西班牙巴塞罗那大都市区首次 COVID-19 大流行期间废水中严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的时间演变。
Time Evolution of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Wastewater during the First Pandemic Wave of COVID-19 in the Metropolitan Area of Barcelona, Spain.
机构信息
Enteric Virus Laboratory, Department of Genetics, Microbiology, and Statistics, Section of Microbiology, Virology, and Biotechnology, School of Biology, University of Barcelona, Barcelona, Spain.
Institute of Nutrition and Food Safety, University of Barcelona, Barcelona, Spain.
出版信息
Appl Environ Microbiol. 2021 Mar 11;87(7). doi: 10.1128/AEM.02750-20.
Two large wastewater treatment plants (WWTP), covering around 2.7 million inhabitants, which represents around 85% of the metropolitan area of Barcelona, were sampled before, during, and after the implementation of a complete lockdown. Five one-step reverse transcriptase quantitative PCR (RT-qPCR) assays, targeting the polymerase (IP2 and IP4), the envelope (E), and the nucleoprotein (N1 and N2) genome regions, were employed for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detection in 24-h composite wastewater samples concentrated by polyethylene glycol (PEG) precipitation. SARS-CoV-2 was detected in a sewage sample collected 41 days ahead of the declaration of the first COVID-19 case. The evolution of SARS-CoV-2 genome copies in wastewater evidenced the validity of water-based epidemiology (WBE) to anticipate COVID-19 outbreaks, to evaluate the impact of control measures, and even to estimate the burden of shedders, including presymptomatic, asymptomatic, symptomatic, and undiagnosed cases. For the latter objective, a model was applied for the estimation of the total number of shedders, evidencing a high proportion of asymptomatic infected individuals. In this way, an infection prevalence of 2.0 to 6.5% was figured. On the other hand, proportions of around 0.12% and 0.09% of the total population were determined to be required for positive detection in the two WWTPs. At the end of the lockdown, SARS-CoV-2 RNA apparently disappeared in the WWTPs but could still be detected in grab samples from four urban sewers. Sewer monitoring allowed for location of specific hot spots of COVID-19, enabling the rapid adoption of appropriate mitigation measures. Water-based epidemiology (WBE) is a valuable early warning tool for tracking the circulation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among the population, including not only symptomatic patients but also asymptomatic, presymptomatic, and misdiagnosed carriers, which represent a high proportion of the infected population. In the specific case of Barcelona, wastewater surveillance anticipated by several weeks not only the original COVID-19 pandemic wave but also the onset of the second wave. In addition, SARS-CoV-2 occurrence in wastewater evidenced the efficacy of the adopted lockdown measures on the circulation of the virus. Health authorities profited from WBE to complement other inputs and adopt rapid and adequate measures to mitigate the effects of the pandemic. For example, sentinel surveillance of specific sewers helped to locate COVID-19 hot spots and to conduct massive numbers of RT-PCR tests among the population.
两座大型污水处理厂(WWTP)覆盖了约 270 万居民,约占巴塞罗那大都市区的 85%,在实施全面封锁前后进行了采样。使用 5 种一步逆转录定量 PCR(RT-qPCR)检测,针对聚合酶(IP2 和 IP4)、包膜(E)和核衣壳蛋白(N1 和 N2)基因组区域,对浓缩后的 24 小时复合污水样本进行严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)RNA 检测。在宣布首例 COVID-19 病例前 41 天,从污水中采集到了 SARS-CoV-2 样本。污水中 SARS-CoV-2 基因组拷贝的演变证明了基于水的流行病学(WBE)在预测 COVID-19 爆发、评估控制措施的影响、甚至估计排毒者的负担(包括有症状、无症状、有症状和未确诊的病例)方面的有效性。为了实现后者的目标,应用了一种模型来估计排毒者的总数,证明了无症状感染者的比例很高。通过这种方式,确定感染率为 2.0%至 6.5%。另一方面,在两座 WWTP 中,确定需要约占总人口的 0.12%和 0.09%才能进行阳性检测。封锁结束后,WWTP 中明显不再检测到 SARS-CoV-2 RNA,但仍能从四个城市污水管中采集的随机样本中检测到。污水监测使特定 COVID-19 热点位置得以定位,从而能够迅速采取适当的缓解措施。基于水的流行病学(WBE)是一种有价值的早期预警工具,可用于追踪严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)在人群中的传播,包括不仅包括有症状的患者,还包括无症状、有症状前和误诊的携带者,这些携带者占感染人群的很大比例。在巴塞罗那的具体情况下,污水监测提前数周预测了最初的 COVID-19 大流行浪潮,以及第二波浪潮的开始。此外,污水中 SARS-CoV-2 的存在证明了所采取的封锁措施对病毒传播的有效性。卫生当局利用 WBE 来补充其他投入,并采取快速和适当的措施来减轻大流行的影响。例如,对特定污水管的哨点监测有助于定位 COVID-19 热点,并对人群进行大量 RT-PCR 检测。