1
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Prasek SM, Pepper IL, Innes GK, Slinski S, Ruedas M, Sanchez A, Brierley P, Betancourt WQ, Stark ER, Foster AR, Betts-Childress ND, Schmitz BW. Population level SARS-CoV-2 fecal shedding rates determined via wastewater-based epidemiology. Sci Total Environ 2022; 838:156535. [PMID: 35688254 PMCID: PMC9172256 DOI: 10.1016/j.scitotenv.2022.156535] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/14/2022] [Accepted: 06/03/2022] [Indexed: 05/21/2023]
Abstract
Wastewater-based epidemiology (WBE) has been utilized as an early warning tool to anticipate disease outbreaks, especially during the COVID-19 pandemic. However, COVID-19 disease models built from wastewater-collected data have been limited by the complexities involved in estimating SARS-CoV-2 fecal shedding rates. In this study, wastewater from six municipalities in Arizona and Florida with distinct demographics were monitored for SARS-CoV-2 RNA between September 2020 and December 2021. Virus concentrations with corresponding clinical case counts were utilized to estimate community-wide fecal shedding rates that encompassed all infected individuals. Analyses suggest that average SARS-CoV-2 RNA fecal shedding rates typically occurred within a consistent range (7.53-9.29 log10 gc/g-feces); and yet, were unique to each community and influenced by population demographics. Age, ethnicity, and socio-economic factors may have influenced shedding rates. Interestingly, populations with median age between 30 and 39 had the greatest fecal shedding rates. Additionally, rates remained relatively constant throughout the pandemic provided conditions related to vaccination and variants were unchanged. Rates significantly increased in some communities when the Delta variant became predominant. Findings in this study suggest that community-specific shedding rates may be appropriate in model development relating wastewater virus concentrations to clinical case counts.
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Affiliation(s)
- Sarah M Prasek
- Water & Energy Sustainable Technology (WEST) Center, University of Arizona, 2959 W. Calle Agua Nueva, Tucson, AZ 85745, USA
| | - Ian L Pepper
- Water & Energy Sustainable Technology (WEST) Center, University of Arizona, 2959 W. Calle Agua Nueva, Tucson, AZ 85745, USA
| | - Gabriel K Innes
- Yuma Center of Excellence for Desert Agriculture (YCEDA), University of Arizona, 6425 W. 8(th) St., Yuma, AZ 85364, USA
| | - Stephanie Slinski
- Yuma Center of Excellence for Desert Agriculture (YCEDA), University of Arizona, 6425 W. 8(th) St., Yuma, AZ 85364, USA
| | - Martha Ruedas
- Yuma Center of Excellence for Desert Agriculture (YCEDA), University of Arizona, 6425 W. 8(th) St., Yuma, AZ 85364, USA
| | - Ana Sanchez
- Yuma Center of Excellence for Desert Agriculture (YCEDA), University of Arizona, 6425 W. 8(th) St., Yuma, AZ 85364, USA
| | - Paul Brierley
- Yuma Center of Excellence for Desert Agriculture (YCEDA), University of Arizona, 6425 W. 8(th) St., Yuma, AZ 85364, USA
| | - Walter Q Betancourt
- Water & Energy Sustainable Technology (WEST) Center, University of Arizona, 2959 W. Calle Agua Nueva, Tucson, AZ 85745, USA
| | - Erika R Stark
- Water & Energy Sustainable Technology (WEST) Center, University of Arizona, 2959 W. Calle Agua Nueva, Tucson, AZ 85745, USA
| | - Aidan R Foster
- Water & Energy Sustainable Technology (WEST) Center, University of Arizona, 2959 W. Calle Agua Nueva, Tucson, AZ 85745, USA
| | - Nick D Betts-Childress
- Water & Energy Sustainable Technology (WEST) Center, University of Arizona, 2959 W. Calle Agua Nueva, Tucson, AZ 85745, USA
| | - Bradley W Schmitz
- Yuma Center of Excellence for Desert Agriculture (YCEDA), University of Arizona, 6425 W. 8(th) St., Yuma, AZ 85364, USA.
