Microorganisms (Oct 2023)

Wastewater Surveillance in Europe for Non-Polio Enteroviruses and Beyond

  • Laura Bubba,
  • Kimberley S. M. Benschop,
  • Soile Blomqvist,
  • Erwin Duizer,
  • Javier Martin,
  • Alexander G. Shaw,
  • Jean-Luc Bailly,
  • Lasse D. Rasmussen,
  • Anda Baicus,
  • Thea K. Fischer,
  • Heli Harvala

DOI
https://doi.org/10.3390/microorganisms11102496
Journal volume & issue
Vol. 11, no. 10
p. 2496

Abstract

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Wastewater surveillance (WWS) was developed in the early 1960s for the detection of poliovirus (PV) circulation in the population. It has been used to monitor several pathogens, including non-polio enteroviruses (NPEVs), which are increasingly recognised as causes of morbidity in children. However, when applying WWS to a new pathogen, it is important to consider the purpose of such a study as well as the suitability of the chosen methodology. With this purpose, the European Non-Polio Enterovirus Network (ENPEN) organised an expert webinar to discuss its history, methods, and applications; its evolution from a culture-based method to molecular detection; and future implementation of next generation sequencing (NGS). The first simulation experiments with PV calculated that a 400 mL sewage sample is sufficient for the detection of viral particles if 1:10,000 people excrete poliovirus in a population of 700,000 people. If the method is applied correctly, several NPEV types are detected. Despite culture-based methods remaining the gold standard for WWS, direct methods followed by molecular-based and sequence-based assays have been developed, not only for enterovirus but for several pathogens. Along with case-based sentinel and/or syndromic surveillance, WWS for NPEV and other pathogens represents an inexpensive, flexible, anonymised, reliable, population-based tool for monitoring outbreaks and the (re)emergence of these virus types/strains within the general population.

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