tetano
Editor, Senior Moderator
mSphere
. 2023 Jun 20;e0013223.
doi: 10.1128/msphere.00132-23. Online ahead of print. Longitudinal and quantitative fecal shedding dynamics of SARS-CoV-2, pepper mild mottle virus, and crAssphage
Peter J Arts[SUP] 1 [/SUP], J Daniel Kelly[SUP] 2 3 4 5 [/SUP], Claire M Midgley[SUP] 6 [/SUP], Khamal Anglin[SUP] 2 3 [/SUP], Scott Lu[SUP] 2 3 [/SUP], Glen R Abedi[SUP] 6 [/SUP], Raul Andino[SUP] 7 [/SUP], Kevin M Bakker[SUP] 8 [/SUP], Bryon Banman[SUP] 1 [/SUP], Alexandria B Boehm[SUP] 9 [/SUP], Melissa Briggs-Hagen[SUP] 6 [/SUP], Andrew F Brouwer[SUP] 8 [/SUP], Michelle C Davidson[SUP] 10 [/SUP], Marisa C Eisenberg[SUP] 8 [/SUP], Miguel Garcia-Knight[SUP] 7 [/SUP], Sterling Knight[SUP] 1 [/SUP], Michael J Peluso[SUP] 11 [/SUP], Jesus Pineda-Ramirez[SUP] 2 3 [/SUP], Ruth Diaz Sanchez[SUP] 2 3 [/SUP], Sharon Saydah[SUP] 6 [/SUP], Michel Tassetto[SUP] 7 [/SUP], Jeffrey N Martin[SUP] 2 [/SUP], Krista R Wigginton[SUP] 1 [/SUP]
Affiliations
Wastewater-based epidemiology (WBE) emerged during the coronavirus disease 2019 (COVID-19) pandemic as a scalable and broadly applicable method for community-level monitoring of infectious disease burden. The lack of high-resolution fecal shedding data for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) limits our ability to link WBE measurements to disease burden. In this study, we present longitudinal, quantitative fecal shedding data for SARS-CoV-2 RNA, as well as for the commonly used fecal indicators pepper mild mottle virus (PMMoV) RNA and crAss-like phage (crAssphage) DNA. The shedding trajectories from 48 SARS-CoV-2-infected individuals suggest a highly individualized, dynamic course of SARS-CoV-2 RNA fecal shedding. Of the individuals that provided at least three stool samples spanning more than 14 days, 77% had one or more samples that tested positive for SARS-CoV-2 RNA. We detected PMMoV RNA in at least one sample from all individuals and in 96% (352/367) of samples overall. CrAssphage DNA was detected in at least one sample from 80% (38/48) of individuals and was detected in 48% (179/371) of all samples. The geometric mean concentrations of PMMoV and crAssphage in stool across all individuals were 8.7 × 10[SUP]4[/SUP] and 1.4 × 10[SUP]4[/SUP] gene copies/milligram-dry weight, respectively, and crAssphage shedding was more consistent for individuals than PMMoV shedding. These results provide us with a missing link needed to connect laboratory WBE results with mechanistic models, and this will aid in more accurate estimates of COVID-19 burden in sewersheds. Additionally, the PMMoV and crAssphage data are critical for evaluating their utility as fecal strength normalizing measures and for source-tracking applications. IMPORTANCE This research represents a critical step in the advancement of wastewater monitoring for public health. To date, mechanistic materials balance modeling of wastewater-based epidemiology has relied on SARS-CoV-2 fecal shedding estimates from small-scale clinical reports or meta-analyses of research using a wide range of analytical methodologies. Additionally, previous SARS-CoV-2 fecal shedding data have not contained sufficient methodological information for building accurate materials balance models. Like SARS-CoV-2, fecal shedding of PMMoV and crAssphage has been understudied to date. The data presented here provide externally valid and longitudinal fecal shedding data for SARS-CoV-2, PMMoV, and crAssphage which can be directly applied to WBE models and ultimately increase the utility of WBE.
Keywords: PMMoV; SARS-CoV-2; crAssphage; fecal shedding; stool.