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2
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Li X, Kulandaivelu J, Guo Y, Zhang S, Shi J, O'Brien J, Arora S, Kumar M, Sherchan SP, Honda R, Jackson G, Luby SP, Jiang G. SARS-CoV-2 shedding sources in wastewater and implications for wastewater-based epidemiology. J Hazard Mater 2022; 432:128667. [PMID: 35339834 PMCID: PMC8908579 DOI: 10.1016/j.jhazmat.2022.128667] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/05/2022] [Accepted: 03/08/2022] [Indexed: 05/21/2023]
Abstract
Wastewater-based epidemiology (WBE) approach for COVID-19 surveillance is largely based on the assumption of SARS-CoV-2 RNA shedding into sewers by infected individuals. Recent studies found that SARS-CoV-2 RNA concentration in wastewater (CRNA) could not be accounted by the fecal shedding alone. This study aimed to determine potential major shedding sources based on literature data of CRNA, along with the COVID-19 prevalence in the catchment area through a systematic literature review. Theoretical CRNA under a certain prevalence was estimated using Monte Carlo simulations, with eight scenarios accommodating feces alone, and both feces and sputum as shedding sources. With feces alone, none of the WBE data was in the confidence interval of theoretical CRNA estimated with the mean feces shedding magnitude and probability, and 63% of CRNA in WBE reports were higher than the maximum theoretical concentration. With both sputum and feces, 91% of the WBE data were below the simulated maximum CRNA in wastewater. The inclusion of sputum as a major shedding source led to more comparable theoretical CRNA to the literature WBE data. Sputum discharging behavior of patients also resulted in great fluctuations of CRNA under a certain prevalence. Thus, sputum is a potential critical shedding source for COVID-19 WBE surveillance.
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Affiliation(s)
- Xuan Li
- School of Civil, Mining and Environmental Engineering, University of Wollongong, Australia
| | | | - Ying Guo
- School of Civil, Mining and Environmental Engineering, University of Wollongong, Australia
| | - Shuxin Zhang
- School of Civil, Mining and Environmental Engineering, University of Wollongong, Australia
| | - Jiahua Shi
- School of Civil, Mining and Environmental Engineering, University of Wollongong, Australia; Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, Australia
| | - Jake O'Brien
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Woollongabba, Queensland 4072, Australia
| | - Sudipti Arora
- Dr. B. Lal Institute of Biotechnology, 6E, Malviya Industrial Area, Malviya Nagar, Jaipur 302017, India
| | - Manish Kumar
- Sustainability Cluster, School of Engineering, University of Petroleum & Energy Studies, Dehradun, Uttarakhand 248007, India
| | - Samendra P Sherchan
- Department of Environmental health sciences, Tulane University, New Orleans, LA 70112, USA; Bioenvironmental Science Program, Morgan Staate University, Baltimore, MD 21251, USA
| | - Ryo Honda
- Faculty of Geosciences and Civil Engineering, Kanazawa University, Kanazawa 920-1192, Japan
| | - Greg Jackson
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Woollongabba, Queensland 4072, Australia
| | - Stephen P Luby
- Stanford Center for Innovation in Global Health, and Stanford Woods Institute for the Environment, Stanford University, Stanford, CA 94305, USA
| | - Guangming Jiang
- School of Civil, Mining and Environmental Engineering, University of Wollongong, Australia; Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, Australia.
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3
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Xiao A, Wu F, Bushman M, Zhang J, Imakaev M, Chai PR, Duvallet C, Endo N, Erickson TB, Armas F, Arnold B, Chen H, Chandra F, Ghaeli N, Gu X, Hanage WP, Lee WL, Matus M, McElroy KA, Moniz K, Rhode SF, Thompson J, Alm EJ. Metrics to relate COVID-19 wastewater data to clinical testing dynamics. Water Res 2022; 212:118070. [PMID: 35101695 PMCID: PMC8758950 DOI: 10.1016/j.watres.2022.118070] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [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: 06/19/2021] [Revised: 11/29/2021] [Accepted: 01/11/2022] [Indexed: 05/02/2023]
Abstract
Wastewater surveillance has emerged as a useful tool in the public health response to the COVID-19 pandemic. While wastewater surveillance has been applied at various scales to monitor population-level COVID-19 dynamics, there is a need for quantitative metrics to interpret wastewater data in the context of public health trends. 24-hour composite wastewater samples were collected from March 2020 through May 2021 from a Massachusetts wastewater treatment plant and SARS-CoV-2 RNA concentrations were measured using RT-qPCR. The relationship between wastewater copy numbers of SARS-CoV-2 gene fragments and COVID-19 clinical cases and deaths varies over time. We demonstrate the utility of three new metrics to monitor changes in COVID-19 epidemiology: (1) the ratio between wastewater copy numbers of SARS-CoV-2 gene fragments and clinical cases (WC ratio), (2) the time lag between wastewater and clinical reporting, and (3) a transfer function between the wastewater and clinical case curves. The WC ratio increases after key events, providing insight into the balance between disease spread and public health response. Time lag and transfer function analysis showed that wastewater data preceded clinically reported cases in the first wave of the pandemic but did not serve as a leading indicator in the second wave, likely due to increased testing capacity, which allows for more timely case detection and reporting. These three metrics could help further integrate wastewater surveillance into the public health response to the COVID-19 pandemic and future pandemics.
