Ma Yu, Zhou Bo, Su Wenzhe, Liu Wenhui, Qu Chanjuan, Miao Yutian, Chen Chun, Ma Mengmeng, Dai Bofeng, Wu Huiwen, Li Xiqing, Zhang Zhoubin
Guangzhou Center for Disease Control and Prevention, Guangzhou City, Guangdong Province, China.
Weiming Environmental Molecular Diagnostics (Changshu) Co., Ltd., Changshu City, Jiangsu Province, China.
China CDC Wkly. 2025 Sep 5;7(36):1160-1167. doi: 10.46234/ccdcw2025.195.
Traditional dengue surveillance operates reactively, frequently lagging behind viral transmission patterns and thereby impeding timely public health responses. Wastewater-based epidemiology (WBE) presents significant potential for proactive early warning systems. This study sought to implement and validate the first community-level WBE system for dengue during an active outbreak, evaluating its capacity to detect cryptic transmission and provide actionable intelligence for public health interventions.
During a dengue virus serotype 1 (DENV-1) outbreak, we collected 618 wastewater grab samples from manholes within a 200-m radius of 8 reported cases, along with matched patient serum and urine samples. We systematically compared magnetic bead and polyethylene glycol (PEG) concentration methods for viral recovery efficiency. DENV-1 ribonucleic acid (RNA) was detected and quantified using reverse transcription quantitative polymerase chain reaction (RT-qPCR). Positive samples underwent genomic sequencing and phylogenetic analysis to confirm environmental signals and determine viral lineages.
The magnetic bead method demonstrated superior performance with a limit of detection of 10 copies/mL and was selected based on its higher recovery efficiency (59.7%). We successfully detected DENV-1 in 14 of 618 wastewater samples tested. Critically, a positive wastewater signal from one residential building preceded the clinical diagnosis of a new case within that same location by several hours. For a single patient, we successfully generated matched viral genomic sequences from serum, urine, and wastewater samples, providing definitive validation of the environmental signal's authenticity.
Community-level wastewater surveillance represents a powerful and effective tool for dengue control programs. This approach provides actionable early warnings by detecting cryptic viral transmission before cases receive clinical identification. Such capabilities enable public health authorities to deploy preemptive, geographically-targeted interventions, including vector control measures, fundamentally improving both the speed and precision of outbreak responses while helping to mitigate disease spread.
传统的登革热监测是被动进行的，常常落后于病毒传播模式，从而妨碍及时的公共卫生应对措施。基于废水的流行病学（WBE）在主动预警系统方面具有巨大潜力。本研究旨在实施并验证首个在登革热疫情活跃期间的社区层面WBE系统，评估其检测隐匿传播以及为公共卫生干预提供可操作情报的能力。
在登革热病毒1型（DENV-1）疫情期间，我们从8例报告病例半径200米范围内的沙井中采集了618份废水抓取样本，同时采集了匹配的患者血清和尿液样本。我们系统地比较了磁珠法和聚乙二醇（PEG）浓缩法在病毒回收效率方面的表现。使用逆转录定量聚合酶链反应（RT-qPCR）检测并定量DENV-1核糖核酸（RNA）。对阳性样本进行基因组测序和系统发育分析，以确认环境信号并确定病毒谱系。
磁珠法表现更优，检测限为每毫升10个拷贝，因其更高的回收效率（59.7%）而被选用。在检测的618份废水样本中，我们成功检测到14份样本中有DENV-1。至关重要的是，来自一栋住宅楼的废水阳性信号比同一地点新病例的临床诊断提前了几个小时。对于一名患者，我们成功从血清、尿液和废水样本中生成了匹配病毒基因组序列，明确验证了环境信号的真实性。
社区层面的废水监测是登革热防控项目的有力且有效工具。这种方法通过在病例获得临床确诊之前检测隐匿病毒传播来提供可操作的早期预警。这些能力使公共卫生当局能够部署先发制人、针对特定地理区域的干预措施，包括病媒控制措施，从根本上提高疫情应对的速度和精准度，同时有助于减轻疾病传播。