. 2023 Jun 20;e0013223.
doi: 10.1128/msphere.00132-23. Online ahead of print. Longitudinal and quantitative fecal shedding dynamics of SARS-CoV-2, pepper mild mottle virus, and crAssphage
Peter J Arts[SUP] 1 [/SUP], J Daniel Kelly[SUP] 2 3 4 5 [/SUP], Claire M Midgley[SUP] 6 [/SUP], Khamal Anglin[SUP] 2 3 [/SUP], Scott Lu[SUP] 2 3 [/SUP], Glen R Abedi[SUP] 6 [/SUP], Raul Andino[SUP] 7 [/SUP], Kevin M Bakker[SUP] 8 [/SUP], Bryon Banman[SUP] 1 [/SUP], Alexandria B Boehm[SUP] 9 [/SUP], Melissa Briggs-Hagen[SUP] 6 [/SUP], Andrew F Brouwer[SUP] 8 [/SUP], Michelle C Davidson[SUP] 10 [/SUP], Marisa C Eisenberg[SUP] 8 [/SUP], Miguel Garcia-Knight[SUP] 7 [/SUP], Sterling Knight[SUP] 1 [/SUP], Michael J Peluso[SUP] 11 [/SUP], Jesus Pineda-Ramirez[SUP] 2 3 [/SUP], Ruth Diaz Sanchez[SUP] 2 3 [/SUP], Sharon Saydah[SUP] 6 [/SUP], Michel Tassetto[SUP] 7 [/SUP], Jeffrey N Martin[SUP] 2 [/SUP], Krista R Wigginton[SUP] 1 [/SUP]
Affiliations
- PMID: 37338211
- DOI: 10.1128/msphere.00132-23
Wastewater-based epidemiology (WBE) emerged during the coronavirus disease 2019 (COVID-19) pandemic as a scalable and broadly applicable method for community-level monitoring of infectious disease burden. The lack of high-resolution fecal shedding data for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) limits our ability to link WBE measurements to disease burden. In this study, we present longitudinal, quantitative fecal shedding data for SARS-CoV-2 RNA, as well as for the commonly used fecal indicators pepper mild mottle virus (PMMoV) RNA and crAss-like phage (crAssphage) DNA. The shedding trajectories from 48 SARS-CoV-2-infected individuals suggest a highly individualized, dynamic course of SARS-CoV-2 RNA fecal shedding. Of the individuals that provided at least three stool samples spanning more than 14 days, 77% had one or more samples that tested positive for SARS-CoV-2 RNA. We detected PMMoV RNA in at least one sample from all individuals and in 96% (352/367) of samples overall. CrAssphage DNA was detected in at least one sample from 80% (38/48) of individuals and was detected in 48% (179/371) of all samples. The geometric mean concentrations of PMMoV and crAssphage in stool across all individuals were 8.7 × 10[SUP]4[/SUP] and 1.4 × 10[SUP]4[/SUP] gene copies/milligram-dry weight, respectively, and crAssphage shedding was more consistent for individuals than PMMoV shedding. These results provide us with a missing link needed to connect laboratory WBE results with mechanistic models, and this will aid in more accurate estimates of COVID-19 burden in sewersheds. Additionally, the PMMoV and crAssphage data are critical for evaluating their utility as fecal strength normalizing measures and for source-tracking applications. IMPORTANCE This research represents a critical step in the advancement of wastewater monitoring for public health. To date, mechanistic materials balance modeling of wastewater-based epidemiology has relied on SARS-CoV-2 fecal shedding estimates from small-scale clinical reports or meta-analyses of research using a wide range of analytical methodologies. Additionally, previous SARS-CoV-2 fecal shedding data have not contained sufficient methodological information for building accurate materials balance models. Like SARS-CoV-2, fecal shedding of PMMoV and crAssphage has been understudied to date. The data presented here provide externally valid and longitudinal fecal shedding data for SARS-CoV-2, PMMoV, and crAssphage which can be directly applied to WBE models and ultimately increase the utility of WBE.
Keywords: PMMoV; SARS-CoV-2; crAssphage; fecal shedding; stool.