Testing specificity and sensitivity of wastewater-based epidemiology for detecting SARS-CoV-2 in four communities on Vancouver Island, Canada

Masri, Nadia Zeina; Card, Kiffer G.; Caws, Emmanuelle A.; Babcock, Alana; Lowe, Christopher J.; Donovan, Shelley; Norum, Shelley; Lyons, Seán; Pol, Sean De; Kostenchuk, Lareina; Dorea, Caetano C.; Lachowsky, Nathan J.; Willerth, Stephanie M.; Fyles, Thomas M.; Buckley, Heather L.

doi:10.1016/j.envadv.2022.100310

Cited by 3 publications

(5 citation statements)

References 33 publications

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“…To detect SARS-CoV-2 at a 99% probability required 38 cases per 100,000 people. 29 Masri et al ( 2022) 30 also assessed the testing sensitivity and specificity of wastewater-based epidemiology for detecting SARS-CoV-2. For different genetic markers, the cut points were 19 cases per 100,000 per week for the N1 gene and 16.3 cases per 100,000 per week for N2.…”

Section: Summary Of the Evidencementioning

confidence: 99%

“…For different genetic markers, the cut points were 19 cases per 100,000 per week for the N1 gene and 16.3 cases per 100,000 per week for N2. 30 Wastewater surveillance can be difficult in remote areas where samples need to be sent to labs outside of the community for analysis. The travel time and shipping conditions can result in degradation of the sample and add to the cost of the procedure.…”

Section: Summary Of the Evidencementioning

confidence: 99%

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Wastewater Surveillance for Communicable Diseases

Clark¹,

Severn²

2023

cjht

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This Horizon Scan summarizes the available information regarding wastewater epidemiology, or wastewater surveillance, for the detection of pathogens that cause communicable diseases. Wastewater surveillance can detect the presence of pathogens or chemical substances within the wastewater system and allows for the monitoring of a broad population with a single sample. Wastewater surveillance has been used for decades but has become more common since it was implemented around the world for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19. In Canada, wastewater surveillance is currently used for the detection of SARS-CoV-2, influenza, and respiratory syncytial virus. Studies conducted in Canada and internationally indicate that wastewater surveillance can be used as a reliable method for detecting pathogens at the population level. Future uses of wastewater surveillance may include monitoring of antibiotic use and antibiotic resistance, detection of cancers in the population, or assessing the prevalence of other infections within communities.

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Section: Summary Of the Evidencementioning

confidence: 99%

Section: Summary Of the Evidencementioning

confidence: 99%

Wastewater Surveillance for Communicable Diseases

Clark¹,

Severn²

2023

cjht

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“…According to these studies, the following criteria speak in favor of an indicator function of PMMoV: high prevalence in human sewage, low seasonal variation, and stability in wastewater [75,76]. However, in wastewater monitoring, PMMoV is controversially discussed as a population marker [7,26,31]. PMMoV concentrations in raw sewage samples are usually higher than 10 4 GC/L, with fluctuations over time [77].…”

Section: Normalization Parametersmentioning

confidence: 99%

“…There is a wide variety of normalization methods documented in the literature [24]. According to the current status, normalization based on flow measurements is chosen most frequently [25][26][27]. Furthermore, standard wastewater parameters such as ammonia (NH 4 -N), total nitrogen (N tot ), or chemical oxygen demand (COD) are used as population markers for normalization.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, some studies also indicate that normalization using biological population markers such as pepper mild mottle virus (PMMoV) [1,7,16,28,29], cross-assembly phages (crAssPhage) [25,29], or Bacteroides HF183 [15] may be useful. However, the added value of these biomarkers is discussed controversially in the literature [7,20,26,[30][31][32]. A central challenge for a comparative evaluation of different normalization methods is the availability of an appropriate standard for assessing SARS-CoV-2 prevalence in a population.…”

Section: Introductionmentioning

confidence: 99%

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SARS-CoV-2 Wastewater Monitoring in Thuringia, Germany: Analytical Aspects and Normalization of Results

Haeusser,

Möller,

Smarsly

et al. 2023

Water

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Wastewater monitoring for SARS-CoV-2 is a valuable tool for surveillance in public health. However, reliable analytical methods and appropriate approaches for the normalization of results are important requirements for implementing state-wide monitoring programs. In times of insufficient case reporting, the evaluation of wastewater data is challenging. Between December 2021 and July 2022, we analyzed 646 samples from 23 WWTPs in Thuringia, Germany. We investigated the performance of a direct capture-based method for RNA extraction (4S-method) and evaluated four normalization methods (NH4-N, COD, Ntot, and PMMoV) in a pooled analysis using different epidemiological metrics. The performance requirements of the 4S method were well met. The method could be successfully applied to implement a state-wide wastewater monitoring program including a large number of medium and small wastewater treatment plants (<100,000 p.e) in high spatial density. Correlations between wastewater data and 7-day incidence or 7-day-hospitalization incidence were strong and independent from the normalization method. For the test positivity rate, PMMoV-normalized data showed a better correlation than data normalized with chemical markers. In times of low testing frequency and insufficient case reporting, 7-day-incidence data might become less reliable. Alternative epidemiological metrics like hospital admissions and test positivity data are increasingly important for evaluating wastewater monitoring data and normalization methods. Furthermore, future studies need to address the variance in biological replicates of wastewater.

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