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Affiliation(s)
- Amy Xiao
- Department of Biological Engineering, Massachusetts Institute of Technology USA; Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology USA
| | - Fuqing Wu
- Department of Biological Engineering, Massachusetts Institute of Technology USA; Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology USA
| | - Mary Bushman
- Harvard T.H. Chan School of Public Health, Harvard University USA
| | - Jianbo Zhang
- Department of Biological Engineering, Massachusetts Institute of Technology USA; Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology USA
| | | | - Peter R Chai
- Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School USA; The Fenway Institute, Fenway Health, Boston, MA USA; The Koch Institute for Integrated Cancer Research, Massachusetts Institute of Technology USA; Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute USA
| | | | | | - Timothy B Erickson
- Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School USA; Harvard Humanitarian Initiative, Harvard University USA
| | - Federica Armas
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Brian Arnold
- Department of Computer Science, Princeton University USA; Center for Statistics and Machine Learning, Princeton University USA
| | - Hongjie Chen
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Franciscus Chandra
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | | | - Xiaoqiong Gu
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - William P Hanage
- Harvard T.H. Chan School of Public Health, Harvard University USA
| | - Wei Lin Lee
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | | | | | - Katya Moniz
- Department of Biological Engineering, Massachusetts Institute of Technology USA; Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology USA
| | | | - Janelle Thompson
- Campus for Research Excellence and Technological Enterprise (CREATE), Singapore; Singapore Centre for Environmental Life Sciences Engineering, Nanyang Technological University, Singapore; Asian School of the Environment, Nanyang Technological University, Singapore
| | - Eric J Alm
- Department of Biological Engineering, Massachusetts Institute of Technology USA; Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology USA; Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore; Broad Institute of MIT and Harvard, Cambridge, MA USA.
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4
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Sakarovitch C, Schlosser O, Courtois S, Proust-Lima C, Couallier J, Pétrau A, Litrico X, Loret JF. Monitoring of SARS-CoV-2 in wastewater: what normalisation for improved understanding of epidemic trends? J Water Health 2022; 20:712-726. [PMID: 35482387 DOI: 10.2166/wh.2022.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
SARS-CoV-2 RNA quantification in wastewater has emerged as a relevant additional means to monitor the COVID-19 pandemic. However, the concentration can be affected by black water dilution factors or movements of the sewer shed population, leading to misinterpretation of measurement results. The aim of this study was to evaluate the performance of different indicators to accurately interpret SARS-CoV-2 in wastewater. Weekly/bi-weekly measurements from three cities in France were analysed from February to September 2021. The concentrations of SARS-CoV-2 gene copies were normalised to the faecal-contributing population using simple sewage component indicators. To reduce the measurement error, a composite index was created to combine simultaneously the information carried by the simple indicators. The results showed that the regularity (mean absolute difference between observation and the smoothed curve) of the simple indicators substantially varied across sampling points. The composite index consistently showed better regularity compared to the other indicators and was associated to the lowest variation in correlation coefficient across sampling points. These findings suggest the recommendation for the use of a composite index in wastewater-based epidemiology to compensate for variability in measurement results.
