Assessment of rapid wastewater surveillance for determination of communicable disease spread in municipalities

• Published in: The Science of the total environment 2023-11, Vol.901, p.166541-166541, Article 166541
• Main Authors: Asadi, Mohsen, Hamilton, Daniel, Shomachuk, Corwyn, Oloye, Femi F., De Lange, Chantel, Pu, Xia, Osunla, Charles A., Cantin, Jenna, El-Baroudy, Seba, Mejia, Edgard M., Gregorchuk, Branden, Becker, Michael G., Mangat, Chand, Brinkmann, Markus, Jones, Paul D., Giesy, John P., McPhedran, Kerry N.
• Format: Article
• Language: English
• Subjects: Communicable diseases; COVID-19; Early warning system; GeneXpert; Influenza; RSV; Wastewater surveillance
• ISSN: 0048-9697; 1879-1026
• DOI: 10.1016/j.scitotenv.2023.166541

Wastewater surveillance (WS) helps to improve the understanding of the spread of communicable diseases in communities. WS can assist public health decision-makers in the design and implementation of timely mitigation measures. There is an increased need to use reliable, cost-effective, simple, and rapid WS systems, given traditional analytical (or ‘gold-standard’) programs are instrument/time-intensive, and dependent on highly skilled personnel. This study investigated the application of the portable GeneXpert platform for WS of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A virus (IAV), influenza B virus (IBV), and respiratory syncytial virus (RSV). The GeneXpert system with the Xpert Xpress-SARS-CoV-2/Flu/RSV test kit uses reverse transcription-quantitative polymerase chain reaction (RT-qPCR) to analyze wastewater samples. From September 2022 through January 2023, wastewater samples were collected from the influents of municipal wastewater treatment plants (MWTPs) of Saskatoon, Prince Albert, and North Battleford in the province of Saskatchewan, Canada. Both raw and concentrated wastewater samples were subjected to the GeneXpert analysis. Results showed that the Saskatoon wastewater viral loads were significantly correlated to Saskatchewan's influenza and COVID-19 clinical cases, with a lead time of 10 days for IAV and a lag time of 4 days for SARS-CoV-2. Additionally, the GeneXpert analysis of the three cities' wastewater samples showed that the raw WS could capture the dynamics of SARS-CoV-2 and IAV due to their correlation with concentrated WS. Interestingly, IBV loads were not detected in any wastewater samples, while the Saskatoon and Prince Albert wastewater samples collected following the 2023 holiday season (end of December and beginning of January) were positive for RSV. This study indicates that the GeneXpert has excellent potential for use in the development of an early warning system for transmissible disease in municipalities and limited-resource communities while simultaneously providing stakeholders with an efficient WS methodology. [Display omitted] •GeneXpert is useful in resource-limited communities for wastewater surveillance.•GeneXpert results are correlated to clinical data for influenza and SARS-CoV-2.•Raw wastewater sample analysis can indicate the trend of viral disease spreads.•Simultaneous transmissibility of diseases can be detected by GeneXpert wastewater surveillance.