Respiratory virus concentrations in human excretions that contribute to wastewater: A systematic review

Abstract

AbstractConcentrations of nucleic acids from a range of respiratory viruses including human influenza A and B, respiratory syncytial virus (RSV), metapneumovirus, parainfluenza virus, rhinovirus, and seasonal coronaviruses in wastewater solids collected from wastewater treatment plants correlate to clinical data on disease occurrence in the community contributing to the wastewater. Viral nucleic acids enter wastewater from various excretions including stool, urine, mucus, sputum, and saliva deposited in toilets or other drains in buildings. In order to relate the measured concentrations in wastewater at a treatment plant to actual number of infections in a community, concentrations of the viral nucleic acids in these human excretions are needed as inputs to a mass balance model. In this study, we carried out a systematic review and meta-analysis to characterize the concentrations and presence of influenza A and B, respiratory syncytial virus (RSV), metapneumovirus, parainfluenza virus, rhinovirus, and seasonal coronaviruses in stool, urine, mucus, sputum, and saliva. The systematic review protocol can be accessed athttps://doi.org/10.17605/OSF.IO/ESVYC. We identified 220 data sets from 50 unique articles that met inclusion criteria and reported information on viral concentrations and presence in these excretions. Data were unevenly distributed across virus type (with the most available for influenza) and excretion type (with the most available for respiratory excretions). The majority of data sets only reported the presence or absence of the virus in an excretion in a cross-sectional study design. There is a need for more concentration data, including longitudinal data, across all respiratory virus and excretion types. Such data would allow quantitatively linking virus wastewater concentrations to numbers of infected individuals.