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. 2021 Nov:283:131194.
doi: 10.1016/j.chemosphere.2021.131194. Epub 2021 Jun 17.

City-level SARS-CoV-2 sewage surveillance

Karin Yaniv  1 , Marilou Shagan  1 , Yair E Lewis  2 , Esti Kramarsky-Winter  1 , Merav Weil  3 , Victoria Indenbaum  3 , Michal Elul  3 , Oran Erster  3 , Alin Sela Brown  3 , Ella Mendelson  4 , Batya Mannasse  3 , Rachel Shirazi  3 , Satish Lakkakula  1 , Oren Miron  5 , Ehud Rinott  5 , Ricardo Gilead Baibich  6 , Iris Bigler  6 , Matan Malul  6 , Rotem Rishti  6 , Asher Brenner  7 , Eran Friedler  8 , Yael Gilboa  8 , Sara Sabach  8 , Yuval Alfiya  8 , Uta Cheruti  8 , Nadav Davidovich  5 , Jacob Moran-Gilad  5 , Yakir Berchenko  9 , Itay Bar-Or  3 , Ariel Kushmaro  10
Affiliations

City-level SARS-CoV-2 sewage surveillance

Karin Yaniv et al. Chemosphere. 2021 Nov.

Abstract

The COVID-19 pandemic created a global crisis impacting not only healthcare systems, but also economics and society. Therefore, it is important to find novel methods for monitoring disease activity. Recent data have indicated that fecal shedding of SARS-CoV-2 is common, and that viral RNA can be detected in wastewater. This suggests that wastewater monitoring is a potentially efficient tool for both epidemiological surveillance, and early warning for SARS-CoV-2 circulation at the population level. In this study we sampled an urban wastewater infrastructure in the city of Ashkelon (̴ 150,000 population), Israel, during the end of the first COVID-19 wave in May 2020 when the number of infections seemed to be waning. We were able to show varying presence of SARS-CoV-2 RNA in wastewater from several locations in the city during two sampling periods, before the resurgence was clinically apparent. This was expressed with a new index, Normalized Viral Load (NVL) which can be used in different area scales to define levels of virus activity such as red (high) or green (no), and to follow morbidity in the population at the tested area. The rise in viral load between the two sampling periods (one week apart) indicated an increase in morbidity that was evident two weeks to a month later in the population. Thus, this methodology may provide an early indication for SARS-CoV-2 infection outbreak in a population before an outbreak is clinically apparent.

Keywords: Early warning; Normalized viral load; Population monitoring; SARS-CoV-2; Wastewater epidemiology.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
Deployment of sampling units in the city of Ashkelon. Numbers 1 to 4 present sampling points for the different neighborhoods in the city, defined in the grey line. Letters A to E present sampling points along the city main sewage stream (blue line) leading to the waste water treatment plant (WWTP), point H at the top. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
Fig. 2
Fig. 2
(a) Cumulative COVID-19 cases in Ashkelon during March until August 2020. Black dash line presents the beginning of the second COVID-19 outbreak (reported by health care diagnostics). Arrows in the zoomed-in box, represent the sampling campaigned dates in May 2020. (b) Normalized SARS-CoV-2 viral loads (NVL) calculated from wastewater collection campaign from different geographic locations at the city of Ashkelon. Numbers 1 to 4 present sampling points for the different neighborhoods in the city, defined in the grey line. Letters A to E presence sampling points along the main city main sewage stream (blue line) leading to the wastewater treatment plant (WWTP). (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
See this image and copyright information in PMC

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