PDF(Pubmed)
Abstract：
Enteric infections are important causes of morbidity and mortality, yet clinical surveillance is limited. Wastewater-based epidemiology (WBE) has been used to study community circulation of individual enteric viruses and panels of respiratory diseases, but there is limited work studying the concurrent circulation of a suite of important enteric viruses. A retrospective WBE study was carried out at two wastewater treatment plants located in California, United States. Using digital droplet polymerase chain reaction (PCR), we measured concentrations of human adenovirus group F, enteroviruses, norovirus genogroups I and II, and rotavirus nucleic acids in wastewater solids two times per week for 26 months (n = 459 samples) between February 2021 and mid-April 2023. A novel probe-based PCR assay was developed and validated for adenovirus. We compared viral nucleic acid concentrations to positivity rates for viral infections from clinical specimens submitted to a local clinical laboratory to assess concordance between the data sets. We detected all viral targets in wastewater solids. At both wastewater treatment plants, human adenovirus group F and norovirus GII nucleic acids were detected at the highest concentrations (median concentrations greater than 105 copies/g), while rotavirus RNA was detected at the lowest concentrations (median on the order of 103 copies/g). Rotavirus, adenovirus group F, and norovirus nucleic acid concentrations were positively associated with clinical specimen positivity rates. Concentrations of tested viral nucleic acids exhibited complex associations with SARS-CoV-2 and other respiratory viral nucleic acids in wastewater, suggesting divergent transmission patterns.IMPORTANCEThis study provides evidence for the use of wastewater solids for the sensitive detection of enteric virus targets in wastewater-based epidemiology programs aimed to better understand the spread of enteric disease at a localized, community level without limitations associated with testing many individuals. Wastewater data can inform clinical, public health, and individual decision-making aimed to reduce the transmission of enteric disease.
摘要：
肠道感染是发病和死亡的重要原因,然而，临床监测是有限的。基于废水的流行病学（WBE）已用于研究单个肠道病毒和呼吸道疾病小组的社区循环，但是研究一组重要肠道病毒的并发传播的工作有限。在位于加利福尼亚的两个污水处理厂进行了WBE回顾性研究，美国。使用数字液滴聚合酶链反应（PCR），我们测量了人腺病毒F组的浓度，肠病毒,诺如病毒基因组I和II,在2021年2月至2023年4月中旬之间，每周两次，持续26个月（n=459个样品）。开发了一种新型的基于探针的PCR测定法，并对腺病毒进行了验证。我们比较了提交给当地临床实验室的临床标本中病毒感染的病毒核酸浓度与阳性率，以评估数据集之间的一致性。我们检测到废水固体中的所有病毒靶标。在两个污水处理厂，在最高浓度（中值浓度大于105拷贝/g）检测到人腺病毒F组和诺如病毒GII核酸，而轮状病毒RNA的检测浓度最低（中位数约为103拷贝/g）。轮状病毒,腺病毒F组,诺如病毒核酸浓度与临床标本阳性率呈正相关。测试的病毒核酸浓度与SARS-CoV-2和废水中的其他呼吸道病毒核酸表现出复杂的关联，暗示了不同的传播模式。重要提示本研究为在基于废水的流行病学计划中使用废水固体敏感检测肠道病毒靶标提供了证据，旨在更好地了解肠道疾病在局部的传播，社区水平没有与测试许多个人相关的限制。废水数据可以为临床提供信息，公共卫生,以及旨在减少肠道疾病传播的个人决策。
