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Existence of SARS-CoV-2 in Wastewater: Implications for Its Environmental Transmission in Developing Communities.
Environmental Science & Technology ( IF 11.4 ) Pub Date : 2020-06-11 , DOI: 10.1021/acs.est.0c02777 Muhammad Usman 1 , Muhammad Farooq 2 , Khalil Hanna 3, 4
Environmental Science & Technology ( IF 11.4 ) Pub Date : 2020-06-11 , DOI: 10.1021/acs.est.0c02777 Muhammad Usman 1 , Muhammad Farooq 2 , Khalil Hanna 3, 4
Affiliation
The ongoing pandemic of coronavirus disease 2019 (COVID-19) is a public health emergency of international concern. The disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in China in December 2019 and was declared a pandemic by the World Health Organization (WHO) on March 11th, 2020 due to its worldwide spread. This disease has now been reported in over 213 counties/territories, with more than 5.5 million confirmed cases and over 0.35 million deaths globally. SARS-CoV-2 is transmitted person-to-person via the inhalation of aerosol/droplets or through contact with contaminated surfaces. Since the detection of SARS-CoV-2 in faecal samples, it has also become clear that coronavirus is also present in human wastewater. SARS-CoV-2 has been identified in sewage in The Netherlands,(1) Australia,(2) Italy,(3) the U.S.,(4) and France.(5) The first report of SARS-CoV-2 detection in sewage came from The Netherlands suggesting its technical feasibility.(1) A study in the Paris area of France reported the existence of SARS-CoV-2 in all raw wastewater samples, and in 6 out of 8 treated wastewater samples.(5) Similarly, 6 out of 12 untreated wastewater samples in Italy were positive for SARS-CoV-2.(3) A study in the U.S. reported higher levels of SARS-CoV-2 in wastewater than would have been expected from clinically confirmed cases.(4) They estimated that roughly 5% of all faecal samples were positive for SARS-CoV-2 in the testing period whereas the number of clinically confirmed cases was 0.026%. In Australia, the number of infected individuals, estimated from untreated wastewater, were in reasonable agreement with clinical observations.(2) Analyzing wastewater for SARS-CoV-2 has therefore been proposed as a warning tool and complementary approach to track the prevalence of infection.(1−5) According to Reuters news (April 16, 2020), Australia’s Government is already planning to monitor its sewage for the presence of coronavirus. Wastewater surveillance for SARS-CoV-2 could provide an unbiased opportunity to track its epidemiology in countries having limited resources for clinical diagnosis. The presence of SARS-CoV-2 in wastewater may also have consequences for public health in developing countries with poor water and sewage infrastructure, inadequate institutional and technical disinfection capabilities, and lack of financing. According to 2017’s World Water Development Report by United Nations, 80% of wastewater worldwide (>95% in some developing countries) is released to the environment without adequate treatment. Wastewater-related exposure to SARS-CoV-2 remains a significant possibility in such vulnerable communities. For example, it is a common practice to dump wastewater without adequate treatment into surface water bodies (e.g., rivers, canals etc.) which downstream are being used for drinking water or irrigation. Cases of accidental contamination of drinking water with raw sewage is commonplace in developing countries, and even reported in the developed world.(6) Additionally, sprinkler irrigation in cities of urban green spaces using treated wastewater could potentially aerosolize the virus if present. Although there is currently no evidence of SARS-CoV-2 transmission via exposure to aerosolized wastewater, this transmission route was identified during the SARS outbreak in 2003. Wastewater aerosols, created by a defective wastewater plumbing system, were identified as a potential transmission route within a housing block in Hong Kong.(7) Finally, the use of wastewater as irrigation water has the potential to impact on soil quality and potential uptake in crops or the contamination of groundwater resources by the virus if present. In the developing world, an additional transmission route may be via faecal-oral contact. Although hypothetical at this stage, the faecal-oral transmission has been reported for many viral diseases such as Ebola Hemorrhagic fever, Hepatitis A, Hepatitis E.(8) It becomes a crucial consideration when over half of the global population (4.2 billion) lacks access to safely managed sanitation.(9) This highlights the need to consider the potential risks to developing communities from environmental transmissions differently than those who are served by adequate disinfection. We, therefore, call governments to integrate safety of wastewater management, drinking water supply and recreational water environments in their fight against the virus. Investments into wastewater infrastructure would be essential to contribute in controlling outbreaks of waterborne diseases. Effective wastewater disinfection to treat and minimize onward environmental transmission of infected wastewater is also essential. A final disinfection step should be imposed urgently if existing wastewater treatment plants are not optimized to remove viruses. There is also an urgent need to provide clear information about the efficiency of the current water disinfection treatments to stop the viral spread. The health of sanitation workers should also be protected by following best safety practices. In summary, a significant knowledge gap exists regarding transmission, persistence, and fate of SARS-CoV-2 in wastewater and the environment requiring greater understanding of the environmental dynamics, persistence, and transmission of this virus. Research is needed to investigate interactions of the virus with environmental surfaces and its persistence, mobility, and fate in soils, in the aquatic environment, and potentially in the food chain. The authors declare no competing financial interest. This article references 9 other publications.
更新日期：2020-07-07
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