Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy.
Clinical Epidemiology Unit, Regional Reference Laboratory of Western Sicily for the Emergence of COVID-19, University Hospital "P. Giaccone", Palermo, Italy.
Front Public Health. 2024 Jul 23;12:1383536. doi: 10.3389/fpubh.2024.1383536. eCollection 2024.
Seasonal influenza generally represents an underestimated public health problem with significant socioeconomic implications. Monitoring and detecting influenza epidemics are important tasks that require integrated strategies. Wastewater-based epidemiology (WBE) is an emerging field that uses wastewater data to monitor the spread of disease and assess the health of a community. It can represent an integrative surveillance tool for better understanding the epidemiology of influenza and prevention strategies in public health.
We conducted a study that detected the presence of Influenza virus RNA using a wastewater-based approach. Samples were collected from five wastewater treatment plants in five different municipalities, serving a cumulative population of 555,673 Sicilian inhabitants in Italy. We used the RT-qPCR test to compare the combined weekly average of Influenza A and B viral RNA in wastewater samples with the average weekly incidence of Influenza-like illness (ILI) obtained from the Italian national Influenza surveillance system. We also compared the number of positive Influenza swabs with the viral RNA loads detected from wastewater. Our study investigated 189 wastewater samples.
Cumulative ILI cases substantially overlapped with the Influenza RNA load from wastewater samples. Influenza viral RNA trends in wastewater samples were similar to the rise of ILI cases in the population. Therefore, wastewater surveillance confirmed the co-circulation of Influenza A and B viruses during the season 2022/2023, with a similar trend to that reported for the weekly clinically confirmed cases.
Wastewater-based epidemiology does not replace traditional epidemiological surveillance methods, such as laboratory testing of samples from infected individuals. However, it can be a valuable complement to obtaining additional information on the incidence of influenza in the population and preventing its spread.
季节性流感通常被视为一个被低估的公共卫生问题，具有重大的社会经济影响。监测和发现流感疫情是需要综合战略的重要任务。污水流行病学（WBE）是一个新兴领域，利用污水数据来监测疾病的传播并评估社区的健康状况。它可以作为更好地了解流感流行病学和公共卫生预防策略的综合监测工具。
我们进行了一项研究，使用污水为基础的方法检测流感病毒 RNA 的存在。从意大利五个不同城市的五个污水处理厂采集样本，这些城市的总人口为 555673 名西西里岛居民。我们使用 RT-qPCR 测试来比较污水样本中甲型和乙型流感病毒 RNA 的每周综合平均值与从意大利国家流感监测系统获得的流感样疾病（ILI）的每周平均发病率。我们还将阳性流感拭子的数量与从污水中检测到的病毒 RNA 负荷进行了比较。我们的研究调查了 189 个污水样本。
累积的 ILI 病例与污水样本中的流感 RNA 负荷高度重叠。污水样本中流感病毒 RNA 的趋势与人群中 ILI 病例的上升相似。因此，污水监测证实了 2022/2023 季节甲型和乙型流感病毒的共同传播，其趋势与报告的每周临床确诊病例相似。
污水流行病学并不能替代传统的流行病学监测方法，例如对感染个体样本进行实验室检测。然而，它可以作为获取人群中流感发病率的额外信息并预防其传播的有价值的补充。
