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Experts say India’s environmental monitoring system of wild poliovirus environmental monitoring in municipal wastewater can be leveraged to detect coronavirus disease (Covid-19) among local communities.
New research suggests that testing sewage for traces of Sars-Cov-2, the virus that causes Covid-19, could indicate the spread of the disease in a population. A study published in the scientific journal Lancet on April 1 said the virus was being released into people’s feces five weeks after their respiratory specimens tested negative for Sars-Cov-2.
The studies also record the persistent shedding of genetic material from the ribonucleic acid virus (RNA) in human excreta such as feces, saliva, sputum and urine, which find their way into the sewers.
“One of the most resistant components of a virus is its RNA, which remains in the wastewater even after the virus is not viable,” said Swapneil Parikh, internist at Kasturba Gandhi hospital and co-investigator of convalescent plasma at Brihanmumbai Municipal Corporation (BMC) trials in Mumbai.
The BMC is close to launching a pilot environmental monitoring program in Mumbai, based on a proposal submitted by Parikh and other experts, which was approved by Maharashtra’s minister Aaditya Thackeray earlier this month, according to Parikh.
“The protocols for it have not yet been validated, but have been adopted by the ministry of health and a team of WHO experts. Once they have shared the methodology, we can start the exercise, perhaps early next week, “he said.
According to experts, this real-time monitoring of wastewater can help detect and contain Covid-19 infections early.
“In theory, it can be redesigned to track the Sars-Cov-2 virus in sewage,” said Giridhara Babu, director of life epidemiology at the Indian Public Health Foundation. “While it is still a theoretical possibility because the viruses themselves are different, work is ongoing globally to fill the evidence gaps. To implement this in India, the National Institute of Virology would first have to validate a standardized protocol for monitoring Sars-Cov-2 in wastewater. ”
Pankaj Bhatnagar, leader of the interim team at India’s National Polio Surveillance Project, said: “The methodology and test protocols for the detection and isolation of poliovirus from municipal wastewater are being applied after standardization after years of research. Since poliovirus and Sars-CoV-2 have different biological characteristics, laboratory test protocols for the detection of Sars-CoV-2 in wastewater are different and are still evolving. ”
Bhatnagar also clarified that research on this issue is still in its infancy, and that there is currently no conclusive evidence to support such a proposal.
The required evidence is being investigated by researchers from around the world, including those from the Gandhinagar Indian Institute of Technology (IIT), which is part of the Covid-19 WBE Collaborative, an international project launched by 51 universities and research institutes. The consortium, a partnership between the Sewage Analysis CORe group Europe (SCORE) and the Global Water Pathogen Project, has established a standard protocol to ensure consistency in data collection and inference.
“While case-finding through testing on human subjects is important, it would be beneficial to supplement it with a wastewater-based epidemiology approach that is less invasive and less financially demanding. It is well documented that wastewater monitoring can be leveraged to control the spread of infectious diseases, “said Manish Kumar, assistant professor in the earth science department, IIT Gandhinagar, and one of the consortium collaborators.
In India, WBE played a vital role in polio eradication in 2011. India continues to monitor wastewater at 52 wastewater treatment plants and unregulated catchment areas where wastewater is drained in nine states and one Union territory.
By testing these sites weekly for traces of wild polioviruses, authorities were able to launch preventive immunization campaigns in affected areas. In 2018, for example, when traces of a wild poliovirus strain were detected in sewage in Mumbai, the results resulted in widespread immunization campaigns to prevent an outbreak.
“There certainly is merit both in leveraging India’s environmental surveillance for polio and in the broader system for polio monitoring. At the state and district levels, medical officers have excellent training and good data management. I don’t know to what extent manpower and experience will be co-opted in the Covid-19 effort, but they can be valuable resources, “said a member of the National Certification Committee for Polio Eradication, requesting anonymity.
Babu and Kumar emphasized that Sars-Cov-2 environmental surveillance is in no way a substitute for individual case findings, or any other mode of public health surveillance.
“Environmental surveillance can be successful only when complemented by sentinel surveillance, hospital admission data, prescription data, human biovigilance, and mortality and morbidity data to create effective responses,” said Babu, who was part of the polio team at the World Health Organization. in Karnataka for six years.
“India would have a significant advantage over other countries in the use of such environmental monitoring after our experience with polio. If we can adjust our methodology to monitor Sars-Cov-2, it would also benefit other parts of the world, “he said.
