Timing and Trends for Municipal Wastewater, Lab-Confirmed Case , and Syndromic Case Surveillance of COVID-19 in Raleigh, North Carolina
Timing and Trends for Municipal Wastewater, Lab-Confirmed Case , and Syndromic Case Surveillance of COVID-19 in Raleigh, North Carolina
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DOI：
10.2105/ajph.2022.307108
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发表时间：
2023-01-01
影响因子：
12.7
通讯作者：
Harris, Angela
中科院分区：
文献类型：
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作者：
Kotlarz, Nadine;Holcomb, David A.;Harris, Angela
目标.比较一个主要大都市地区的4种COVID-19监测指标。我们分析了2020年4月10日至12月13日北卡罗来纳州罗利废水流入物和主要固体中的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）RNA。我们将废水结果与实验室确诊的COVID-19病例和综合征型COVID样疾病（CLI）病例进行了比较，以回答3个问题：（1）它们是否相关？(2)不同的监视系统在时间上是如何排列的？(3)是否有重大变化的时期（即，趋势）对齐？结果在罗利污水处理厂，废水进水，废水初级固体，实验室确认的情况下，和CLI强烈或中度相关。早些时候观察到实验室确认病例和废水流入的趋势，其次是CLI，最后是废水初级固体。所有4个指标均显示2020年6月、7月和11月COVID-19持续增加，而2020年8月和9月持续下降。2020年，在一个主要大都市地区，城市污水、实验室确诊病例和COVID-19综合征病例监测的时间和趋势基本一致。我们的研究结果为投资SARS-CoV-2废水和CLI监测提供了证据，以补充通过实验室确认病例提供的信息。
Objectives. To compare 4 COVID-19 surveillance metrics in a major metropolitan area.Methods. We analyzed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in wastewater influent and primary solids in Raleigh, North Carolina, from April 10 through December 13, 2020. We compared wastewater results with lab-confirmed COVID-19 cases and syndromic COVID-like illness (CLI) cases to answer 3 questions: (1) Did they correlate? (2) What was the temporal alignment of the different surveillance systems? (3) Did periods of significant change (i.e., trends) align?Results. In the Raleigh sewershed, wastewater influent, wastewater primary solids, lab-confirmed cases, and CLI were strongly or moderately correlated. Trends in lab-confirmed cases and wastewater influent were observed earlier, followed by CLI and, lastly, wastewater primary solids. All 4 metrics showed sustained increases in COVID-19 in June, July, and November 2020 and sustained decreases in August and September 2020.Conclusions. In a major metropolitan area in 2020, the timing of and trends in municipal wastewater, lab-confirmed case, and syndromic case surveillance of COVID-19 were in general agreement.Public Health Implications. Our results provide evidence for investment in SARS-CoV-2 wastewater and CLI surveillance to complement information provided through lab-confirmed cases.