The ongoing global pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a Public Health Emergency of International Concern, ...which was officially declared by the World Health Organization. SARS-CoV-2 is a member of the family Coronaviridae that consists of a group of enveloped viruses with single-stranded RNA genome, which cause diseases ranging from common colds to acute respiratory distress syndrome. Although the major transmission routes of SARS-CoV-2 are inhalation of aerosol/droplet and person-to-person contact, currently available evidence indicates that the viral RNA is present in wastewater, suggesting the need to better understand wastewater as potential sources of epidemiological data and human health risks. Here, we review the current knowledge related to the potential of wastewater surveillance to understand the epidemiology of COVID-19, methodologies for the detection and quantification of SARS-CoV-2 in wastewater, and information relevant for human health risk assessment of SARS-CoV-2. There has been growing evidence of gastrointestinal symptoms caused by SARS-CoV-2 infections and the presence of viral RNA not only in feces of infected individuals but also in wastewater. One of the major challenges in SARS-CoV-2 detection/quantification in wastewater samples is the lack of an optimized and standardized protocol. Currently available data are also limited for conducting a quantitative microbial risk assessment (QMRA) for SARS-CoV-2 exposure pathways. However, modeling-based approaches have a potential role to play in reducing the impact of the ongoing COVID-19 outbreak. Furthermore, QMRA parameters obtained from previous studies on relevant respiratory viruses help to inform risk assessments of SARS-CoV-2. Our understanding on the potential role of wastewater in SARS-CoV-2 transmission is largely limited by knowledge gaps in its occurrence, persistence, and removal in wastewater. There is an urgent need for further research to establish methodologies for wastewater surveillance and understand the implications of the presence of SARS-CoV-2 in wastewater.
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•Presence of SARS-CoV-2 RNA in wastewater has been reported.•SARS-CoV-2 RNA in wastewater can be used to monitor COVID-19 in a community.•Effective concentration method is needed for recovery of SARS-CoV-2 from wastewater.•Surrogate coronavirus data help to predict survival of SARS-CoV-2 in wastewater.•Data on the infectivity of SARS-CoV-2 in wastewater for risk assessment are limited.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Background The airborne spreading of enteric viruses can occur through the aerosol and droplets produced by toilet flushing. These can contaminate the surrounding environment, but few data exist to ...estimate the risk of exposure and infection. For this reason environmental monitoring of air and selected surfaces was carried out in 2 toilets of an office building and in 3 toilets of a hospital before and after cleaning operations. Methods To reveal the presence of norovirus, enterovirus, rhinovirus, human rotavirus, and Torque teno virus and to quantify human adenovirus and bacteria counts, molecular and cultural methods were used. Results On the whole, viruses were detected on 78% of surfaces and in 81% of aerosol. Among the researched viruses, only human adenovirus and Torque teno virus were found in both surface and air samples. In several cases the same adenovirus strain was concurrently found in all matrices. Bacterial counts were unrelated to viral presence and cleaning did not seem to substantially reduce contamination. Conclusions The data collected in our study confirm that toilets are an important source of viral contamination, mainly in health care settings, where disinfection can have a crucial role in preventing virus spread.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Biological risk assessment in occupational settings currently is based on either qualitative or semiquantitative analysis. In this study, a quantitative microbial risk assessment (QMRA) has been ...applied to estimate the human adenovirus (HAdV) health risk due to bioaerosol exposure in a wastewater treatment plant (WWTP). A stochastic QMRA model was developed considering HAdV as the index pathogen, using its concentrations in different areas and published dose⁻response relationship for inhalation. A sensitivity analysis was employed to examine the impact of input parameters on health risk. The QMRA estimated a higher average risk in sewage influent and biological oxidation tanks (15.64% and 12.73% for an exposure of 3 min). Sensitivity analysis indicated HAdV concentration as a predominant factor in the estimated risk. QMRA results were used to calculate the exposure limits considering four different risk levels (one illness case per 100, 1.000, 10.000, and 100.000 workers): for 3 min exposures, we obtained 565, 170, 54, and 6 GC/m³ of HAdV. We also calculated the maximum time of exposure for each level for different areas. Our findings can be useful to better define the effectiveness of control measures, which would thus reduce the virus concentration or the exposure time.