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Affiliation(s)
| | | | - Sophie Courtois
- SUEZ, CIRSEE, 38 rue du Président Wilson, 78230 Le Pecq, France
| | - Cécile Proust-Lima
- Université de Bordeaux, INSERM, Bordeaux Population Health Center, UMR1219, F-33000 Bordeaux, France
| | - Joanne Couallier
- SUEZ, LYRE, 15 av Léonard de Vinci, 33600 Pessac, France E-mail:
| | - Agnès Pétrau
- SUEZ Rivages Pro Tech, Technopôle Izarbel, 2 Allée Théodore Monod, 64210 Bidart, France
| | - Xavier Litrico
- SUEZ, CB21, 16 Place de l'Iris, 92040 Paris La Défense, France
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5
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Perkins TA, Stephens M, Alvarez Barrios W, Cavany S, Rulli L, Pfrender ME. Performance of Three Tests for SARS-CoV-2 on a University Campus Estimated Jointly with Bayesian Latent Class Modeling. Microbiol Spectr 2022; 10:e0122021. [PMID: 35044220 PMCID: PMC8768831 DOI: 10.1128/spectrum.01220-21] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/12/2021] [Indexed: 12/19/2022] Open
Abstract
Accurate tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been critical in efforts to control its spread. The accuracy of tests for SARS-CoV-2 has been assessed numerous times, usually in reference to a gold standard diagnosis. One major disadvantage of that approach is the possibility of error due to inaccuracy of the gold standard, which is especially problematic for evaluating testing in a real-world surveillance context. We used an alternative approach known as Bayesian latent class modeling (BLCM), which circumvents the need to designate a gold standard by simultaneously estimating the accuracy of multiple tests. We applied this technique to a collection of 1,716 tests of three types applied to 853 individuals on a university campus during a 1-week period in October 2020. We found that reverse transcriptase PCR (RT-PCR) testing of saliva samples performed at a campus facility had higher sensitivity (median, 92.3%; 95% credible interval [CrI], 73.2 to 99.6%) than RT-PCR testing of nasal samples performed at a commercial facility (median, 85.9%; 95% CrI, 54.7 to 99.4%). The reverse was true for specificity, although the specificity of saliva testing was still very high (median, 99.3%; 95% CrI, 98.3 to 99.9%). An antigen test was less sensitive and specific than both of the RT-PCR tests, although the sample sizes with this test were small and the statistical uncertainty was high. These results suggest that RT-PCR testing of saliva samples at a campus facility can be an effective basis for surveillance screening to prevent SARS-CoV-2 transmission in a university setting. IMPORTANCE Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been vitally important during the COVID-19 pandemic. There are a variety of methods for testing for this virus, and it is important to understand their accuracy in choosing which one might be best suited for a given application. To estimate the accuracy of three different testing methods, we used a data set collected at a university that involved testing the same samples with multiple tests. Unlike most other estimates of test accuracy, we did not assume that one test was perfect but instead allowed for some degree of inaccuracy in all testing methods. We found that molecular tests performed on saliva samples at a university facility were similarly accurate as molecular tests performed on nasal samples at a commercial facility. An antigen test appeared somewhat less accurate than the molecular tests, but there was high uncertainty about that.
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Affiliation(s)
- T. Alex Perkins
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, USA
| | - Melissa Stephens
- Genomics and Bioinformatics Core Facility, University of Notre Dame, Notre Dame, Indiana, USA
| | | | - Sean Cavany
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, USA
| | - Liz Rulli
- Notre Dame Research, University of Notre Dame, Notre Dame, Indiana, USA
| | - Michael E. Pfrender
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, USA
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6
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Cluzel N, Courbariaux M, Wang S, Moulin L, Wurtzer S, Bertrand I, Laurent K, Monfort P, Gantzer C, Guyader SL, Boni M, Mouchel JM, Maréchal V, Nuel G, Maday Y. A nationwide indicator to smooth and normalize heterogeneous SARS-CoV-2 RNA data in wastewater. Environ Int 2022; 158:106998. [PMID: 34991258 PMCID: PMC8608586 DOI: 10.1016/j.envint.2021.106998] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/20/2021] [Accepted: 11/21/2021] [Indexed: 05/18/2023]
Abstract
Since many infected people experience no or few symptoms, the SARS-CoV-2 epidemic is frequently monitored through massive virus testing of the population, an approach that may be biased and may be difficult to sustain in low-income countries. Since SARS-CoV-2 RNA can be detected in stool samples, quantifying SARS-CoV-2 genome by RT-qPCR in wastewater treatment plants (WWTPs) has been carried out as a complementary tool to monitor virus circulation among human populations. However, measuring SARS-CoV-2 viral load in WWTPs can be affected by many experimental and environmental factors. To circumvent these limits, we propose here a novel indicator, the wastewater indicator (WWI), that partly reduces and corrects the noise associated with the SARS-CoV-2 genome quantification in wastewater (average noise reduction of 19%). All data processing results in an average correlation gain of 18% with the incidence rate. The WWI can take into account the censorship linked to the limit of quantification (LOQ), allows the automatic detection of outliers to be integrated into the smoothing algorithm, estimates the average measurement error committed on the samples and proposes a solution for inter-laboratory normalization in the absence of inter-laboratory assays (ILA). This method has been successfully applied in the context of Obépine, a French national network that has been quantifying SARS-CoV-2 genome in a representative sample of French WWTPs since March 5th 2020. By August 26th, 2021, 168 WWTPs were monitored in the French metropolitan and overseas territories of France. We detail the process of elaboration of this indicator, show that it is strongly correlated to the incidence rate and that the optimal time lag between these two signals is only a few days, making our indicator an efficient complement to the incidence rate. This alternative approach may be especially important to evaluate SARS-CoV-2 dynamics in human populations when the testing rate is low.
