ArticleThe Science of the total environment2022
Use of sewage surveillance for COVID-19 to guide public health response: A case study in Hong Kong.
Article in The Science of the total environment, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed.
- Nontraditional Data in Pandemic Preparedness and Response: Identifying and Addressing First- and Last-Mile Challenges.Journal of medical Internet research · 2026Article
- Environmental and microbial factors shaping SARS-CoV-2 RNA decay in wastewater: insights from batch tests and a lab-scale sewer pipeline simulator.Scientific reports · 2026Article
- Utilizing wastewater surveillance to model behavioural responses and prevent healthcare overload during "Disease X" outbreaks.Emerging microbes & infections · 2025Article
- Advances in Wastewater-Based Epidemiology for Pandemic Surveillance: Methodological Frameworks and Future Perspectives.Microorganisms · 2025Review
- Article
- Aggregate Sampling to Detect Pathogens and Antimicrobial Resistance Genes Associated with Bovine Respiratory Disease in US Feedlots: A Pilot Study.Veterinary sciences · 2025Article
- Epidemiological dynamics and early warning of norovirus and rotavirus A in Yantai City in 2023-2024 based on wastewater surveillance.Frontiers in microbiology · 2025Article
- Public health actions in response to pathogen detection in wastewater and the environment: a scoping review.Frontiers in public health · 2025Article
- The first detection of SARS-CoV-2 RNA in the wastewater of Bucharest, Romania.Scientific reports · 2024Article
- Article
- A survey of the representativeness and usefulness of wastewater-based surveillance systems in 10 countries across Europe in 2023.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2024Article
- A scoping review of global SARS-CoV-2 wastewater-based epidemiology in light of COVID-19 pandemic.Heliyon · 2024Article
- Battery-free, wireless, and electricity-driven soft swimmer for water quality and virus monitoring.Science advances · 2024Article
- Global trends in the research and development of medical/pharmaceutical wastewater treatment over the half-century.Chemosphere · 2023Review
- The city-wide full-scale interactive application of sewage surveillance programme for assisting real-time COVID-19 pandemic control - A case study in Hong Kong.The Science of the total environment · 2023Article
- Wastewater surveillance and an automated robot: effectively tracking SARS-CoV-2 transmission in the post-epidemic era.National science review · 2023Article
- Article
- A rapid, high-throughput, and sensitive PEG-precipitation method for SARS-CoV-2 wastewater surveillance.Water research · 2023Article
- Development of quantitative wastewater surveillance models facilitated the precise epidemic management of COVID-19.The Science of the total environment · 2023Article
- Citywide wastewater SARS-CoV-2 levels strongly correlated with multiple disease surveillance indicators and outcomes over three COVID-19 waves.The Science of the total environment · 2023Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Sewage surveillance could help develop proactive response to the Coronavirus Disease 2019 (COVID-19) pandemic, but currently there are limited reports about examples in practical exercises. Here, we report a use case of intensified sewage surveillance to initiate public health action to thwart a looming Delta variant outbreak in Hong Kong. On 21 June 2021, albeit under basically contained COVID-19 situation in Hong Kong, routine sewage surveillance identified a high viral load of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a sewage sample from one site covering over 33,000 population, suggesting infected cases living in the respective sewershed. The use of a newly developed method based on allele-specific real-time quantitative polymerase chain reaction (AS RT-qPCR) served to alert the first documentation of the Delta variant in local community sewage three days before the case was confirmed to be a Delta variant carrier. Intensified sewage surveillance was triggered. Targeted upstream sampling at sub-sewershed areas pinpointed the source of positive viral signal across spatial scales from sewershed to building level, and assisted in determining the specific area for issuing a compulsory testing order for individuals on 23 June 2021. A person who lived in a building with the positive result of sewage testing was confirmed to be infected with COVID-19 on 24 June 2021. Viral genome sequences determined from the sewage sample were compared to those from the clinic specimens of the matched patient, and confirmed that the person was the source of the positive SARS-CoV-2 signal in the sewage sample. This study could help build confidences for public health agencies in using the sewage surveillance in their own communities.
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