In Italy, the phenomenon of vaccine hesitancy has increased with time and represents a complex problem that requires a continuous monitoring. Misinformation on media and social media seems to be one ...of the determinants of the vaccine hesitancy since, for instance, 42.8 percent of Italian citizens used the internet to obtain vaccine information in 2016.
This article reports a quantitative analysis of 560 YouTube videos related to the link between vaccines and autism or other serious side effects on children.
The analysis revealed that most of the videos were negative in tone and that the annual number of uploaded videos has increased during the considered period, that goes from 27 December 2007 to 31 July 2017, with a peak of 224 videos in the first seven months of 2017.
These findings suggest that the public institutions should be more engaged in establishing a web presence in order to provide reliable information, answers, stories, and videos so to respond to questions of the public about vaccination. These actions could be useful to allow citizens to make informed decisions about vaccines so to comply with vaccination regulations.
Besides the predominant ways of transmission of SARS-CoV-2 (namely, contacts and large droplets) the airborne one is increasingly taken into consideration as a result of latest research findings. ...Nevertheless, this possibility has been already suggested by previous studies on other coronaviruses including SARS-CoV and MERS-CoV. To describe the state of the art of coronaviruses and airborne transmission, a systematic review was carried out using the PRISMA methodology. Overall, 64 papers were selected and classified into three main groups: laboratory experiments (12 papers), air monitoring (22) and epidemiological and airflow model studies (30). The airborne transmission of SARS-CoV-2 is suggested by the studies of the three groups, but none has yet obtained complete evidence. The sampling and detection methods have not been validated, therefore monitoring results are affected by a possible underestimation. Then, epidemiological investigations only hypothesize the airborne transmission as a possible explanation for some illness cases, but without estimating its attributable risk. Nevertheless, while waiting for more evidence, it is urgent to base advice on preventive measures, such as the use of masks, safe distancing and air ventilation, on the precautionary principle.
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•DPSIR applied to beach contamination through data search and fieldwork.•Fieldwork allowed to gain insight into local pressures, state, and health impact of beach-stranded.•Main local ...responses: waste removal from drainage system and recycling of stranded material.•Local and regional efforts are required to build a systemic view of beach contamination.
Beaches are affected by the accumulation of natural and anthropogenic material; however, this environmental issue has not yet been explored from a One Health perspective. In this paper, the conceptual framework of DPSIR (Drivers-Pressures-State-Impact-Response) was used to understand the beach-stranded material issue in a systemic way and a data-based classification for some environmental indicators was developed to support the DPSIR analysis. The model was applied to an Italian coastal municipality as a case study, through the collection of data from a variety of data sources: publicly accessible database, data from a stakeholders’ network (i.e., coastal authority, solid waste company, sewerage company, drainage consortium), and fieldwork consisting in microbiological analysis of stranded material and underlying sand, visual census of macrolitter along beach and waterways. In the study area, solid wastes production was a high pressure (768 kg/capita/year), but in situ visual observations of floating wastes at the outlet of the canals revealed that the contribution of local waterways to marine litter was negligible, thus suggesting the effectiveness of the measures adopted along local waterways by the drainage consortium (i.e., grids at the drainage pumping stations). Nevertheless, very high quantity of anthropogenic wastes was counted during the beach litter surveys (603 items/100 m), probably as a result of coastal current pathway that transported material from major watercourses (>100 km2 drainage basin size; 23 items/h). On the contrary, local sewage production represented a very high pressure (>33,000 m3/km) that impacted on the microbiological quality of the stranded material with moderate to high level of fecal bacteria indicators detected in the beach cast. The underlying sand was affected by such contamination, with most of the sample within the provisional limit set by WHO for enterococci in beach sand (60 CFU/g) that was associated to a health risk of<5 % of gastroenteritis attributable to accidental ingestion of sand; nevertheless, some enterococci peak values (980 MPN/g) could be associated to a health risk for gastroenteritis>10 %. The beach-stranded material was collected without separating the sand, with annual quantity of 1,243 kg/m, that was processed in a dedicated facility allowing to recover up to 98 % of sand and biomass after the treatment, with moderate expenditure for the coastal municipality (22 €/m). Overall, this study allowed to better figure out the cause-effect relationships underlying the accumulation of stranded material along shoreline and the effectiveness of the management practices toward beach-stranded material. Therefore, the usage of the DPSIR framework as structuring model to understand the problem of stranded material could be useful for beach managers and administrators, and its adoption within beach management programs is worth for improving beach quality.