and data users should promote knowledge co-development. We believe active involvement of academic researchers will contribute to building robust surveillance programs that will ultimately provide new insights into population health. https://doi.org/10.1289/EHP11519.

Adsorption of SARS-CoV-2 onto granular activated carbon (GAC) in wastewater: Implications for improvements in passive sampling

Based on recent studies, passive sampling is a promising method for detecting SARS-CoV-2 in wastewater surveillance (WWS) applications. Passive sampling has many advantages over conventional sampling approaches. However, the potential benefits of passive sampling are also coupled with apparent limitations. We established a passive sampling technique for detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in wastewater using electronegative filters. Though, it was evident that the adsorption capacity of the filters constrained their use. This work intends to demonstrate an optimized passive sampling technique for SARS-CoV-2 in wastewater using granular activated carbon (GAC). Through bench-scale batch-adsorption studies and sewershed deployments, we established the adsorption characteristics of SARS-CoV-2 and two human feacal viruses (PMMoV and CrAssphage) onto GAC. A pseudo-second-order model best-described adsorption kinetics for SARS-CoV-2 in either deionized (DI) water and SARS-CoV-2, CrAssphage, and PMMoV in wastewater. In both laboratory batch-adsorption experiments and in-situ sewershed deployments, the maximum amount of SARS-CoV-2 adsorbed by GAC occurred at ~60 h in wastewater. In wastewater, the maximum adsorption of PMMoV and CrAssphage by GAC occurred at ~60 h. In contrast, the adsorption capacity was reached in DI water seeded with SARS-CoV-2 after ~35 h. The equilibrium assay modeled the maximum adsorption quantity (qmax) in wastewater with spiked SARS-CoV-2 concentrations using a Hybrid Langmuir-Freundlich equation, a qmax of 2.5 × 109 GU/g was calculated. In paired sewershed deployments, it was found that GAC adsorbs SARS-CoV-2 in wastewater more effectively than electronegative filters. Based on the anticipated viral loading in wastewater, bi-weekly sampling intervals with deployments up to ~96 h are highly feasible without reaching adsorption capacity with GAC. GAC offers improved sensitivity and reproducibility to capture SARS-CoV-2 RNA in wastewater, promoting a scalable and convenient alternative for capturing viral pathogens in wastewater.

Passive sampling to scale wastewater surveillance of infectious disease: Lessons learned from COVID-19

Much of what is known and theorized concerning passive sampling techniques has been developed considering chemical analytes. Yet, historically, biological analytes, such as Salmonella typhi, have been collected from wastewater via passive sampling with Moore swabs. In response to the COVID-19 pandemic, passive sampling is re-emerging as a promising technique to monitor SARS-CoV-2 RNA in wastewater. Method comparisons and disease surveillance using composite, grab, and passive sampling for SARS-CoV-2 RNA detection have found passive sampling with a variety of materials routinely produced qualitative results superior to grab samples and useful for sub-sewershed surveillance of COVID-19. Among individual studies, SARS-CoV-2 RNA concentrations derived from passive samplers demonstrated heterogeneous correlation with concentrations from paired composite samples ranging from weak (R2 = 0.27, 0.31) to moderate (R2 = 0.59) to strong (R2 = 0.76). Among passive sampler materials, electronegative membranes have shown great promise with linear uptake of SARS-CoV-2 RNA observed for exposure durations of 24 to 48 h and in several cases RNA positivity on par with composite samples. Continuing development of passive sampling methods for the surveillance of infectious diseases via diverse forms of fecal waste should focus on optimizing sampler materials for the efficient uptake and recovery of biological analytes, kit-free extraction, and resource-efficient testing methods capable of rapidly producing qualitative or quantitative data. With such refinements passive sampling could prove to be a fundamental tool for scaling wastewater surveillance of infectious disease, especially among the 1.8 billion persons living in low-resource settings served by non-traditional wastewater collection infrastructure.

Wastewater Surveillance for SARS-CoV-2 RNA in Canada

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.