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. 2023 Jul 1:880:162694.
doi: 10.1016/j.scitotenv.2023.162694. Epub 2023 Mar 8.

Impact of the COVID-19 pandemic on the prevalence of influenza A and respiratory syncytial viruses elucidated by wastewater-based epidemiology

Hiroki Ando  1 , Warish Ahmed  2 , Ryo Iwamoto  3 , Yoshinori Ando  4 , Satoshi Okabe  1 , Masaaki Kitajima  5
Affiliations

Impact of the COVID-19 pandemic on the prevalence of influenza A and respiratory syncytial viruses elucidated by wastewater-based epidemiology

Hiroki Ando et al. Sci Total Environ. .

Abstract

Since the COVID-19 pandemic, a decrease in the prevalence of Influenza A virus (IAV) and respiratory syncytial virus (RSV) has been suggested by clinical surveillance. However, there may be potential biases in obtaining an accurate overview of infectious diseases in a community. To elucidate the impact of the COVID-19 on the prevalence of IAV and RSV, we quantified IAV and RSV RNA in wastewater collected from three wastewater treatment plants (WWTPs) in Sapporo, Japan, between October 2018 and January 2023, using highly sensitive EPISENS™ method. From October 2018 to April 2020, the IAV M gene concentrations were positively correlated with the confirmed cases in the corresponding area (Spearman's r = 0.61). Subtype-specific HA genes of IAV were also detected, and their concentrations showed trends that were consistent with clinically reported cases. RSV A and B serotypes were also detected in wastewater, and their concentrations were positively correlated with the confirmed clinical cases (Spearman's r = 0.36-0.52). The detection ratios of IAV and RSV in wastewater decreased from 66.7 % (22/33) and 42.4 % (14/33) to 4.56 % (12/263) and 32.7 % (86/263), respectively in the city after the COVID-19 prevalence. The present study demonstrates the potential usefulness of wastewater-based epidemiology combined with the preservation of wastewater (wastewater banking) as a tool for better management of respiratory viral diseases.

Keywords: COVID-19; Influenza A virus; RSV; Typing; Wastewater banking; Wastewater-based epidemiology.

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Conflict of interest statement

Declaration of competing interest Ryo Iwamoto and Yoshinori Ando are employees of SHIONOGI & Co., Ltd. Masaaki Kitajima who received research funding from SHIONOGI & Co., Ltd. and AdvanSentinel, Inc. and patent royalties from SHIONOGI Co., Ltd. Satoshi Okabe received research funding from SHIONOGI Co., Ltd. and AdvanSentinel, Inc. Hiroki Ando and Warish Ahmed have no competing interests to declare.

Figures

Unlabelled Image
Graphical abstract
Fig. 1
Fig. 1
Sampling locations of wastewater treatment plants (WWTPs). Influent wastewater was collected monthly at WWTP A between October 2018 and April 2020, and weekly at WWTP B and WWTP C between May 2020 and January 2023.
Fig. 2
Fig. 2
The dynamics of the concentration of influenza A virus (IAV) RNA in influent wastewater and weekly clinical confirmed influenza cases in Sapporo City. The bars represent the clinical confirmed cases in Sapporo City, and the plots denote the wastewater concentrations of viral RNA normalized by PMMoV. The circle plots denote the wastewater concentrations at WWTP A as determined by the EPISENS-M_K method between October 2018 and April 2020, while square and triangle plots denote the wastewater concentrations at WWTP B and WWTP C, respectively, as determined by the EPISENS-M method between May 2020 and January 2023. ND refers to the non-detection of virus RNA in wastewater. The first infected person with SARS-CoV-2 was clinically confirmed on February 14, 2020 in Sapporo City. (A) Concentrations of the universal region of IAV RNA (M gene) in wastewater collected between October 2018 and January 2023, (B) Concentrations of HA genes of IAV in wastewater collected from October 2018 to April 2020 and from December 2022 to January 2023. Red and yellow plots denote the HA gene concentrations of H1pdm type and H3 types in wastewater, respectively. Red and yellow bars denote the confirmed reported number of the infected with H1N1pdm and H3N2 subtypes, respectively. In this study period, no influenza patient infected with H1N1 subtype was reported in Sapporo City. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
Fig. 3
Fig. 3
The dynamics of the concentration of respiratory syncytial virus (RSV) RNA in influent wastewater and weekly clinical confirmed RSV cases in Sapporo City. The plots denote the wastewater concentrations of viral RNA normalized by PMMoV. The circle plots denote the wastewater concentrations at WWTP A as determined by the EPISENS-M_K method between October 2018 and April 2020, while square and triangle plots denote the wastewater concentrations at WWTP B and WWTP C, respectively, as determined by the EPISENS-M method between May 2020 and January 2023. ND refers to the non-detection of viral RNA from wastewater. The first infected person with SARS-CoV-2 was clinically confirmed on February 14, 2020 in Sapporo City. (A) The blue and yellow (with varied darkness) plots denote the RNV N gene concentrations of the RSV A type and RSV B type, respectively. In Sapporo City, confirmed cases with each serotype of RSV were not reported. (B) The red plots denote the RSV RNA concentrations with an assay detecting both RSV A and RSV B serotypes, and the grey bars denote the confirmed reported number of the infected with RSV in Sapporo City. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
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