Girón-Guzmán Inés, Cuevas-Ferrando Enric, Barranquero Regino, Díaz-Reolid Azahara, Puchades-Colera Pablo, Falcó Irene, Pérez-Cataluña Alba, Sánchez Gloria
Institute of Agrochemistry and Food Technology, IATA-CSIC, Av. Agustín Escardino 7, Paterna, Valencia 46980, Spain.
Institute of Agrochemistry and Food Technology, IATA-CSIC, Av. Agustín Escardino 7, Paterna, Valencia 46980, Spain.
Water Res. 2024 May 15;255:121463. doi: 10.1016/j.watres.2024.121463. Epub 2024 Mar 16.
Wastewater-based epidemiology (WBE) has lately arised as a promising tool for monitoring and tracking viral pathogens in communities. In this study, we analysed WBE's role as a multi-pathogen surveillance strategy to detect the presence of several viral illness causative agents. Thus, an epidemiological study was conducted from October 2021 to February 2023 to estimate the weekly levels of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), Respiratory Syncytial virus (RSV), and Influenza A virus (IAV) in influent wastewater samples (n = 69). In parallel, a one-year study (October 2021 to October 2022) was performed to assess the presence of pathogenic human enteric viruses. Besides, monitoring of proposed viral fecal contamination indicators crAssphage and Pepper mild mottle virus (PMMoV) was also assessed, along with plaque counting of somatic coliphages. Genetic material of rotavirus (RV), human astrovirus (HAStV), and norovirus genogroup I (GI) and GII was found in almost all samples, while hepatitis A and E viruses (HAV and HEV) only tested positive in 3.77 % and 22.64 % of the samples, respectively. No seasonal patterns were overall found for enteric viruses, although RVs had a peak prevalence in the winter months. All samples tested positive for SARS-CoV-2 RNA, with a mean concentration of 5.43 log genome copies per liter (log GC/L). The tracking of the circulating SARS-CoV-2 variants of concern (VOCs) was performed by both duplex RT-qPCR and next generation sequencing (NGS). Both techniques reliably showed how the dominant VOC transitioned from Delta to Omicron during two weeks in Spain in December 2021. RSV and IAV viruses peaked in winter months with mean concentrations 6.40 and 4.10 log GC/L, respectively. Moreover, the three selected respiratory viruses strongly correlated with reported clinical data when normalised by wastewater physico-chemical parameters and presented weaker correlations when normalising sewage concentration levels with crAssphage or somatic coliphages titers. Finally, predictive models were generated for each respiratory virus, confirming high reliability on WBE data as an early-warning system and communities illness monitoring system. Overall, this study presents WBE as an optimal tool for multi-pathogen tracking reflecting viral circulation and diseases trends within a selected area, its value as a multi-pathogen early-warning tool stands out due to its public health interest.
基于废水的流行病学（WBE）最近已成为一种用于监测和追踪社区中病毒病原体的有前景的工具。在本研究中，我们分析了WBE作为一种多病原体监测策略在检测多种病毒性疾病病原体方面的作用。因此，于2021年10月至2023年2月开展了一项流行病学研究，以估算进水废水样本（n = 69）中严重急性呼吸综合征冠状病毒2（SARS-CoV-2）、呼吸道合胞病毒（RSV）和甲型流感病毒（IAV）的每周水平。同时，进行了一项为期一年的研究（2021年10月至2022年10月），以评估致病性人类肠道病毒的存在情况。此外，还对提议的病毒粪便污染指标crAssphage和辣椒轻斑驳病毒（PMMoV）进行了监测，并对体细胞噬菌体进行了噬菌斑计数。在几乎所有样本中都发现了轮状病毒（RV）、人类星状病毒（HAStV）以及诺如病毒基因组I（GI）和GII的遗传物质，而甲型和戊型肝炎病毒（HAV和HEV）仅分别在3.77%和22.64%的样本中检测呈阳性。尽管RV在冬季月份患病率最高，但总体上未发现肠道病毒的季节性模式。所有样本的SARS-CoV-2 RNA检测均呈阳性，平均浓度为每升5.43 log基因组拷贝数（log GC/L）。通过双重RT-qPCR和下一代测序（NGS）对循环中的SARS-CoV-2关注变体（VOC）进行了追踪。这两种技术均可靠地显示了2021年12月在西班牙的两周内，主导的VOC如何从德尔塔变体转变为奥密克戎变体。RSV和IAV病毒在冬季月份达到峰值，平均浓度分别为6.40和4.10 log GC/L。此外，当通过废水理化参数进行标准化时，三种选定的呼吸道病毒与报告的临床数据高度相关，而当用crAssphage或体细胞噬菌体滴度对污水浓度水平进行标准化时，相关性较弱。最后，针对每种呼吸道病毒生成了预测模型，证实了WBE数据作为预警系统和社区疾病监测系统具有高度可靠性。总体而言，本研究表明WBE是一种用于多病原体追踪的最佳工具，能够反映选定区域内的病毒传播情况和疾病趋势，由于其对公共卫生的重要意义，其作为多病原体预警工具的价值尤为突出。
