%0 Journal Article
%T Rapid and extensive SARS-CoV-2 Omicron variant infection wave revealed by wastewater surveillance in Shenzhen following the lifting of a strict COVID-19 strategy.
%A Li Y
%A Du C
%A Lv Z
%A Wang F
%A Zhou L
%A Peng Y
%A Li W
%A Fu Y
%A Song J
%A Jia C
%A Zhang X
%A Liu M
%A Wang Z
%A Liu B
%A Yan S
%A Yang Y
%A Li X
%A Zhang Y
%A Yuan J
%A Xu S
%A Chen M
%A Shi X
%A Peng B
%A Chen Q
%A Qiu Y
%A Wu S
%A Jiang M
%A Chen M
%A Tang J
%A Wang L
%A Hu L
%A Wei B
%A Xia Y
%A Ji JS
%A Wan C
%A Lu H
%A Zhang T
%A Zou X
%A Fu S
%A Hu Q
%J Sci Total Environ
%V 949
%N 0
%D 2024 Nov 1
%M 39102947
%F 10.753
%R 10.1016/j.scitotenv.2024.175235
%X Wastewater-based epidemiology (WBE) has emerged as a promising tool for monitoring the spread of COVID-19, as SARS-CoV-2 can be shed in the faeces of infected individuals, even in the absence of symptoms. This study aimed to optimize a prediction model for estimating COVID-19 infection rates based on SARS-CoV-2 RNA concentrations in wastewater, and reveal the infection trends and variant diversification in Shenzhen, China following the lifting of a strict COVID-19 strategy. Faecal samples (n = 4337) from 1204 SARS-CoV-2 infected individuals hospitalized in a designated hospital were analysed to obtain Omicron variant-specific faecal shedding dynamics. Wastewater samples from 6 wastewater treatment plants (WWTPs) and 9 pump stations, covering 3.55 million people, were monitored for SARS-CoV-2 RNA concentrations and variant abundance. We found that the viral load in wastewater increased rapidly in December 2022 in the two districts, demonstrating a sharp peak in COVID-19 infections in late-December 2022, mainly caused by Omicron subvariants BA.5.2.48 and BF.7.14. The prediction model, based on the mass balance between total viral load in wastewater and individual faecal viral shedding, revealed a surge in the cumulative infection rate from <0.1 % to over 70 % within three weeks after the strict COVID-19 strategy was lifted. Additionally, 39 cryptic SARS-CoV-2 variants were identified in wastewater, in addition to those detected through clinical surveillance. These findings demonstrate the effectiveness of WBE in providing comprehensive and efficient assessments of COVID-19 infection rates and identifying cryptic variants, highlighting its potential for monitoring emerging pathogens with faecal shedding.