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Early warning COVID-19 outbreak in long-term care facilities using wastewater surveillance: correlation, prediction, and interaction with clinical and serological statuses.
Pang, Xiaoli; Lee, Bonita E; Gao, Tiejun; Rosychuk, Rhonda J; Immaraj, Linnet; Qiu, Judy Y; Wen, Jiabi; Zelyas, Nathan; Howden, Krista; Wallace, Janelle; Risling, Eleanor; Little, Lorie A; Kim, John; Wood, Heidi; Robinson, Alyssia; Parkins, Michael; Hubert, Casey R J; Frankowski, Kevin; Hrudey, Steve E; Sikora, Christopher.
Afiliación
  • Pang X; Department of Laboratory Medicine & Pathology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada; Public Health Laboratory, Alberta Precision Laboratories, Edmonton, AB, Canada; Li Ka Shing Institute of Virology, University of Alberta, Edmonton, AB, Canada. Electro
  • Lee BE; Li Ka Shing Institute of Virology, University of Alberta, Edmonton, AB, Canada; Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
  • Gao T; Department of Laboratory Medicine & Pathology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada.
  • Rosychuk RJ; Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
  • Immaraj L; Department of Laboratory Medicine & Pathology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada.
  • Qiu JY; Department of Laboratory Medicine & Pathology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada; Public Health Laboratory, Alberta Precision Laboratories, Edmonton, AB, Canada.
  • Wen J; School of Public Health, University of Alberta, Edmonton, AB, Canada.
  • Zelyas N; Department of Laboratory Medicine & Pathology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada; Public Health Laboratory, Alberta Precision Laboratories, Edmonton, AB, Canada.
  • Howden K; Edmonton Zone, Alberta Health Services, Edmonton, AB, Canada.
  • Wallace J; Edmonton Zone, Alberta Health Services, Edmonton, AB, Canada.
  • Risling E; Edmonton Zone, Alberta Health Services, Edmonton, AB, Canada.
  • Little LA; Edmonton Zone, Alberta Health Services, Edmonton, AB, Canada.
  • Kim J; National Microbiology Laboratory, Winnipeg, MB, Canada.
  • Wood H; National Microbiology Laboratory, Winnipeg, MB, Canada.
  • Robinson A; National Microbiology Laboratory, Winnipeg, MB, Canada.
  • Parkins M; Department of Medicine and Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, AB, Canada.
  • Hubert CRJ; Department of Biological Sciences, University of Calgary, Calgary, AB, Canada.
  • Frankowski K; Advancing Canadian Water Assets, University of Calgary, Calgary, AB, Canada.
  • Hrudey SE; Department of Laboratory Medicine & Pathology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada.
  • Sikora C; Department of Medicine, University of Alberta, Edmonton, AB, Canada; School of Public Health, University of Alberta, Edmonton, AB, Canada; Edmonton Zone, Alberta Health Services, Edmonton, AB, Canada.
Lancet Microbe ; 5(10): 100894, 2024 Oct.
Article en En | MEDLINE | ID: mdl-39182502
ABSTRACT

BACKGROUND:

The unprecedented COVID-19 pandemic has highlighted the strategic value of wastewater-based surveillance (WBS) of SARS-CoV-2. This multisite 28-month-long study focused on WBS for older residents in 12 long-term care facilities (LTCFs) in Edmonton (AB, Canada) by assessing relationships between COVID-19, WBS, and serostatus during the pandemic.

METHODS:

Wastewater samples collected two to three times per week were tested for SARS-CoV-2 using RT-quantitative PCR. The serostatus of antibodies was examined using immunoassays. The data of clinical COVID-19 outbreaks based on extensive testing were obtained from local public health officials. Analyses included calculating correlations between 7-day rolling averages for WBS and COVID-19 cases and investigating whether WBS led or lagged confirmed outbreaks using a multinomial test.

FINDINGS:

Wastewater results correlated well with clinical COVID-19 infections and outbreaks at participating LTCFs. 1058 (36·0%) of 2936 collected wastewater samples were SARS-CoV-2 positive, compared with 1247 people (resident n=671, staff n=572, and unknown n=4) reporting positive test results of 21 673 clinical samples assessed (5·8%). WBS led clinical testing in 32 (60·4%) confirmed outbreaks, which was significantly different from WBS lagged (12 outbreaks [22·6%, 95% CI 11·3-33·7]). Non-detection of WBS SARS-CoV-2 served as a negative predictor for outbreaks. WBS results attested protective immunity in vaccinated individuals before the omicron wave. A parallel increase in the proportions of positive WBS SARS-CoV-2 and anti-nucleocapsid antibodies underlined that omicron was an immunity-evading variant despite high seropositivity of neutralising antibodies after multiple doses of vaccine.

INTERPRETATION:

Implementation of WBS could enable targeted clinical investigations and improve cost-effectiveness of COVID-19 outbreak management in LTCFs. WBS and serostatus provided informed dynamic changes of infections and immunity. Critical evidence was that LTCF WBS is an effective early warning system to support rapid public health outbreak management and protect vulnerable older populations.

FUNDING:

Canadian Immunity Task Force for COVID-19 and Alberta Health.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuidados a Largo Plazo / Aguas Residuales / SARS-CoV-2 / COVID-19 Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: Lancet Microbe Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuidados a Largo Plazo / Aguas Residuales / SARS-CoV-2 / COVID-19 Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: Lancet Microbe Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido