School of Chemical, Biological, and Environmental Engineering, Oregon State University (OSU), Corvallis, Oregon, USA.
Department of Research and Innovation, Clean Water Services, Hillsboro, Oregon, USA.
Environ Health Perspect. 2022 Jun;130(6):67010. doi: 10.1289/EHP10289. Epub 2022 Jun 29.
Positive correlations have been reported between wastewater SARS-CoV-2 concentrations and a community's burden of infection, disease or both. However, previous studies mostly compared wastewater to clinical case counts or nonrepresentative convenience samples, limiting their quantitative potential.
This study examined whether wastewater SARS-CoV-2 concentrations could provide better estimations for SARS-CoV-2 community prevalence than reported cases of COVID-19. In addition, this study tested whether wastewater-based epidemiology methods could identify neighborhood-level COVID-19 hotspots and SARS-CoV-2 variants.
Community SARS-CoV-2 prevalence was estimated from eight randomized door-to-door nasal swab sampling events in six Oregon communities of disparate size, location, and demography over a 10-month period. Simultaneously, wastewater SARS-CoV-2 concentrations were quantified at each community's wastewater treatment plant and from 22 Newport, Oregon, neighborhoods. SARS-CoV-2 RNA was sequenced from all positive wastewater and nasal swab samples. Clinically reported case counts were obtained from the Oregon Health Authority.
Estimated community SARS-CoV-2 prevalence ranged from 8 to 1,687/10,000 persons. Community wastewater SARS-CoV-2 concentrations ranged from 2.9 to gene copies per liter. Wastewater SARS-CoV-2 concentrations were more highly correlated (Pearson's ; ) with community prevalence than were clinically reported cases of COVID-19 (Pearson's ; ). Monte Carlo simulations indicated that wastewater SARS-CoV-2 concentrations were significantly better than clinically reported cases at estimating prevalence (). In addition, wastewater analyses determined neighborhood-level COVID-19 hot spots and identified SARS-CoV-2 variants (B.1 and B.1.399) at the neighborhood and city scales.
The greater reliability of wastewater SARS-CoV-2 concentrations over clinically reported case counts was likely due to systematic biases that affect reported case counts, including variations in access to testing and underreporting of asymptomatic cases. With these advantages, combined with scalability and low costs, wastewater-based epidemiology can be a key component in public health surveillance of COVID-19 and other communicable infections. https://doi.org/10.1289/EHP10289.
已有研究报告显示，废水中 SARS-CoV-2 浓度与社区感染负担、疾病负担或两者均呈正相关。然而，之前的研究大多将废水与临床病例数或非代表性的便利样本进行比较，限制了其定量潜力。
本研究旨在检验废水中 SARS-CoV-2 浓度是否比 COVID-19 报告病例更能准确估计社区 SARS-CoV-2 流行率。此外，本研究还测试了基于废水的流行病学方法是否能够识别社区层面的 COVID-19 热点和 SARS-CoV-2 变体。
本研究在 10 个月的时间里，在俄勒冈州 6 个大小、位置和人口统计学特征不同的社区进行了 8 次随机上门鼻拭子采样，估计了社区 SARS-CoV-2 的流行率。同时，在每个社区的污水处理厂和俄勒冈州纽波特的 22 个社区定量检测废水中的 SARS-CoV-2 浓度。从所有阳性废水和鼻拭子样本中对 SARS-CoV-2 RNA 进行测序。从俄勒冈州卫生局获得临床报告病例数。
估计的社区 SARS-CoV-2 流行率范围为 8 至 1687/10000 人。社区废水中的 SARS-CoV-2 浓度范围为 2.9 至 基因拷贝/升。废水 SARS-CoV-2 浓度与社区流行率的相关性（皮尔逊相关系数；）明显高于临床报告的 COVID-19 病例数（皮尔逊相关系数；）。蒙特卡罗模拟表明，与临床报告病例相比，废水 SARS-CoV-2 浓度在估计流行率方面具有显著优势（）。此外，废水分析在社区和城市层面确定了 COVID-19 热点地区，并鉴定了 SARS-CoV-2 变体（B.1 和 B.1.399）。
与临床报告病例数相比，废水 SARS-CoV-2 浓度的可靠性更高，这可能是由于影响报告病例数的系统偏差，包括检测机会的差异和无症状病例的漏报。鉴于这些优势，结合可扩展性和低成本，基于废水的流行病学可以成为 COVID-19 和其他传染病公共卫生监测的关键组成部分。