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Affiliation(s)
- Nicolas Cluzel
- Sorbonne Université, Maison des Modélisations Ingénieries et Technologies (SUMMIT), 75005 Paris, France.
| | - Marie Courbariaux
- Sorbonne Université, Maison des Modélisations Ingénieries et Technologies (SUMMIT), 75005 Paris, France
| | - Siyun Wang
- Sorbonne Université, Maison des Modélisations Ingénieries et Technologies (SUMMIT), 75005 Paris, France
| | - Laurent Moulin
- Eau de Paris, Département de Recherche, Développement et Qualité de l'Eau, 33 avenue Jean Jaurès, F-94200 Ivry sur Seine, France
| | - Sébastien Wurtzer
- Eau de Paris, Département de Recherche, Développement et Qualité de l'Eau, 33 avenue Jean Jaurès, F-94200 Ivry sur Seine, France
| | | | - Karine Laurent
- Sorbonne Université, Maison des Modélisations Ingénieries et Technologies (SUMMIT), 75005 Paris, France
| | - Patrick Monfort
- HydroSciences Montpellier, UMR 5151, Université de Montpellier, CNRS, IRD, F-34093 Montpellier, France
| | | | - Soizick Le Guyader
- Ifremer, laboratoire de Microbiologie, SG2M/LSEM, BP 21105, 44311 Nantes, France
| | - Mickaël Boni
- Institut de Recherche Biomédicale des Armées, 1 place Valérie André, F-91220 Brétigny-sur-Orge, France
| | - Jean-Marie Mouchel
- Sorbonne Université, CNRS, EPHE, UMR 7619 Metis, e-LTER Zone Atelier Seine, F-75005 Paris, France
| | - Vincent Maréchal
- Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, F-75012 Paris, France
| | - Grégory Nuel
- Stochastics and Biology Group, Probability and Statistics (LPSM, CNRS 8001), Sorbonne University, Campus Pierre et Marie Curie, 4 Place Jussieu, 75005 Paris, France
| | - Yvon Maday
- Sorbonne Université, CNRS, Université de Paris, Laboratoire Jacques-Louis Lions (LJLL), F-75005 Paris, France; Institut Universaire de France, France.
