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Published on: June 30, 2023
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Biomarkers selection for population normalization in SARS-CoV-2 wastewater-based epidemiology
Shu-Yu Hsu1, Mohamed Bayati2, Chenhui Li2
1School of Natural Resources, University of Missouri, Columbia, MO 65201, USA; Center for Agroforestry, University of Missouri, Columbia, MO 65201, USA.
Water Research
|August 28, 2022
Summary
Paraxanthine (PARA) is the most reliable biomarker for normalizing SARS-CoV-2 wastewater data, improving COVID-19 case prediction. This wastewater-based epidemiology approach aids in tracking viral loads and population dynamics.
Area of Science:
- Environmental Science
- Public Health
- Analytical Chemistry
Background:
- Wastewater-based epidemiology (WBE) is crucial for tracking SARS-CoV-2.
- Accurate normalization of viral loads using population biomarkers is essential for reliable WBE data.
- Existing normalization methods may not fully account for population fluctuations and wastewater dilution.
Purpose of the Study:
- To investigate and validate five population biomarkers (PMMoV, creatinine, 5-HIAA, caffeine, paraxanthine) for normalizing SARS-CoV-2 loads in wastewater.
- To evaluate the utility of these biomarkers in assessing real-time contributing population.
- To improve the correlation between normalized SARS-CoV-2 loads and reported clinical cases.
Main Methods:
- Analysis of wastewater samples from 64 WWTPs in Missouri.
- Application of direct and indirect normalization approaches using selected biomarkers.
- Evaluation of biomarker performance in reflecting population dynamics and wastewater dilution.
- Testing the best performing biomarker for improving SARS-CoV-2 load and case number correlation.
Main Results:
- Paraxanthine (PARA) demonstrated the highest reliability for per capita SARS-CoV-2 load normalization due to accuracy, low variability, and temporal consistency.
- Biomarker normalization, except for creatinine, effectively accounted for wastewater dilution and human waste input variations.
- PARA enabled accurate real-time assessment of the contributing population.
- Normalization using PARA significantly improved the correlation between SARS-CoV-2 loads and reported COVID-19 cases.
Conclusions:
- Paraxanthine (PARA) is a superior biomarker for WBE, complementing existing normalization methods.
- This approach enhances the understanding of population dynamics for more accurate infectious disease surveillance.
- PARA-based normalization aids in forecasting SARS-CoV-2 prevalence within specific community sewersheds.
Keywords:
ParaxanthinePopulation biomarkerPopulation normalizationSARS-CoV-2Wastewater-based epidemiology
