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Publications

Journal Article Review Research Support, Non-U.S. Gov't Ppublish 54 citations

PubMed: 38095438 DOI: 10.1128/cmr.00103-22

Wastewater-based surveillance as a tool for public health action: SARS-CoV-2 and beyond.

Clin Microbiol Rev 37(1):e0010322

Authors: Michael D Parkins, Bonita E Lee, Nicole Acosta, Maria Bautista, Casey R J Hubert, Steve E Hrudey, Kevin Frankowski, Xiao-Li Pang

Affiliations

  • Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada.
  • Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • O'Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
  • Department of Biological Sciences, Faculty of Science, University of Calgary, Calgary, Alberta, Canada.
  • Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada.
  • Advancing Canadian Water Assets, University of Calgary, Calgary, Alberta, Canada.
  • Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada. Provincial Health Laboratory, Alberta Health Services, Calgary, Alberta, Canada.

Abstract

Wastewater-based surveillance (WBS) has undergone dramatic advancement in the context of the coronavirus disease 2019 (COVID-19) pandemic. The power and potential of this platform technology were rapidly realized when it became evident that not only did WBS-measured SARS-CoV-2 RNA correlate strongly with COVID-19 clinical disease within monitored populations but also, in fact, it functioned as a leading indicator. Teams from across the globe rapidly innovated novel approaches by which wastewater could be collected from diverse sewersheds ranging from wastewater treatment plants (enabling community-level surveillance) to more granular locations including individual neighborhoods and high-risk buildings such as long-term care facilities (LTCF). Efficient processes enabled SARS-CoV-2 RNA extraction and concentration from the highly dilute wastewater matrix. Molecular and genomic tools to identify, quantify, and characterize SARS-CoV-2 and its various variants were adapted from clinical programs and applied to these mixed environmental systems. Novel data-sharing tools allowed this information to be mobilized and made immediately available to public health and government decision-makers and even the public, enabling evidence-informed decision-making based on local disease dynamics. WBS has since been recognized as a tool of transformative potential, providing near-real-time cost-effective, objective, comprehensive, and inclusive data on the changing prevalence of measured analytes across space and time in populations. However, as a consequence of rapid innovation from hundreds of teams simultaneously, tremendous heterogeneity currently exists in the SARS-CoV-2 WBS literature. This manuscript provides a state-of-the-art review of WBS as established with SARS-CoV-2 and details the current work underway expanding its scope to other infectious disease targets.

MeSH

Sars-Cov-2, Poliomyelitis, Public Health, Microbiology, Covid-19, Sewage, Severe Acute Respiratory Syndrome-Related Coronavirus

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