Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Wastewater Based Epidemiology for Viral Surveillance in an Endemic Perspective: Evidence and Challenges

Version 1 : Received: 7 February 2024 / Approved: 8 February 2024 / Online: 8 February 2024 (09:16:44 CET)

A peer-reviewed article of this Preprint also exists.

Verani, M.; Pagani, A.; Federigi, I.; Lauretani, G.; Atomsa, N.T.; Rossi, V.; Viviani, L.; Carducci, A. Wastewater-Based Epidemiology for Viral Surveillance from an Endemic Perspective: Evidence and Challenges. Viruses 2024, 16, 482. Verani, M.; Pagani, A.; Federigi, I.; Lauretani, G.; Atomsa, N.T.; Rossi, V.; Viviani, L.; Carducci, A. Wastewater-Based Epidemiology for Viral Surveillance from an Endemic Perspective: Evidence and Challenges. Viruses 2024, 16, 482.

Abstract

Wastewater-Based Epidemiology (WBE) is currently used to monitor not only the spread of the pandemic virus SARS-CoV-2 but also for other viruses in endemic conditions, particularly in the absence of syndromic surveillance. Continuous monitoring of sewage requires high costs and significant time investment, highlighting the need for standardized methods and structured monitoring strategies. In this context, we conducted weekly wastewater monitoring in northwestern Italy, targeting Human Adenovirus (HAdV), Norovirus Genogroup II (NoVggII), Enterovirus (EV), and SARS-CoV-2. Samples collected at the entrance of treatment plants were concentrated using PEG/NaCl precipitation and viral nucleic acids were extracted and detected by real-time (RT-)qPCR. NoVggII resulted the most identified target (84.4%), followed by HAdV, SARS-CoV-2, and EV. Only HAdV and EV exhibited seasonal peaks in spring and summer. SARS-CoV-2 results compared with data previously collected in the same study area (February 2021 to September 2021) revealed a shift from an epidemic to a pandemic status, likely due to the evolution of variants. In conclusion, WBE, using standardized methods and an efficient monitoring strategy, proves valuable for virus surveillance in pandemic and epidemic scenarios, enabling the identification of temporal-local distribution patterns that are useful for making informed public health decision.

Keywords

Wastewater-Based Epidemiology; wastewater surveillance; Human Adenovirus; Enterovirus; Norovirus; SARS-CoV-2; endemic environmental monitoring

Subject

Public Health and Healthcare, Public, Environmental and Occupational Health

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