Regressing SARS-CoV-2 Sewage Measurements Onto COVID-19 Burden in the Population: A Proof-of-Concept for Quantitative Environmental Surveillance.

Itay Bar-Or,Eran Friedler,Eden Bitkover,Ariel Kushmaro,Yakir Berchenko,Batya Mannasse,Rachel Shirazi,Hala Abu-Ali,Oran Erster,Yossi Paitan,Marilou Shagan,Michal Elul,Yair E Lewis,Ehud Rinott,Ella Mendelson,Karin Yaniv,Victoria Indenbaum,Merav Weil,Eden Ozer,Oded Nir,Zeev Ronen,Esti Kramarsky‐Winter

doi:10.3389/fpubh.2021.561710

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an RNA virus, a member of the coronavirus family of respiratory viruses that includes severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) and the Middle East respiratory syndrome (MERS). It has had an acute and dramatic impact on health care systems, economies, and societies of affected countries during the past 8 months. Widespread testing and tracing efforts are being employed in many countries in attempts to contain and mitigate this pandemic. Recent data has indicated that fecal shedding of SARS-CoV-2 is common and that the virus RNA can be detected in wastewater. This indicates that wastewater monitoring may provide a potentially efficient tool for the epidemiological surveillance of SARS-CoV-2 infection in large populations at relevant scales. In particular, this provides important means of (i) estimating the extent of outbreaks and their spatial distributions, based primarily on in-sewer measurements, (ii) managing the early-warning system quantitatively and efficiently, and (iii) verifying disease elimination. Here we report different virus concentration methods using polyethylene glycol (PEG), alum, or filtration techniques as well as different RNA extraction methodologies, providing important insights regarding the detection of SARS-CoV-2 RNA in sewage. Virus RNA particles were detected in wastewater in several geographic locations in Israel. In addition, a correlation of virus RNA concentration to morbidity was detected in Bnei-Barak city during April 2020. This study presents a proof of concept for the use of direct raw sewage-associated virus data, during the pandemic in the country as a potential epidemiological tool.

Highlights

Waterborne pathogens, including viruses, bacteria, and protozoa can be shed into the urban water cycle via sewers [1, 2], urban runoff, agricultural runoff, and wastewater discharges [3, 4]
Coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel RNA virus belonging to a group of viruses that includes amongst others severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS)
We examined virus concentration methods from sewage samples (Table 1)

Summary

INTRODUCTION

Waterborne pathogens, including viruses, bacteria, and protozoa can be shed into the urban water cycle via sewers [1, 2], urban runoff, agricultural runoff, and wastewater discharges [3, 4]. Treated wastewater is often used for agriculture and industrial and may cause biological and environmental concerns [5, 6]. Fecal indicator bacteria are often used as a marker for the microbial quality of the treated effluents but obviously, they have limitations in representing viral pollution. Coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel RNA virus belonging to a group of viruses that includes amongst others severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). SARS-CoV-2 is one of more than 37 coronaviruses in the Coronaviridae family, within the order Nidovirales, and it is TABLE 1 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus concentration methods from sewage

Sample Method principle

MATERIALS AND METHODS

RESULTS AND DISCUSSION

DATA AVAILABILITY STATEMENT