Abstract：
OBJECTIVE: The COVID-19 pandemic has drawn attention to the benefit of wastewater-based epidemiology, particularly when case numbers are underreported. Underreporting may be an issue with mpox, where biological reasons and stigma may prevent patients from getting tested. Therefore, we aimed to assess the validity of wastewater surveillance for monitoring mpox virus DNA in wastewater of a Central European city and its association with official case numbers.
METHODS: Wastewater samples were collected between 1 July and 28 August 2022 in the catchment area of Basel, Switzerland, and the number of mpox virus genome copies they contained was determined by real-time quantitative PCR. Logistic regression analyses were used to determine the odds of detectability of mpox virus DNA in wastewater, categorised as detectable or undetectable. Mann-Whitney U tests were used to determine associations between samples that tested positive for the mpox virus and officially reported cases and patients\' recorded symptomatic phases.
RESULTS: Mpox virus DNA was detected in 15 of 39 wastewater samples. The number of positive wastewater samples was associated with the number of symptomatic cases (odds ratio [OR] = 2.18, 95% confidence interval (CI) = 1.38-3.43, p = 0.001). The number of symptomatic cases differed significantly between days with positive versus negative wastewater results (median = 11 and 8, respectively, p = 0.0024).
CONCLUSIONS: Mpox virus DNA was detectable in wastewater, even when officially reported case numbers were low (0-3 newly reported mpox cases corresponding to 6-12 symptomatic patients). Detectability in wastewater was significantly associated with the number of symptomatic patients within the catchment area. These findings illustrate the value of wastewater-based surveillance systems when assessing the prevalence of emerging and circulating infectious diseases.
METHODS: Wastewater samples were collected between 1 July and 28 August 2022 in the catchment area of Basel, Switzerland, and the number of mpox virus genome copies they contained was determined by real-time quantitative PCR. Logistic regression analyses were used to determine the odds of detectability of mpox virus DNA in wastewater, categorised as detectable or undetectable. Mann-Whitney U tests were used to determine associations between samples that tested positive for the mpox virus and officially reported cases and patients\' recorded symptomatic phases.
RESULTS: Mpox virus DNA was detected in 15 of 39 wastewater samples. The number of positive wastewater samples was associated with the number of symptomatic cases (odds ratio [OR] = 2.18, 95% confidence interval (CI) = 1.38-3.43, p = 0.001). The number of symptomatic cases differed significantly between days with positive versus negative wastewater results (median = 11 and 8, respectively, p = 0.0024).
CONCLUSIONS: Mpox virus DNA was detectable in wastewater, even when officially reported case numbers were low (0-3 newly reported mpox cases corresponding to 6-12 symptomatic patients). Detectability in wastewater was significantly associated with the number of symptomatic patients within the catchment area. These findings illustrate the value of wastewater-based surveillance systems when assessing the prevalence of emerging and circulating infectious diseases.
摘要：
目标：COVID-19大流行引起了人们对废水流行病学的关注，特别是当病例数量被低估时。少报可能是天花的问题，生物原因和污名可能会阻止患者接受测试。因此,我们旨在评估一个中欧城市废水中的水痘病毒DNA监测的有效性及其与官方病例数的关联.
方法：2022年7月1日至8月28日在巴塞尔集水区收集了废水样品，瑞士,并且通过实时定量PCR确定它们所包含的痘病毒基因组拷贝数。Logistic回归分析用于确定废水中痘病毒DNA的可检测性的几率，归类为可检测或不可检测。使用Mann-WhitneyU检验来确定检测为痘病毒阳性的样本与官方报告的病例和患者记录的症状期之间的关联。
结果：在39个废水样品中的15个中检测到了痘病毒DNA。阳性废水样本的数量与有症状病例的数量相关（比值比[OR]=2.18，95％置信区间（CI）=1.38-3.43，p=0.001）。废水结果为阳性和阴性的天数之间，有症状的病例数存在显着差异（中位数分别为11和8，p=0.0024)。
结论：废水中可检测到痘病毒DNA，即使官方报告的病例数很低（0-3例新报告的水痘病例对应6-12例症状患者）。废水的可检测性与集水区内有症状的患者数量显着相关。这些发现说明了基于废水的监测系统在评估新出现和流行传染病的患病率时的价值。
方法：2022年7月1日至8月28日在巴塞尔集水区收集了废水样品，瑞士,并且通过实时定量PCR确定它们所包含的痘病毒基因组拷贝数。Logistic回归分析用于确定废水中痘病毒DNA的可检测性的几率，归类为可检测或不可检测。使用Mann-WhitneyU检验来确定检测为痘病毒阳性的样本与官方报告的病例和患者记录的症状期之间的关联。
结果：在39个废水样品中的15个中检测到了痘病毒DNA。阳性废水样本的数量与有症状病例的数量相关（比值比[OR]=2.18，95％置信区间（CI）=1.38-3.43，p=0.001）。废水结果为阳性和阴性的天数之间，有症状的病例数存在显着差异（中位数分别为11和8，p=0.0024)。
结论：废水中可检测到痘病毒DNA，即使官方报告的病例数很低（0-3例新报告的水痘病例对应6-12例症状患者）。废水的可检测性与集水区内有症状的患者数量显着相关。这些发现说明了基于废水的监测系统在评估新出现和流行传染病的患病率时的价值。
