Leveraging an established neighbourhood-level, open access wastewater monitoring network to address public health priorities: a population-based study.
Leveraging an established neighbourhood-level, open access wastewater monitoring network to address public health priorities: a population-based study.
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DOI：
10.1016/s2666-5247(22)00289-0
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发表时间：
2023-01
期刊：
影响因子：
38.2
通讯作者：
Halden, Rolf U.
中科院分区：
文献类型：
--
作者：
Bowes, Devin A.;Driver, Erin M.;Kraberger, Simona;Fontenele, Rafaela S.;Holland, LaRinda A.;Wright, Jillian;Johnston, Bridger;Savic, Sonja;Newell, Melanie Engstrom;Adhikari, Sangeet;Kumar, Rahul;Goetz, Hanah;Binsfeld, Allison;Nessi, Kaxandra;Watkins, Payton;Mahant, Akhil;Zevitz, Jacob;Deitrick, Stephanie;Brown, Philip;Dalton, Richard;Garcia, Chris;Inchausti, Rosa;Holmes, Wydale;Tian, Xiao-Jun;Varsani, Arvind;Lim, Efrem S.;Scotch, Matthew;Halden, Rolf U.
在2019冠状病毒病大流行之前，美国阿片类药物流行引发了亚利桑那州滕佩的市政和学术合作，这导致了世界上第一个开放获取的仪表板，其特点是通过基于废水的流行病学（WBE）了解邻里水平的趋势。这项研究旨在展示废水监测一旦建立并被社区接受，如何能够随时适应新出现的公共卫生优先事项。在亚利桑那州大滕佩的这项基于人群的研究中，修改了现有的阿片类药物监测WBE网络，通过分析11个连续的废水集水区来跟踪SARS-CoV-2的传播。从2020年4月1日至2021年3月31日（2020年7月增加了7区和滕佩圣卢克医院），每周3天（星期二、星期四和星期六）在废水收集系统内的每个采样位置收集未经处理废水的流量加权和时间加权24小时复合样品。采用逆转录定量PCR方法检测了从污水中分离的SARS冠状病毒2型E基因，并对每个流域的SARS冠状病毒E基因拷贝数进行了测定。亚利桑那州卫生服务部自2020年5月23日起每日报告亚利桑那州滕佩市内按邮政编码新发现的COVID-19临床病例。马尔马拉县一级每日新增阳性病例、COVID-19相关住院人数、死亡人数和长期护理机构死亡人数可公开获得，并从马尔马拉县流行病曲线仪表板收集。在邮政编码水平和城市水平上汇总每个集水区废水中测量的SARS-CoV-2病毒载量（每天的基因组拷贝数），并使用均方根误差与临床报告的数据进行比较，以研究WBE的预警能力。在2020年4月1日至2021年3月31日期间，分析了1556个废水样本。大多数地区的病毒水平在2020年6月和2020年12月至2021年1月达到峰值。在2020年8月下旬秋季（秋季）学期开始时，在亚利桑那州州立大学（第6和第7区）附近的集水区发现了另一波病毒载量。此外，从2020年5月4日开始的一周，在亚利桑那州瓜达卢佩镇发现了早期感染热点，并通过有针对性的干预措施成功缓解。与新报告的临床病例相比，观察到WBE的预警潜力发生了变化，从领先（平均8.5天[SD 2.1]，2020年6月）变为滞后（-2.0天[1.4]，2021年1月）指标。从利用现有的社区级WBE报告仪表板中吸取的经验教训包括：（1）社区的购买是关键，（2）公共数据共享是有效的，（3）子邮政编码（邮政编码）数据可以帮助查明风险人群，真实的时间跟踪干预成功，并揭示当地临床测试能力对WBE预警能力的影响。这一将WBE工作从阿片类药物过渡到COVID-19的成功示范鼓励了WBE的扩展，以应对新出现和重新出现的威胁（例如，天花和脊髓灰质炎）。美国国立卫生研究院的RADx-rad倡议，国家科学基金会，弗吉尼亚G派珀慈善信托基金，J M卡普兰基金和弗林基金会。
Before the COVID-19 pandemic, the US opioid epidemic triggered a collaborative municipal and academic effort in Tempe, Arizona, which resulted in the world's first open access dashboard featuring neighbourhood-level trends informed by wastewater-based epidemiology (WBE). This study aimed to showcase how wastewater monitoring, once established and accepted by a community, could readily be adapted to respond to newly emerging public health priorities. In this population-based study in Greater Tempe, Arizona, an existing opioid monitoring WBE network was modified to track SARS-CoV-2 transmission through the analysis of 11 contiguous wastewater catchments. Flow-weighted and time-weighted 24 h composite samples of untreated wastewater were collected at each sampling location within the wastewater collection system for 3 days each week (Tuesday, Thursday, and Saturday) from April 1, 2020, to March 31, 2021 (Area 7 and Tempe St Luke's Hospital were added in July, 2020). Reverse transcription quantitative PCR targeting the E gene of SARS-CoV-2 isolated from the wastewater samples was used to determine the number of genome copies in each catchment. Newly detected clinical cases of COVID-19 by zip code within the City of Tempe, Arizona were reported daily by the Arizona Department of Health Services from May 23, 2020. Maricopa County-level new positive cases, COVID-19-related hospitalisations, deaths, and long-term care facility deaths per day are publicly available and were collected from the Maricopa County Epidemic Curve Dashboard. Viral loads of SARS-CoV-2 (genome copies per day) measured in wastewater from each catchment were aggregated at the zip code level and city level and compared with the clinically reported data using root mean square error to investigate early warning capability of WBE. Between April 1, 2020, and March 31, 2021, 1556 wastewater samples were analysed. Most locations showed two waves in viral levels peaking in June, 2020, and December, 2020–January, 2021. An additional wave of viral load was seen in catchments close to Arizona State University (Areas 6 and 7) at the beginning of the fall (autumn) semester in late August, 2020. Additionally, an early infection hotspot was detected in the Town of Guadalupe, Arizona, starting the week of May 4, 2020, that was successfully mitigated through targeted interventions. A shift in early warning potential of WBE was seen, from a leading (mean of 8·5 days [SD 2·1], June, 2020) to a lagging (−2·0 days [1·4], January, 2021) indicator compared with newly reported clinical cases. Lessons learned from leveraging an existing neighbourhood-level WBE reporting dashboard include: (1) community buy-in is key, (2) public data sharing is effective, and (3) sub-ZIP-code (postal code) data can help to pinpoint populations at risk, track intervention success in real time, and reveal the effect of local clinical testing capacity on WBE's early warning capability. This successful demonstration of transitioning WBE efforts from opioids to COVID-19 encourages an expansion of WBE to tackle newly emerging and re-emerging threats (eg, mpox and polio). National Institutes of Health's RADx-rad initiative, National Science Foundation, Virginia G Piper Charitable Trust, J M Kaplan Fund, and The Flinn Foundation.