Abstract
The ongoing global pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a Public Health Emergency of International Concern, which was officially declared by the World Health Organization. SARS-CoV-2 is a member of the family Coronaviridae that consists of a group of enveloped viruses with single-stranded RNA genome, which cause diseases ranging from common colds to acute respiratory distress syndrome. Although the major transmission routes of SARS-CoV-2 are inhalation of aerosol/droplet and person-to-person contact, currently available evidence indicates that the viral RNA is present in wastewater, suggesting the need to better understand wastewater as potential sources of epidemiological data and human health risks. Here, we review the current knowledge related to the potential of wastewater surveillance to understand the epidemiology of COVID-19, methodologies for the detection and quantification of SARS-CoV-2 in wastewater, and information relevant for human health risk assessment of SARS-CoV-2. There has been growing evidence of gastrointestinal symptoms caused by SARS-CoV-2 infections and the presence of viral RNA not only in feces of infected individuals but also in wastewater. One of the major challenges in SARS-CoV-2 detection/quantification in wastewater samples is the lack of an optimized and standardized protocol. Currently available data are also limited for conducting a quantitative microbial risk assessment (QMRA) for SARS-CoV-2 exposure pathways. However, modeling-based approaches have a potential role to play in reducing the impact of the ongoing COVID-19 outbreak. Furthermore, QMRA parameters obtained from previous studies on relevant respiratory viruses help to inform risk assessments of SARS-CoV-2. Our understanding on the potential role of wastewater in SARS-CoV-2 transmission is largely limited by knowledge gaps in its occurrence, persistence, and removal in wastewater. There is an urgent need for further research to establish methodologies for wastewater surveillance and understand the implications of the presence of SARS-CoV-2 in wastewater.
Highlights
Evidence for the presence of SARS-CoV-2 and related CoVs in wastewaterOur knowledge on the presence of CoVs in wastewater is largely limited likely due, at least in part, to the lack of previous environmental investigations focusing on CoVs
Two studies demonstrated the presence of culturable SARS-CoV-2 in fecal samples from COVID-19 patients (Wang et al, 2020b; Zhang et al, 2020a), a more recent study reported that culturable virus was not isolated from feces despite high viral RNA concentrations (Wölfel et al, 2020)
wastewater treatment plant (WWTP) workers in 11 cities in Northern Ohio were evaluated via questionnaire for a 12-month study; controls were college maintenance and refiner workers
Summary
Our knowledge on the presence of CoVs in wastewater is largely limited likely due, at least in part, to the lack of previous environmental investigations focusing on CoVs. Prior investigations demonstrated that standard virus concentration methods are inefficient to recover enveloped viruses from environmental water samples (Haramoto et al, 2009; Ye et al, 2016). Despite these considerations, one of the first detections of CoVs in wastewater was achieved in 2013 (Wong et al, 2013a). This study reported on detection of DNA and RNA viruses over a 12-month study in the USA and CoVs were found in wastewater in 1 of 12 samples using microarrays.
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