Complementing RNA Detection with Pharmaceutical Monitoring for Early Warning of Viral Outbreaks through Wastewater-Based Epidemiology
Complementing RNA Detection with Pharmaceutical Monitoring for Early Warning of Viral Outbreaks through Wastewater-Based Epidemiology
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DOI：
10.1021/acs.estlett.2c00259
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发表时间：
2022-06-14
影响因子：
10.9
通讯作者：
Aga, Diana S.
中科院分区：
文献类型：
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作者：
Halwatura, Lahiruni M.;Mclerran, Isabella S.;Aga, Diana S.
基于废水的流行病学使用病毒核酸来预测社区病毒暴发面临许多挑战，包括感染个体病毒脱落的差异和废水基质的干扰。在这项研究中，我们证明，监测未经处理的污水中的药物残留提供了与未来病毒爆发相关的补充信息。我们监测了63种药物活性化合物，包括用于治疗新冠肺炎和流感的抗病毒药物，以及通常用于缓解感染症状的非处方药。每周在纽约西部的四个市政污水处理厂进行抽样。检测与治疗新冠肺炎症状有关的药物残留，包括阿奇霉素(1.99~5.00mg/L)、氯喹(0.01~33.00mg/L)、羟基氯喹(0.05~30.54mg/L)和洛匹那韦(13.75~181.20 mg/L)。在发现的与新冠肺炎相关的药物总数与报告病例的5天滚动平均值之间观察到显著的相关性(p<；0.001)。在所有污水处理厂采样的SARS-CoV-2RNA拷贝数量激增之前，扑热息痛浓度大约在2.5周内飙升。结果表明，非处方药的止痛药浓度，特别是原始污水中的对乙酰氨基酚可用于补充病毒RNA数据，作为在社区一级有效管理病毒爆发的早期预警系统。
Wastewater-based epidemiology using viral nucleic acids to predict community viral outbreaks has many challenges, including differences in viral shedding of infected individuals and interference from the wastewater matrix. In this study, we demonstrate that monitoring pharmaceutical residues in untreated sewage provides complementary information that correlates with future occurrences of viral outbreaks. We monitored 63 pharmaceutically active compounds, including antivirals used to treat COVID-19 and influenza and over-the-counter drugs commonly used to relieve the symptoms of infection. Weekly sampling was conducted at four municipal sewage treatment plants in Western New York. Residues of drugs associated with managing COVID-19 symptoms were detected, including azithromycin (1.99-5.00 mu g/L), chloroquine (0.01-33.00 mu g/L), hydroxychloroquine (0.05-30.54 mu g/L), and lopinavir (13.75-181.20 mu g/L). A significant correlation (p < 0.001) was observed between the total COVID-19-related drugs detected and the 5-day rolling averages of reported cases. Acetaminophen concentrations spiked approximately 2.5 weeks before a spike in SARS-CoV-2 RNA copies in all wastewater treatment plants sampled. The results suggest over-the-counter analgesic concentrations, in particular, acetaminophen in raw sewage to be used to complement viral RNA data as an early warning system for effective management of viral outbreaks at the community level.