Long-term tracking of opioid consumption in two United States cities using wastewater-based epidemiology approach

Gushgari, Adam J.; Venkatesan, Arjun K.; Chen, Jing; Steele, Joshua C.; Halden, Rolf U.

doi:10.1016/j.watres.2019.06.003

Cited by 57 publications

(45 citation statements)

References 51 publications

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“…We estimate that WBE today could reach some 2.1 billion people around the world whose household is connected to one of the approximately 105,600 wastewater treatment plants operated globally. Halden et al 2015;Venkatesan and Halden, 2014) was created over the course of a dozen years primarily with discretionary funds from philanthropists and support from partnering municipalities (Gushgari et al 2018(Gushgari et al , 2019Chen et al 2019;Driver et al, 2020). Among the latter, the city of Tempe, AZ stands out as an innovator in WBE data communication, by immediately releasing obtained wastewater data on locally consumed licit and illicit opioids via an online dashboard to inform the public, emergency response teams, and policy makers (ASU-Tempe, 2020).…”

Section: Seasonal Change In the Focus Of Wbe Observations -City Of Tementioning

confidence: 99%

Computational analysis of SARS-CoV-2/COVID-19 surveillance by wastewater-based epidemiology locally and globally: Feasibility, economy, opportunities and challenges

Hart

Halden

2020

Science of The Total Environment

Self Cite

495

520

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Journal Pre-proof J o u r n a l P r e -p r o o f 2 Abstract:With the economic and practical limits of medical screening for SARS-CoV-2/COVID-19 coming sharply into focus worldwide, scientists are turning now to wastewater-based epidemiology (WBE) as a potential tool for assessing and managing the pandemic. We employed computational analysis and modeling to examine the feasibility, economy, opportunities and challenges of enumerating active coronavirus infections locally and globally using WBE.Depending on local conditions, detection in community wastewater of one symptomatic/asymptomatic infected case per 100 to 2,000,000 non-infected people is theoretically feasible, with some practical successes now being reported from around the world. Computer simulations for past, present and emerging epidemic hotspots (e.g., Wuhan, Milan, Madrid, New York City, Teheran, Seattle, Detroit and New Orleans) identified temperature, average in-sewer travel time and per-capita water use as key variables. WBE surveillance of populations is shown to be orders of magnitude cheaper and faster than clinical screening, yet cannot fully replace it. Cost savings worldwide for one-time national surveillance campaigns are estimated to be in the million to billion US dollar range (US$), depending on a nation's population size and number of testing rounds conducted. For resource poor regions and nations, WBE may represent the only viable means of effective surveillance. Important limitations of WBE rest with its inability to identify individuals and to pinpoint their specific locations. Not compensating for temperature effects renders WBE data vulnerable to severe under-/overestimation of infected cases. Effective surveillance may be envisioned as a two-step process in which WBE serves to identify and enumerate infected cases, where after clinical testing then serves to identify infected individuals in WBE-revealed hotspots. Data provided here demonstrate this approach to save money, be broadly applicable worldwide, and potentially aid Journal Pre-proof J o u r n a l P r e -p r o o f 3 in precision management of the pandemic, thereby helping to accelerate the global economic recovery that billions of people rely upon for their livelihoods.

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Section: Seasonal Change In the Focus Of Wbe Observations -City Of Tementioning

confidence: 99%

Computational analysis of SARS-CoV-2/COVID-19 surveillance by wastewater-based epidemiology locally and globally: Feasibility, economy, opportunities and challenges

Hart

Halden

2020

Science of The Total Environment

Self Cite

495

520

View full text Add to dashboard Cite

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“…Municipal wastewater is a composite biological sample of an entire community with each member of the community inputting biological specimens every day. It is therefore no surprise that wastewater has been tapped as an epidemiological tool to gauge aspects of public health, such as narcotic usage, 1 , 2 the reemergence of poliovirus, 3 , 4 and infection rates of viral 5 , 6 and bacterial 7 , 8 diseases. COVID-19 has accelerated the interest in wastewater-based epidemiology (WBE) due to the fact that SARS-CoV-2 genes are detected in the feces of many infected individuals.…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 RNA in Wastewater Settled Solids Is Associated with COVID-19 Cases in a Large Urban Sewershed

Graham

Loeb

Wolfe

et al. 2020

Environ. Sci. Technol.