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7
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Corchis-Scott R, Geng Q, Seth R, Ray R, Beg M, Biswas N, Charron L, Drouillard KD, D'Souza R, Heath DD, Houser C, Lawal F, McGinlay J, Menard SL, Porter LA, Rawlings D, Scholl ML, Siu KWM, Tong Y, Weisener CG, Wilhelm SW, McKay RML. Averting an Outbreak of SARS-CoV-2 in a University Residence Hall through Wastewater Surveillance. Microbiol Spectr 2021; 9:e0079221. [PMID: 34612693 DOI: 10.1101/2021.06.23.21259176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 05/26/2023] Open
Abstract
A wastewater surveillance program targeting a university residence hall was implemented during the spring semester 2021 as a proactive measure to avoid an outbreak of COVID-19 on campus. Over a period of 7 weeks from early February through late March 2021, wastewater originating from the residence hall was collected as grab samples 3 times per week. During this time, there was no detection of SARS-CoV-2 by reverse transcriptase quantitative PCR (RT-qPCR) in the residence hall wastewater stream. Aiming to obtain a sample more representative of the residence hall community, a decision was made to use passive samplers beginning in late March onwards. Adopting a Moore swab approach, SARS-CoV-2 was detected in wastewater samples just 2 days after passive samplers were deployed. These samples also tested positive for the B.1.1.7 (Alpha) variant of concern (VOC) using RT-qPCR. The positive result triggered a public health case-finding response, including a mobile testing unit deployed to the residence hall the following day, with testing of nearly 200 students and staff, which identified two laboratory-confirmed cases of Alpha variant COVID-19. These individuals were relocated to a separate quarantine facility, averting an outbreak on campus. Aggregating wastewater and clinical data, the campus wastewater surveillance program has yielded the first estimates of fecal shedding rates of the Alpha VOC of SARS-CoV-2 in individuals from a nonclinical setting. IMPORTANCE Among early adopters of wastewater monitoring for SARS-CoV-2 have been colleges and universities throughout North America, many of whom are using this approach to monitor congregate living facilities for early evidence of COVID-19 infection as an integral component of campus screening programs. Yet, while there have been numerous examples where wastewater monitoring on a university campus has detected evidence for infection among community members, there are few examples where this monitoring triggered a public health response that may have averted an actual outbreak. This report details a wastewater-testing program targeting a residence hall on a university campus during spring 2021, when there was mounting concern globally over the emergence of SARS-CoV-2 variants of concern, reported to be more transmissible than the wild-type Wuhan strain. In this communication, we present a clear example of how wastewater monitoring resulted in actionable responses by university administration and public health, which averted an outbreak of COVID-19 on a university campus.
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Affiliation(s)
- Ryland Corchis-Scott
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Qiudi Geng
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Rajesh Seth
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- Civil and Environmental Engineering, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Rajan Ray
- Civil and Environmental Engineering, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Mohsan Beg
- Student Counselling Centre, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Nihar Biswas
- Civil and Environmental Engineering, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Lynn Charron
- Residence Services, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Kenneth D Drouillard
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- School of the Environment, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Ramsey D'Souza
- Windsor-Essex County Health Unit, Windsor, Ontario, Canada
| | - Daniel D Heath
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- Department of Integrative Biology, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Chris Houser
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- School of the Environment, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Felicia Lawal
- Windsor-Essex County Health Unit, Windsor, Ontario, Canada
| | - James McGinlay
- Residence Services, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Sherri Lynne Menard
- Environmental Health and Safety, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Lisa A Porter
- Department of Biomedical Sciences, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Diane Rawlings
- Residence Services, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Matthew L Scholl
- Student Health Services, University of Windsorgrid.267455.7University of Windsor, grid.267455.7, Windsor, Ontario, Canada
| | - K W Michael Siu
- Department of Chemistry and Biochemistry, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Yufeng Tong
- Department of Chemistry and Biochemistry, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Christopher G Weisener
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- School of the Environment, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Steven W Wilhelm
- Department of Microbiology, The University of Tennessee, Knoxville, Tennessee, USA
- Great Lakes Center for Fresh Waters and Human Health, Bowling Green State University, Bowling Green, Ohio, USA
| | - R Michael L McKay
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- School of the Environment, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- Great Lakes Center for Fresh Waters and Human Health, Bowling Green State University, Bowling Green, Ohio, USA
