Patterns of SARS-CoV-2 circulation revealed by a nationwide sewage surveillance programme, the Netherlands, August 2020 to February 2022
van Boven, Michiel; Hetebrij, Wouter A; Swart, Arno; Nagelkerke, Erwin; van der Beek, Rudolf Fhj; Stouten, Sjors; Hoogeveen, Rudolf T; Miura, Fuminari; Kloosterman, Astrid; van der Drift, Anne-Merel R; Welling, Anne; Lodder, Willemijn J; de Roda Husman, Ana Maria
(2023) Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin, volume 28, issue 25
(Article)
Abstract
BackgroundSurveillance of SARS-CoV-2 in wastewater offers a near real-time tool to track circulation of SARS-CoV-2 at a local scale. However, individual measurements of SARS-CoV-2 in sewage are noisy, inherently variable and can be left-censored.AimWe aimed to infer latent virus loads in a comprehensive sewage surveillance programme that includes all sewage
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treatment plants (STPs) in the Netherlands and covers 99.6% of the Dutch population.MethodsWe applied a multilevel Bayesian penalised spline model to estimate time- and STP-specific virus loads based on water flow-adjusted SARS-CoV-2 qRT-PCR data for one to four sewage samples per week for each of the more than 300 STPs.ResultsThe model captured the epidemic upsurges and downturns in the Netherlands, despite substantial day-to-day variation in the measurements. Estimated STP virus loads varied by more than two orders of magnitude, from ca 1012 virus particles per 100,000 persons per day in the epidemic trough in August 2020 to almost 1015 per 100,000 in many STPs in January 2022. The timing of epidemics at the local level was slightly shifted between STPs and municipalities, which resulted in less pronounced peaks and troughs at the national level.ConclusionAlthough substantial day-to-day variation is observed in virus load measurements, wastewater-based surveillance of SARS-CoV-2 that is performed at high sampling frequency can track long-term progression of an epidemic at a local scale in near real time.
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Keywords: Humans, Sewage, Netherlands/epidemiology, SARS-CoV-2, Wastewater-Based Epidemiological Monitoring, Bayes Theorem, COVID-19/epidemiology, RNA, Viral, Coronavirus, Covid-19, Public Health, Environmental and Occupational Health, Epidemiology, Virology
ISSN: 1560-7917
Publisher: Centre Europeen pour la Surveillance Epidemiologique du SIDA
Note: Funding Information: This research was financed by the Dutch Ministry of Health, Welfare and Sport, and by the Japan Society for the Promotion of Science (FM, JSPS KAKENHI Grant number 20J00793). The funders had no role in the design and conduct of the study, nor the decision to prepare and submit the manuscript for publication. Funding Information: We are indebted to representatives of the Dutch Water Authorities, in particular Mark van der Werf, Imke Leenen, and Bert Palsma, for facilitating the current study. We would like to thank all STP personnel working in water laboratories responsible for the actual sampling of wastewater. We gratefully acknowledge comments on the manuscript by Susan van den Hof, Irene Veldhuijzen, and Rianne van Gageldonk-Lafeber. This research was financed by the Dutch Ministry of Health, Welfare and Sport, and by the Japan Society for the Promotion of Science (FM, JSPS KAKENHI Grant number 20J00793). This work was published as a preprint article on MedRxiv (Michiel van Boven, Wouter A Hetebrij, Arno Swart, Erwin Nagelkerke, Rudolf FHJ van der Beek, Sjors Stouten, et al. Modelling patterns of SARS-CoV-2 circulation in the Netherlands, August 2020-February 2022, revealed by a nationwide sewage surveillance program. 30 May 2022. doi: https://doi.org/10.1101/2022.05.25.22275569). Publisher Copyright: © 2023 European Centre for Disease Prevention and Control (ECDC). All rights reserved.
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