Environmental surveillance of Sars-Cov-2 in wastewater in Apulia region, Southern Italy
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Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy. Italy
Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy.
Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy Italy
Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, 00161 Rome, Italy
Agency for the Environmental Prevention and Protection (ARPA Puglia), Corso Trieste 27, 70126, Bari, Italy Italy
Department of Health Promotion and Animal Welfare, Apulia Region, Bari, Italy Italy
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A533
Background and Objective:
Monitoring SARS-CoV-2 in untreated wastewater can provide an early warning system for virus circulation. The Istituto Superiore di Sanità coordinates the SARI project (Environmental surveillance using wastewater in Italy) in Italy which enlists 18 Regions and two Autonomous Provinces. The activities were carried out with the financial support of the Italian Government (L.D. 25.05.2021 n.73), and the European Commission, DG ENV (Grant Agreement 060701/2021/864481/SUB/ENV.C2). The study aims to: 1) predict the number of COVID-19 cases/100,000 inhabitants in the 15 days after SARS-CoV-2 detection in wastewater 2) investigate the factors influencing the presence of the virus in wastewater.

Overall, 16 wastewater treatment plants (WWTPs) were enrolled in Apulia Region (Southern Italy), serving municipalities with 50,000-150,000 inhabitants (14 WWTPs) and >150,000 inhabitants (2 WWTPs). Sampling was carried out weekly or biweekly, respectively, by Regional Agency for Protection of Environment. The laboratory analyzes were performed according to national SARI protocol. A ROC curve model was applied to predict number COVID-19 cases and a Poisson Regression model was used to investigate the factors influencing the viral presence/load in wastewater.

From October 2021 to July 2022, 607 samples were analyzed, of which 592 (97.5%) tested positive for SARS-CoV-2. The statistical analyses showed that at least 11 COVID-19 cases/100,000 inhabitants served by WWTP would occur after a wastewater sample resulted positive for SARS-CoV-2. In the period January-July 2022, winter months were associated with a higher probability of virus detection. An inverse correlation was found between the SARS-CoV-2 load in wastewater and the range of atmospheric temperature and mean atmospheric pressure/sampling day.

The presence of SARS-CoV-2 in wastewater can be used to predict COVID-19 cases, supporting the potential of wastewater-based epidemiology. However, further studies are required because our predictive model remains limited for the complexity and uncertainties associated with the process.

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