Utilizing river and wastewater as a SARS-CoV-2 surveillance tool to predict trends and identify variants of concern in settings with limited formal sewage systems.

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Barnes, Kayla ORCID: 0000-0002-8291-4388, Levy, Joshua, Andersen, Kristian ORCID: 0000-0001-6431-5982, Gauld, Jillian, Rigby, Jonathan, Kanjerwa, Oscar, Uzzell, Christopher ORCID: 0000-0002-4204-3485, Chilupsya, Chisomo, Anscombe, Catherine, Tomkins-Tinch, Christopher ORCID: 0000-0002-9114-6421 et al (show 16 more authors) , Mbeti, Omar, Cairns, Edward, Thole, Herbert, McSweeney, Shannon, Chibwana, Marah, Ashton, Philip, Jere, Khuzwayo ORCID: 0000-0003-3376-8529, Meschke, John, Diggle, Peter, Cornick, Jennifer, Jambo, Kondwani ORCID: 0000-0002-3195-2210, Kawalazira, Gift, Paterson, Steve ORCID: 0000-0002-1307-2981, Nyirenda, Tonney, Feasey, Nicholas ORCID: 0000-0003-4041-1405 and Chilima, Benjamin (2023) Utilizing river and wastewater as a SARS-CoV-2 surveillance tool to predict trends and identify variants of concern in settings with limited formal sewage systems. [Preprint]

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Abstract

The COVID-19 pandemic continues to impact health systems globally and robust surveillance is critical for pandemic control, however not all countries can sustain community surveillance programs. Wastewater surveillance has proven valuable in high-income settings, but little is known about how river and informal sewage in low-income countries can be used for environmental surveillance of SARS-CoV-2. In Malawi, a country with limited community-based COVID-19 testing capacity, we explored the utility of rivers and wastewater for SARS-CoV-2 surveillance. From May 2020 - January 2022, we collected water from up to 112 river or informal sewage sites/month, detecting SARS-CoV-2 in 8.3% of samples. Peak SARS-CoV-2 detection in water samples predated peaks in clinical cases. Sequencing of water samples identified the Beta, Delta, and Omicron variants, with Delta and Omicron detected well in advance of detection in patients. Our work highlights wastewater can be used for detecting emerging waves, identifying variants of concern and function as an early warning system in settings with no formal sewage systems.

Item Type:	Preprint
Uncontrolled Keywords:	Vaccine Related, Emerging Infectious Diseases, Prevention, Biodefense, Clinical Research, 3 Good Health and Well Being
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User:	Symplectic Admin
Date Deposited:	24 Apr 2023 07:40
Last Modified:	26 Apr 2024 00:23
DOI:	10.21203/rs.3.rs-2801767/v1
Open Access URL:	https://doi.org/10.21203/rs.3.rs-2801767/v1
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3169884