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Corchis-Scott R, Geng Q, Seth R, Ray R, Beg M, Biswas N, Charron L, Drouillard KD, D’Souza R, Heath DD, Houser C, Lawal F, McGinlay J, Menard SL, Porter LA, Rawlings D, Scholl ML, Siu KWM, Tong Y, Weisener CG, Wilhelm SW, McKay RML. Averting an Outbreak of SARS-CoV-2 in a University Residence Hall through Wastewater Surveillance. Microbiol Spectr 2021; 9:e0079221. [PMID: 34612693 PMCID: PMC8510253 DOI: 10.1128/spectrum.00792-21] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/06/2021] [Indexed: 12/23/2022] Open
Abstract
A wastewater surveillance program targeting a university residence hall was implemented during the spring semester 2021 as a proactive measure to avoid an outbreak of COVID-19 on campus. Over a period of 7 weeks from early February through late March 2021, wastewater originating from the residence hall was collected as grab samples 3 times per week. During this time, there was no detection of SARS-CoV-2 by reverse transcriptase quantitative PCR (RT-qPCR) in the residence hall wastewater stream. Aiming to obtain a sample more representative of the residence hall community, a decision was made to use passive samplers beginning in late March onwards. Adopting a Moore swab approach, SARS-CoV-2 was detected in wastewater samples just 2 days after passive samplers were deployed. These samples also tested positive for the B.1.1.7 (Alpha) variant of concern (VOC) using RT-qPCR. The positive result triggered a public health case-finding response, including a mobile testing unit deployed to the residence hall the following day, with testing of nearly 200 students and staff, which identified two laboratory-confirmed cases of Alpha variant COVID-19. These individuals were relocated to a separate quarantine facility, averting an outbreak on campus. Aggregating wastewater and clinical data, the campus wastewater surveillance program has yielded the first estimates of fecal shedding rates of the Alpha VOC of SARS-CoV-2 in individuals from a nonclinical setting. IMPORTANCE Among early adopters of wastewater monitoring for SARS-CoV-2 have been colleges and universities throughout North America, many of whom are using this approach to monitor congregate living facilities for early evidence of COVID-19 infection as an integral component of campus screening programs. Yet, while there have been numerous examples where wastewater monitoring on a university campus has detected evidence for infection among community members, there are few examples where this monitoring triggered a public health response that may have averted an actual outbreak. This report details a wastewater-testing program targeting a residence hall on a university campus during spring 2021, when there was mounting concern globally over the emergence of SARS-CoV-2 variants of concern, reported to be more transmissible than the wild-type Wuhan strain. In this communication, we present a clear example of how wastewater monitoring resulted in actionable responses by university administration and public health, which averted an outbreak of COVID-19 on a university campus.
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Affiliation(s)
- Ryland Corchis-Scott
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
| | - Qiudi Geng
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
| | - Rajesh Seth
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
- Civil and Environmental Engineering, University of Windsor, Windsor, Ontario, Canada
| | - Rajan Ray
- Civil and Environmental Engineering, University of Windsor, Windsor, Ontario, Canada
| | - Mohsan Beg
- Student Counselling Centre, University of Windsor, Windsor, Ontario, Canada
| | - Nihar Biswas
- Civil and Environmental Engineering, University of Windsor, Windsor, Ontario, Canada
| | - Lynn Charron
- Residence Services, University of Windsor, Windsor, Ontario, Canada
| | - Kenneth D. Drouillard
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
- School of the Environment, University of Windsor, Windsor, Ontario, Canada
| | - Ramsey D’Souza
- Windsor-Essex County Health Unit, Windsor, Ontario, Canada
| | - Daniel D. Heath
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
- Department of Integrative Biology, University of Windsor, Windsor, Ontario, Canada
| | - Chris Houser
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
- School of the Environment, University of Windsor, Windsor, Ontario, Canada
| | - Felicia Lawal
- Windsor-Essex County Health Unit, Windsor, Ontario, Canada
| | - James McGinlay
- Residence Services, University of Windsor, Windsor, Ontario, Canada
| | - Sherri Lynne Menard
- Environmental Health and Safety, University of Windsor, Windsor, Ontario, Canada
| | - Lisa A. Porter
- Department of Biomedical Sciences, University of Windsor, Windsor, Ontario, Canada
| | - Diane Rawlings
- Residence Services, University of Windsor, Windsor, Ontario, Canada
| | - Matthew L. Scholl
- Student Health Services, University of Windsor, Windsor, Ontario, Canada
| | - K. W. Michael Siu
- Department of Chemistry and Biochemistry, University of Windsor, Windsor, Ontario, Canada
| | - Yufeng Tong
- Department of Chemistry and Biochemistry, University of Windsor, Windsor, Ontario, Canada
| | - Christopher G. Weisener
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
- School of the Environment, University of Windsor, Windsor, Ontario, Canada
| | - Steven W. Wilhelm
- Department of Microbiology, The University of Tennessee, Knoxville, Tennessee, USA
- Great Lakes Center for Fresh Waters and Human Health, Bowling Green State University, Bowling Green, Ohio, USA
| | - R. Michael L. McKay
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
- School of the Environment, University of Windsor, Windsor, Ontario, Canada
- Great Lakes Center for Fresh Waters and Human Health, Bowling Green State University, Bowling Green, Ohio, USA
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