329

420

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Wastewater-based epidemiology may be useful for informing public health response to viral diseases like COVID-19 caused by SARS-CoV-2. We quantified SARS-CoV-2 RNA in wastewater influent and primary settled solids in two wastewater treatment plants to inform the preanalytical and analytical approaches and to assess whether influent or solids harbored more viral targets. The primary settled solids samples resulted in higher SARS-CoV-2 detection frequencies than the corresponding influent samples. Likewise, SARS-CoV-2 RNA was more readily detected in solids using one-step digital droplet (dd)RT-PCR than with two-step RT-QPCR and two-step ddRT-PCR, likely owing to reduced inhibition with the one-step ddRT-PCR assay. We subsequently analyzed a longitudinal time series of 89 settled solids samples from a single plant for SARS-CoV-2 RNA as well as coronavirus recovery (bovine coronavirus) and fecal strength (pepper mild mottle virus) controls. SARS-CoV-2 RNA targets N1 and N2 concentrations correlated positively and significantly with COVID-19 clinically confirmed case counts in the sewershed. Together, the results demonstrate that measuring SARS-CoV-2 RNA concentrations in settled solids may be a more sensitive approach than measuring SARS-CoV-2 in influent.

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“…Wastewater surveillance involves monitoring chemical or microbiological targets to gain insight into the behaviors or characteristics of a community. This approach has been used to characterize opioid abuse ( Gushgari et al., 2019 ), to facilitate polio eradication ( Hovi et al., 2012 ), and as an ‘early warning’ signal for the spread of viral gastroenteritis ( Hellmér et al., 2014 ). For SARS-CoV-2, this tool can potentially detect the initial occurrence or reemergence of COVID-19 in a local community ( Medema et al., 2020 ), characterize trends in incidence or prevalence, and even complement case data to assess clinical testing coverage, in part because it captures both asymptomatic and symptomatic infections ( WRF, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Early-pandemic wastewater surveillance of SARS-CoV-2 in Southern Nevada: Methodology, occurrence, and incidence/prevalence considerations

et al. 2021

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The World Health Organization (WHO) classified COVID-19 as a global pandemic, with the situation ultimately requiring unprecedented measures to mitigate the effects on public health and the global economy. Although SARS-CoV-2 (the virus responsible for COVID-19) is primarily respiratory in nature, multiple studies confirmed its genetic material could be detected in the feces of infected individuals, thereby highlighting sewage as a potential indicator of community incidence or prevalence. Numerous wastewater surveillance studies subsequently confirmed detection of SARS-CoV-2 RNA in wastewater and wastewater-associated solids/sludge. However, the methods employed in early studies vary widely so it is unclear whether differences in reported concentrations reflect true differences in epidemiological conditions, or are instead driven by methodological artifacts. The current study aimed to compare the performance of virus recovery and detection methods, detect and quantify SARS-CoV-2 genetic material in two Southern Nevada sewersheds from March–May 2020, and better understand the potential link between COVID-19 incidence/prevalence and wastewater concentrations of SARS-CoV-2 RNA. SARS-CoV-2 surrogate recovery (0.34%–55%) and equivalent sample volume (0.1 mL–1 L) differed between methods and target water matrices, ultimately impacting method sensitivity and reported concentrations. Composite sampling of influent and primary effluent resulted in a ∼10-fold increase in concentration relative to corresponding grab primary effluent samples, presumably highlighting diurnal variability in SARS-CoV-2 signal. Detection and quantification of four SARS-CoV-2 genetic markers (up to ∼10 6 gene copies per liter), along with ratios of SARS-CoV-2 to pepper mild mottle virus (PMMoV), exhibited comparability with public health data for two sewersheds in an early phase of the pandemic. Finally, a wastewater model informed by fecal shedding rates highlighted the potential significance of new cases (i.e., incidence rather than prevalence) when interpreting wastewater surveillance data.

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Long-term tracking of opioid consumption in two United States cities using wastewater-based epidemiology approach

Cited by 57 publications

References 51 publications

Computational analysis of SARS-CoV-2/COVID-19 surveillance by wastewater-based epidemiology locally and globally: Feasibility, economy, opportunities and challenges

Computational analysis of SARS-CoV-2/COVID-19 surveillance by wastewater-based epidemiology locally and globally: Feasibility, economy, opportunities and challenges

SARS-CoV-2 RNA in Wastewater Settled Solids Is Associated with COVID-19 Cases in a Large Urban Sewershed

Early-pandemic wastewater surveillance of SARS-CoV-2 in Southern Nevada: Methodology, occurrence, and incidence/prevalence considerations

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