Minimizing errors in RT-PCR detection and quantification of SARS-CoV-2 RNA for wastewater surveillance.

Wastewater surveillance for pathogens using reverse transcription-polymerase chain reaction (RT-PCR) is an effective and resource-efficient tool for gathering community-level public health information, including the incidence of coronavirus disease-19 (COVID-19). Surveillance of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) in wastewater can potentially provide an early warning signal of COVID-19 infections in a community. The capacity of the world's environmental microbiology and virology laboratories for SARS-CoV-2 RNA characterization in wastewater is increasing rapidly.

Pathogen performance testing of a natural swimming pool using a cocktail of microbiological surrogates and QMRA-derived management goals.

In recent decades, natural swimming pools (NSPs) have gained popularity in Europe, especially in Germany and Austria. NSPs differ from swimming pools in that they utilize biological treatment processes based on wetland processes with no disinfection residual. However, data are missing on the specific log-reduction performance of NSPs to address enteric virus, bacteria, and parasitic protozoa removal considered necessary to meet the North American risk-based benchmark (<35 illnesses per 1,000 swimming events) set by the USEPA for voluntary swimming.

Modelling faecal pathogen flows and health risks in urban Bangladesh: Implications for sanitation decision making.

Faecal-oral infections are a major component of the disease burden in low-income contexts, with inadequate sanitation seen as a contributing factor. However, demonstrating health effects of sanitation interventions - particularly in urban areas - has proved challenging and there is limited empirical evidence to support sanitation decisions that maximise health gains. This study aimed to develop, apply and validate a systems modelling approach to inform sanitation infrastructure and service decision-making in urban environments by examining enteric pathogen inputs, transport and reduction by various sanitation systems, and estimating corresponding exposure and public health impacts.

Screening Level Risk Assessment (SLRA) of human health risks from faecal pathogens associated with a Natural Swimming Pond (NSP).

Natural swimming ponds (NSPs) are artificially created bodies of water intended for human recreation, characterised by the substitution of chemical disinfection with natural biological processes for water purification. NSPs are growing in popularity, however little is known regarding the public health risks. A screening level risk assessment was undertaken as an initial step in assessing the first Canadian public NSP located in Edmonton, Alberta.

Implementation of environmental surveillance for SARS-CoV-2 virus to support public health decisions: Opportunities and challenges.

Analysing wastewater can be used to track infectious disease agents that are shed via stool and urine. Sewage surveillance of SARS-CoV-2 has been suggested as a tool to determine the extent of COVID-19 in cities and serve as an early warning for (re-)emergence of SARS-CoV-2 circulation in communities. The focus of this review is on the strength of evidence, opportunities and challenges for the application of sewage surveillance to inform public health decision making.

Utility of QMRA to compare health risks associated with alternative urban sewer overflow management strategies.

Wet weather sewer overflows pose potential short-term public health risks. With increasing populations, aging infrastructure and climate change, utilities are challenged with managing sewerage infrastructure to provide optimum outcomes. This study compared how modelled public health risk profiles could change under alternative sewer overflow management strategies during 12 and 24-month rainfall-runoff events.

Faecal Pathogen Flows and Their Public Health Risks in Urban Environments: A Proposed Approach to Inform Sanitation Planning.

Public health benefits are often a key political driver of urban sanitation investment in developing countries, however, pathogen flows are rarely taken systematically into account in sanitation investment choices. While several tools and approaches on sanitation and health risks have recently been developed, this research identified gaps in their ability to predict faecal pathogen flows, to relate exposure risks to the existing sanitation services, and to compare expected impacts of improvements. This paper outlines a conceptual approach that links faecal waste discharge patterns with potential pathogen exposure pathways to quantitatively compare urban sanitation improvement options.

A theoretical approach to using faecal indicator data to model norovirus concentration in surface water for QMRA: Glomma River, Norway.

Monitoring of faecal indicator organisms, such as Escherichia coli, in environmental and drinking waters is inadequate for the protection public health, primarily due to the poor relationship between E. coli and the occurrence of human pathogens, especially viruses, in environmental samples. Nevertheless, measurements of faecal indicator organisms within the risk based approach, can provide valuable information related to the magnitude and variability of faecal contamination, and hence provide insight into the expected level of potential pathogen contamination.

Evaluation of three full-scale stormwater treatment systems with respect to water yield, pathogen removal efficacy and human health risk from faecal pathogens.

In this study, three full-scale, operational stormwater harvesting systems located in Melbourne, Australia were evaluated with respect to water yields; pathogen removal performance by analysis of native surrogate data (Escherichiacoli, somatic coliphages and Clostridium perfringens); and potential human health risk associated with exposures to faecal pathogens using Quantitative Microbial Risk Assessment (QMRA). The water yield assessment confirmed variation between design and measured yields. Faecal contamination of urban stormwater was site specific and variable.

Variability in the recovery of a virus concentration procedure in water: Implications for QMRA.

Methods for analysing water for viruses are known to have variable and relatively poor recovery efficiencies. Quantitative method recovery data are needed to correct virus enumeration results so that estimates of virus concentrations in surface waters for QMRA are not too low. Obtaining quantitative data representing method recoveries for different pathogenic viruses is a significant challenge.

Microbial risk assessment of drinking water based on hydrodynamic modelling of pathogen concentrations in source water.

Norovirus contamination of drinking water sources is an important cause of waterborne disease outbreaks. Knowledge on pathogen concentrations in source water is needed to assess the ability of a drinking water treatment plant (DWTP) to provide safe drinking water. However, pathogen enumeration in source water samples is often not sufficient to describe the source water quality.

Incorporating method recovery uncertainties in stochastic estimates of raw water protozoan concentrations for QMRA.

The impact of incorporating recovery data on protozoan concentration estimates was investigated for Cryptosporidium and Giardia using a large dataset (n=99) of [oo]cyst assay results with paired recovery estimates. Stochastic [oo]cyst concentration was estimated using three approaches: I-no availability/consideration of recovery, II-limited recovery data, where sample recovery was considered as an independent random variable, and III-every [oo]cyst assay result was adjusted for a concurrently derived recovery estimate. Critically, Approach I underestimated [oo]cyst concentrations by about 100% compared to Approaches II and III, which were similar.