A wastewater-based epidemiology tool for COVID-19 surveillance in Portugal
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The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in wastewater produced interest in its use for sentinel surveillance at a community level and as a complementary approach to syndromic surveillance. With this work, we set the foundations for wastewater-based epidemiology (WBE) in Portugal by monitoring the trends of SARS-CoV-2 RNA circulation in the community, on a nationwide perspective during different epidemiological phases of the pandemic. The Charité assays (E_Sarbecco, RdRP, and N_Sarbecco) were applied to monitor, over 32-weeks (April to December 2020), the dynamics of SARS-CoV-2 RNA at the inlet of five wastewater treatment plants (WWTP), which together serve more than two million people in Portugal. Raw wastewater from three Coronavirus disease 2019 (COVID-19) reference hospitals was also analyzed during this period. In total, more than 600 samples were tested. For the first weeks, detection of SARS-CoV-2 RNA was sporadic, with concentrations varying from 103 to 105 genome copies per liter (GC/L). Prevalence of SARS-CoV-2 RNA increased steeply by the end of May into late June, mainly in Lisboa e Vale do Tejo region (LVT), during the reopening phase. After the summer, with the reopening of schools in mid-September and return to partial face-to-face work, a pronounced increase of SARS-CoV-2 RNA in wastewater was detected. In the LVT area, SARS-CoV-2 RNA load agreed with reported trends in hotspots of infection. Synchrony between trends of SARS-CoV-2 RNA in raw wastewater and daily new COVID-19 cases highlights the value of WBE as a surveillance tool, particularly after the phasing out of the epidemiological curve and when hotspots of disease re-emerge in the population which might be difficult to spot based solely on syndromic surveillance and contact tracing. This is the first study crossing several epidemiological stages highlighting the long-term use of WBE for SARS-CoV-2.
Monteiro , S , Rente , D , Cunha , M V , Gomes , M C , Marques , T A , Lourenço , A B , Cardoso , E , Álvaro , P , Silva , M , Coelho , N , Vilaça , J , Meireles , F , Brôco , N , Carvalho , M & Santos , R 2022 , ' A wastewater-based epidemiology tool for COVID-19 surveillance in Portugal ' , Science of the Total Environment , vol. 804 , 150264 . https://doi.org/10.1016/j.scitotenv.2021.150264
Science of the Total Environment
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DescriptionFunding: Strategic funding of Fundação para a Ciência e a Tecnologia (FCT), Portugal, to cE3c and BioISI Research Units ( UIDB/00329/2020 and UIDB/04046/2020 ] is also gratefully acknowledged. This work was supported by Programa Operacional de Competitividade e Internacionalização (POCI) (FEDER component), Programa Operacional Regional de Lisboa , and Programa Operacional Regional do Norte (Project COVIDETECT, ref. 048467 ).
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