TY - JOUR
T1 - Leveraging wastewater
T2 - Validating the national-scale SARS-CoV-2 surveillance system in Cyprus for elevated public health surveillance and enhanced epidemiological insight
AU - The PULSE Consortium
AU - Karaolia, Popi
AU - Quattrocchi, Annalisa
AU - Richter, Jan
AU - Loutsiou, Panagiota
AU - C. Iakovides, Iakovos
AU - Violaris, Anaxagoras
AU - Manoli, Kyriakos
AU - Michael, Costas
AU - Christodoulou, Christina
AU - Pavlou, Pavlos
AU - Kyriakou, Marios
AU - G. Eliades, Demetrios
AU - Haralambous, Christos
AU - Constantinou, Elisavet
AU - G. Michael, Stella
AU - Larcou-Yiannakou, Angeliki
AU - Nikolopoulos, Georgios
AU - Fatta-Kassinos, Despo
N1 - Publisher Copyright:
© 2024 Elsevier Ltd
PY - 2024/6
Y1 - 2024/6
N2 - The validation of a cross-country, national-scale SARS-CoV-2 wastewater surveillance system for the monitoring of public health in the Republic of Cyprus, took place during October 2021-September 2022. The chronicle of SARS-CoV-2 genetic marker concentrations and prevailing Variants of Concern (VoCs) in all large Wastewater Treatment Plants (WWTPs) of Cyprus for a continuous period of 1 year, was recorded through an integrated, multi-disciplinary sewage-based surveillance system set up to track, visualize and make the collected information and statistical analysis outcomes, publicly available. Composite sampling and physicochemical parameter normalization of Population Equivalents (PE) and SARS-CoV-2 genetic marker concentration loads were utilized. Chemical Oxygen Demand (COD) was selected for normalization of genetic fragment loads. The selection of a normalization method should be tailored according to the characteristics of each individual city/WWTP population structure, flows and wastewater origin. Metagenomic sequencing showed the transition of the SARS-CoV-2 genome from the Delta to the Omicron variant prevalence, in agreement with changes in wastewater gene concentrations. Differences in the early detection of SARS-CoV-2 genetic markers were found among cities. The established system was able to track and monitor the trend of SARS-CoV-2, even in times of absence of other public health measures such as tracing of confirmed COVID-19 cases, showing the capacity of the wastewater system to quickly capture shifts in infections. The work done herein, confirmed the ability of the national-scale system to timely observe pandemic trends, evaluate effects of control measures implemented and monitor the burden of infected patients that shed SARS-CoV-2 fragments.
AB - The validation of a cross-country, national-scale SARS-CoV-2 wastewater surveillance system for the monitoring of public health in the Republic of Cyprus, took place during October 2021-September 2022. The chronicle of SARS-CoV-2 genetic marker concentrations and prevailing Variants of Concern (VoCs) in all large Wastewater Treatment Plants (WWTPs) of Cyprus for a continuous period of 1 year, was recorded through an integrated, multi-disciplinary sewage-based surveillance system set up to track, visualize and make the collected information and statistical analysis outcomes, publicly available. Composite sampling and physicochemical parameter normalization of Population Equivalents (PE) and SARS-CoV-2 genetic marker concentration loads were utilized. Chemical Oxygen Demand (COD) was selected for normalization of genetic fragment loads. The selection of a normalization method should be tailored according to the characteristics of each individual city/WWTP population structure, flows and wastewater origin. Metagenomic sequencing showed the transition of the SARS-CoV-2 genome from the Delta to the Omicron variant prevalence, in agreement with changes in wastewater gene concentrations. Differences in the early detection of SARS-CoV-2 genetic markers were found among cities. The established system was able to track and monitor the trend of SARS-CoV-2, even in times of absence of other public health measures such as tracing of confirmed COVID-19 cases, showing the capacity of the wastewater system to quickly capture shifts in infections. The work done herein, confirmed the ability of the national-scale system to timely observe pandemic trends, evaluate effects of control measures implemented and monitor the burden of infected patients that shed SARS-CoV-2 fragments.
KW - COVID-19
KW - SARS-CoV-2
KW - Urban Wastewater
KW - Variants of Concern
KW - Wastewater Surveillance
KW - Wastewater-Based Epidemiology
UR - http://www.scopus.com/inward/record.url?scp=85192738991&partnerID=8YFLogxK
U2 - 10.1016/j.jece.2024.112953
DO - 10.1016/j.jece.2024.112953
M3 - Article
AN - SCOPUS:85192738991
SN - 2213-3437
VL - 12
JO - Journal of Environmental Chemical Engineering
JF - Journal of Environmental Chemical Engineering
IS - 3
M1 - 112953
ER -