ABSTRACT
L'Institut de recherche biomédicale des armées (IRBA), largement impliqué dans la recherche sur le SARS-CoV-2, a cofondé le réseau sentinelle Obépine chargé de détecter, de qualifier et de quantifier le génome du virus dans les eaux usées en France. Durant cette pandémie, l'épidémiologie basée sur les eaux usées s'est avérée être un outil de santé publique de premier ordre pour évaluer la dynamique virale dans les populations et l'environnement. Obépine a également mené des travaux de recherche ayant démontré la faible infectiosité des matières fécales et des eaux usées et permis de détecter en avance de phase les vagues épidémiques liées aux nouveaux variants. L'IRBA a adapté cet outil performant au suivi des infections virales sur le porte-avions Charles-de-Gaulle à la suite d'une première épidémie à bord en 2020. Cet outil de surveillance a facilité la gestion du risque de contamination virale à bord lors des escales et des entrées de personnels. La lutte contre la circulation virale permettant le maintien de la capacité opérationnelle repose sur un ensemble de mesures : vaccination du personnel, suivi des eaux noires par PCR pour la détection d'une circulation virale, capacité de diagnostic par PCR des sujets symptomatiques ou contacts pour l'identification et le suivi des cas. Cet outil innovant peut être réorienté vers la recherche d'autres agents pathogènes dans les eaux noires, voire, à terme, permettre d'assurer une surveillance sanitaire des militaires, en mer ou à terre, en métropole ou sur une base outre-mer.
ABSTRACT
The French Armed Forces Biomedical Research Institute (IRBA) deeply involved in research on SARS-COV-2, participated in the creation of the Obépine sentinel network in charge of detecting, qualifying and quantifying the virus genome in wastewater in France. During this pandemic, wastewater-based epidemiology has proven to be a first class public health tool for assessing viral dynamics in populations and environment. Obépine has also conducted research demonstrating the low infectivity of faeces and wastewater and allowed for early detection of epidemic waves linked to new variants. The IRBA has adapted this powerful tool to the monitoring of viral infections on board the aircraft carrier Charles-de-Gaulle in order to get an operational system for anticipation after the first local outbreak in 2020. The presence of this surveillance and anticipation tool has allowed a better management of SARS-CoV-2 contingent introductions on board during stopovers or crewmembers entries. The combination of a mandatory vaccination protocol and the surveillance of viral circulation in black waters has made it possible to identify and locate cases, and thus to continue the operational mission in the COVID-19 environment while limiting the spread and preserving the health of the crew. This innovative tool can easily be redirected to the search for any other pathogens in blackwater or even, in the long term, to ensure health surveillance of any military establishment, at sea or on land, in France or on overseas bases.
ABSTRACT
Since March 2020, the Obépine (Observatoire Epidémiologique dans les Eaux Usées) research consortium has been working on exploiting the presence of SARS-CoV-2 in wastewater to propose epidemiological monitoring of COVID-19 in France. Although wastewater epidemiology is a long-standing discipline, it has never been so widely deployed on a national and international scale. Bringing together research teams with varied skills, Obépine has established the first protocols for quantifying the viral genome in samples from wastewater treatment plants (WWTPs). The sentinel network, which was built with the support of the French Ministry of Higher Education, Research and Innovation, currently includes 200 WWTPs in mainland France and overseas. It allows the bi-weekly assessment of the dynamics of the epidemic in more than 33% of the French population. This paper presents the genesis of a surveillance project and the lines of research of a network that wishes to work - in the near future - to complete the existing early warning and monitoring systems for endemic or emerging infections. © 2021 Academie Veterinaire de France. All rights reserved.
ABSTRACT
SARS-CoV-2 is a coronavirus causing a globalized outbreak called COVID-19. SARS-CoV-2 transmission is associated with inhalation of contaminated respiratory droplets and could causes severe complications. Until today several "waves" of infections have been observed despite implementation of strict health policies. Decisions for such sanitary measures are based on population health monitoring. Unfortunately, for COVID-19, a significant proportion of individuals are asymptomatic but play a role in the virus transmission. To overcome these limitations, several strategies were developed including genome quantification in wastewater that could allow monitoring of the health status of population, since shedding of SARS-CoV-2 in patient stool is frequent. Wastewater-based epidemiology (WBE) was established and several countries implemented this approach to allow COVID-19 outbreak monitoring. In France, the OBEPINE project performed a quantitative analysis of SARS-CoV-2 in raw wastewater samples collected from major wastewater treatment plants (WWTP) since March 2020. In the greater Paris area 1101 samples (507 for five WWTP and 594 for sewer) were collected. This 16 months monitoring allows us to observe the outbreak dynamics. Comparison of WBE indicators with health data lead to several important observation; the good level of correlation with incidence rates, the average 3 days lead time, and the sensitivity (WBE change when incidence is > to 7/100000 inhabitants). We also compared the local monitoring (city level) with the regional monitoring, to help cluster identification. Moreover, variants of concern (VOC) emerged due to the selection pressure. We developed a specific RT-qPCR method targeting the deletion H69-V70 in the spike protein, using this deletion as a proxy of the B.1.1.7 presence in the wastewater. With this data we demonstrate the predominant role played by this strain in the third wave. All these results allow a better description and understanding of the pandemic and highlight the role of such WBE indicators.
Subject(s)
COVID-19 , SARS-CoV-2 , Disease Outbreaks , Humans , Respiratory Aerosols and Droplets , WastewaterABSTRACT
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. Although SARS-CoV-2 is considered to be mainly transmitted by inhalation of contaminated droplets and aerosols, SARS-CoV-2 is also detected in human feces and to a less extent in urine, and in raw wastewaters (to date viral RNA only) suggesting that other routes of infection may exist. Monitoring SARS-CoV-2 genomes in wastewaters has been proposed as a complementary approach for tracing the dynamics of virus transmission within human population connected to wastewater network. The understanding on SARS-CoV-2 transmission through wastewater surveillance, the development of epidemic modeling and the evaluation of SARS-CoV-2 transmission from contaminated wastewater are largely limited by our knowledge on viral RNA genome persistence and virus infectivity preservation in such an environment. Using an integrity based RT-qPCR assay this study led to the discovery that SARS-CoV-2 RNA can persist under several forms in wastewaters, which provides important information on the presence of SARS-CoV-2 in raw wastewaters and associated risk assessment.