Indian Journal of Public Health

LETTER TO THE EDITOR
Year
: 2020  |  Volume : 64  |  Issue : 6  |  Page : 247--248

Wastewater monitoring and public health surveillance of SARS-CoV-2


Kumar Manoj 
 Assistant Professor, Head of the Department, Department of Botany, Marwari College, Tilka Manjhi Bhagalpur University, Bhagalpur, Bihar, India

Correspondence Address:
Kumar Manoj
Department of Botany, Marwari College, Tilka Manjhi Bhagalpur University, Bhagalpur - 812 007, Bihar
India




How to cite this article:
Manoj K. Wastewater monitoring and public health surveillance of SARS-CoV-2.Indian J Public Health 2020;64:247-248


How to cite this URL:
Manoj K. Wastewater monitoring and public health surveillance of SARS-CoV-2. Indian J Public Health [serial online] 2020 [cited 2021 Sep 24 ];64:247-248
Available from: https://www.ijph.in/text.asp?2020/64/6/247/285610


Full Text



Dear Editor,

It is essential to continuously monitor the prevalence of SARS-CoV-2 and take appropriate measures to prevent and control the spread of the disease in the community. However, it is very difficult to track the virus because most people are asymptomatic; and further, it is not possible to do active clinical testing of all individuals, due to resource and cost constraints. Furthermore, COVID-19 may also show second or more waves. Under these circumstances, the passive, but effective, method of sewage or wastewater monitoring can be used to trace and track the presence of SARS-CoV-2, through their genetic material RNA, and screen entire community.

SARS-CoV-2 presence in wastewater is predictable because they can infect gastrointestinal tract and are shed through the stools of the patients.[1] Researchers in the Netherlands were the first to successfully isolate and detect SARS-CoV-2 in wastewater.[2] Very recently, researchers from Australia and the USA have also advocated sewage monitoring for SARS-CoV-2 surveillance in the community.[3],[4]

The sewage surveillance for SARS-CoV-2 has many advantages.[2] (i) Circulation of the coronavirus in population can be monitored, especially where clinical testing is limited. (ii) Real-time data analysis and estimating number of infected individuals in the community. For example, sewage data evaluation in the USA revealed exponentially higher number of infected cases than actual clinical record.[4] (iii) As an early warning system sensitive tool to provide information about emergence or reemergence of SARS-CoV-2 in the community, especially when COVID-19 prevalence is low or no clinical case is reported.[2] Furthermore, stool samples may test positive for the viral RNA even after respiratory tract tests negative.[1] (iv) As a complementary tool to the active clinical testing.[2] (v) Preparing a geographical map for COVID-19 hotspots and nonhotspots.[4]

Wastewater-based epidemiology can be used to detect environmental presence of viruses. Deshpande et al. have demonstrated about wastewater surveillance to detect wild poliovirus transmission in India.[5] A similar intervention can be used for monitoring SARS-CoV-2. The approach should involve sample collection and processing (centrifugation, filtration, and sample concentration), RNA extraction, RT-PCR (with standard primers), electrophoretic PCR products detection and sequencing, and comparison to the SARS-CoV-2 genome from the gene banks.[2] Another approach is the use of paper-based device as a sensor to trace biomarkers of COVID-19 in the sewer system, overcoming the limitations of laboratory-based PCR testing; with additional advantages of real-time on-site detection of pathogen for early interventions; fast diagnostics; easy to transport and store; and easy to incinerate the biomedical wastes.[6]

Passive surveillance through wastewater mining and monitoring of SARS-CoV-2, as a subset of National Water Quality Monitoring Network, therefore, can be utilized to assess community or public health in COVID-19 pandemic as well as postpandemic scenarios. The monitoring should commence in red, orange, as well as green zones to alert health officials in advance about the possible second wave of COVID-19.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Xiao F, Tang M, Zheng X, Liu Y, Li X, Shan H. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology 2020;158:1831-3.
2Medema G, Heijnen L, Elsinga G, Italiaander R, Brouwer A. Presence of SARS-Coronavirus-2 in Sewage. medRxiv; 2020.
3University of Queensland News. Australian Researchers Trace Sewage for Early Warning COVID-19 Spread. The University of Queensland; 2020. Available from: https://www.uq.edu.au/news/article/2020/04/australian-researchers-trace-sewage-early-warning-co vid-19-spread. [Last accessed on 2020 Apr 19].
4Francescani C, Anoruo NA. Sewage Analysis Suggests a New England Metro Area with Fewer Than 500 COVID-19 Cases May have Exponentially More. ABC News; 2020. Available from: https://abcnews.go.com/US/sewage-analysis-sug gests-england-metro -area-fewer-500/story?id=70068740. [Last accessed on 2020 Apr 19].
5Deshpande JM, Shetty SJ, Siddiqui ZA. Environmental surveillance system to track wild poliovirus transmission. Appl Environ Microbiol 2003;69:2919-27.
6Mao K, Zhang H, Yang Z. Can a paper-based device trace COVID-19 sources with wastewater-based epidemiology? Environ Sci Technol 2020;54:3733-5.