SARS-CoV-2 Titers in Wastewater Are Higher than Expected from Clinically Confirmed Cases

ABSTRACT Wastewater surveillance represents a complementary approach to clinical surveillance to measure the presence and prevalence of emerging infectious diseases like the novel coronavirus SARS-CoV-2. This innovative data source can improve the precision of epidemiological modeling to understand...

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Autores principales: Fuqing Wu, Jianbo Zhang, Amy Xiao, Xiaoqiong Gu, Wei Lin Lee, Federica Armas, Kathryn Kauffman, William Hanage, Mariana Matus, Newsha Ghaeli, Noriko Endo, Claire Duvallet, Mathilde Poyet, Katya Moniz, Alex D. Washburne, Timothy B. Erickson, Peter R. Chai, Janelle Thompson, Eric J. Alm
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Publicado: American Society for Microbiology 2020
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spelling oai:doaj.org-article:3c98b8bdcb9f4a0aaab4e483b107aa192021-12-02T19:46:20ZSARS-CoV-2 Titers in Wastewater Are Higher than Expected from Clinically Confirmed Cases10.1128/mSystems.00614-202379-5077https://doaj.org/article/3c98b8bdcb9f4a0aaab4e483b107aa192020-08-01T00:00:00Zhttps://journals.asm.org/doi/10.1128/mSystems.00614-20https://doaj.org/toc/2379-5077ABSTRACT Wastewater surveillance represents a complementary approach to clinical surveillance to measure the presence and prevalence of emerging infectious diseases like the novel coronavirus SARS-CoV-2. This innovative data source can improve the precision of epidemiological modeling to understand the penetrance of SARS-CoV-2 in specific vulnerable communities. Here, we tested wastewater collected at a major urban treatment facility in Massachusetts and detected SARS-CoV-2 RNA from the N gene at significant titers (57 to 303 copies per ml of sewage) in the period from 18 to 25 March 2020 using RT-qPCR. We validated detection of SARS-CoV-2 by Sanger sequencing the PCR product from the S gene. Viral titers observed were significantly higher than expected based on clinically confirmed cases in Massachusetts as of 25 March. Our approach is scalable and may be useful in modeling the SARS-CoV-2 pandemic and future outbreaks. IMPORTANCE Wastewater-based surveillance is a promising approach for proactive outbreak monitoring. SARS-CoV-2 is shed in stool early in the clinical course and infects a large asymptomatic population, making it an ideal target for wastewater-based monitoring. In this study, we develop a laboratory protocol to quantify viral titers in raw sewage via qPCR analysis and validate results with sequencing analysis. Our results suggest that the number of positive cases estimated from wastewater viral titers is orders of magnitude greater than the number of confirmed clinical cases and therefore may significantly impact efforts to understand the case fatality rate and progression of disease. These data may help inform decisions surrounding the advancement or scale-back of social distancing and quarantine efforts based on dynamic wastewater catchment-level estimations of prevalence.Fuqing WuJianbo ZhangAmy XiaoXiaoqiong GuWei Lin LeeFederica ArmasKathryn KauffmanWilliam HanageMariana MatusNewsha GhaeliNoriko EndoClaire DuvalletMathilde PoyetKatya MonizAlex D. WashburneTimothy B. EricksonPeter R. ChaiJanelle ThompsonEric J. AlmAmerican Society for MicrobiologyarticleCOVID-19 prevalencePMMoVSARS-CoV-2viral titerswastewaterMicrobiologyQR1-502ENmSystems, Vol 5, Iss 4 (2020)
institution DOAJ
collection DOAJ
language EN
topic COVID-19 prevalence
PMMoV
SARS-CoV-2
viral titers
wastewater
Microbiology
QR1-502
spellingShingle COVID-19 prevalence
PMMoV
SARS-CoV-2
viral titers
wastewater
Microbiology
QR1-502
Fuqing Wu
Jianbo Zhang
Amy Xiao
Xiaoqiong Gu
Wei Lin Lee
Federica Armas
Kathryn Kauffman
William Hanage
Mariana Matus
Newsha Ghaeli
Noriko Endo
Claire Duvallet
Mathilde Poyet
Katya Moniz
Alex D. Washburne
Timothy B. Erickson
Peter R. Chai
Janelle Thompson
Eric J. Alm
SARS-CoV-2 Titers in Wastewater Are Higher than Expected from Clinically Confirmed Cases
description ABSTRACT Wastewater surveillance represents a complementary approach to clinical surveillance to measure the presence and prevalence of emerging infectious diseases like the novel coronavirus SARS-CoV-2. This innovative data source can improve the precision of epidemiological modeling to understand the penetrance of SARS-CoV-2 in specific vulnerable communities. Here, we tested wastewater collected at a major urban treatment facility in Massachusetts and detected SARS-CoV-2 RNA from the N gene at significant titers (57 to 303 copies per ml of sewage) in the period from 18 to 25 March 2020 using RT-qPCR. We validated detection of SARS-CoV-2 by Sanger sequencing the PCR product from the S gene. Viral titers observed were significantly higher than expected based on clinically confirmed cases in Massachusetts as of 25 March. Our approach is scalable and may be useful in modeling the SARS-CoV-2 pandemic and future outbreaks. IMPORTANCE Wastewater-based surveillance is a promising approach for proactive outbreak monitoring. SARS-CoV-2 is shed in stool early in the clinical course and infects a large asymptomatic population, making it an ideal target for wastewater-based monitoring. In this study, we develop a laboratory protocol to quantify viral titers in raw sewage via qPCR analysis and validate results with sequencing analysis. Our results suggest that the number of positive cases estimated from wastewater viral titers is orders of magnitude greater than the number of confirmed clinical cases and therefore may significantly impact efforts to understand the case fatality rate and progression of disease. These data may help inform decisions surrounding the advancement or scale-back of social distancing and quarantine efforts based on dynamic wastewater catchment-level estimations of prevalence.
format article
author Fuqing Wu
Jianbo Zhang
Amy Xiao
Xiaoqiong Gu
Wei Lin Lee
Federica Armas
Kathryn Kauffman
William Hanage
Mariana Matus
Newsha Ghaeli
Noriko Endo
Claire Duvallet
Mathilde Poyet
Katya Moniz
Alex D. Washburne
Timothy B. Erickson
Peter R. Chai
Janelle Thompson
Eric J. Alm
author_facet Fuqing Wu
Jianbo Zhang
Amy Xiao
Xiaoqiong Gu
Wei Lin Lee
Federica Armas
Kathryn Kauffman
William Hanage
Mariana Matus
Newsha Ghaeli
Noriko Endo
Claire Duvallet
Mathilde Poyet
Katya Moniz
Alex D. Washburne
Timothy B. Erickson
Peter R. Chai
Janelle Thompson
Eric J. Alm
author_sort Fuqing Wu
title SARS-CoV-2 Titers in Wastewater Are Higher than Expected from Clinically Confirmed Cases
title_short SARS-CoV-2 Titers in Wastewater Are Higher than Expected from Clinically Confirmed Cases
title_full SARS-CoV-2 Titers in Wastewater Are Higher than Expected from Clinically Confirmed Cases
title_fullStr SARS-CoV-2 Titers in Wastewater Are Higher than Expected from Clinically Confirmed Cases
title_full_unstemmed SARS-CoV-2 Titers in Wastewater Are Higher than Expected from Clinically Confirmed Cases
title_sort sars-cov-2 titers in wastewater are higher than expected from clinically confirmed cases
publisher American Society for Microbiology
publishDate 2020
url https://doaj.org/article/3c98b8bdcb9f4a0aaab4e483b107aa19
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