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Wastewater-based epidemiology (WBE) is currently used to monitor not only the spread of the viral SARS-CoV-2 pandemic but also that of other viruses in endemic conditions, particularly in the absence ...of syndromic surveillance. The continuous monitoring of sewage requires high expenditure and significant time investments, highlighting the need for standardized methods and structured monitoring strategies. In this context, we conducted weekly wastewater monitoring in northwestern Tuscany (Italy) and targeted human adenovirus (HAdV), norovirus genogroup II (NoVggII), enterovirus (EV), and SARS-CoV-2. Samples were collected at the entrances of treatment plants and concentrated using PEG/NaCl precipitation, and viral nucleic acids were extracted and detected through real-time reverse transcription qPCR. NoVggII was the most identified target (84.4%), followed by HAdV, SARS-CoV-2, and EV. Only HAdV and EV exhibited seasonal peaks in spring and summer. Compared with data that were previously collected in the same study area (from February 2021 to September 2021), the results for SARS-CoV-2 revealed a shift from an epidemic to an endemic pattern, at least in the region under investigation, which was likely due to viral mutations that led to the spreading of new variants with increased resistance to summer environmental conditions. In conclusion, using standardized methods and an efficient monitoring strategy, WBE proves valuable for viral surveillance in pandemic and epidemic scenarios, enabling the identification of temporal-local distribution patterns that are useful for making informed public health decisions.
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Reusing reclaimed water is of paramount importance to achieve the 2030 Agenda for Sustainable Development Goals 6 and 13. In Europe, a recent Regulation set minimum requirements for water reuse in ...agriculture. However, some challenges remain considering microbial risks and their prevention. In this study, two urban wastewater treatment plants (WWTPs) were investigated from the perspective of reuse. A five-year investigation was performed on routine monitoring parameters collected under different weather conditions (wet/dry) and treatments (chlorination/non-chlorination) in inlet and outlet samples. Moreover, a three-month investigation focused on microbial parameters, including indicators, index pathogens (Human Adenovirus—HAdV, Salmonella spp.), and other viral pathogens (norovirus, enterovirus, and SARS-CoV-2). The long-term study revealed the compliance of both WWTPs for chemical parameters (organic substances and solids) in more than 90% of samples, whereas for Escherichia coli, the compliance ranged from 96.1% with chlorination under dry weather to 16.7% without chlorination in wet days. E. coli was positively associated with chemical oxygen demand (COD), which could be a promising and online measurable proxy of E. coli. The study on microbial performance demonstrated sound reliability in detecting E. coli as a suitable surrogate for Salmonella in chlorinated effluents, but neither bacterial nor viral indicators are able to represent HAdV. Although chlorination was able to remove most of the pathogens considered, the compliance with microbial indicators seems insufficient to represent viral water safety.
The new epidemiological scenario has so far focused on the environmental circulation of human viral pathogens. Owing to the side effects of chemical disinfectants, there is an increasing need for ...knowledge on the use of virucidal compounds, especially those of a natural origin. Climacostol is a molecule produced by a freshwater ciliate and it exhibits activity against bacterial and fungal pathogens. We thus also speculated that there might be an effect on viral viability, which has never been tested. To evaluate such activity, we chose human adenovirus (HAdV), which is representative of waterborne viruses. We conducted experiments using HAdV serotype 5, whose titer was determined by infecting HeLa cell cultures. HAdV5 was shown to be sensitive to climacostol at a concentration of 0.0002 mg/mL, with an approximate 3 Log10 reduction when the initial titer of HAdV5 was approximately 104 and 103 TCID50/mL. These preliminary results could be an important starting point for further research aimed at improving the characterization of climacostol activity under different experimental conditions and against various viruses, including enveloped ones (i.e., the coronavirus). The production of climacostol by a protist living in fresh water also suggests a possible application in the activated sludge of wastewater treatment plants.
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