하수 감시를 통한 감염병 모니터링

김진영, 김초롱, 김제형, 유재영, 최지예, 김하림, 윤기복, 신미영

감염병조사1과

Monitoring Viruses that Cause Epidemic Diseases

in Wastewater

J. Y. Kim, C. R. Kim, J. H. Kim, J. Y. Yu, G. Y. Choi,
H. R. Kim, K. B. Yoon, M. Y. Shin, Y. J. An

Infectious Disease Research Division 1

Abstract

Wastewater-based epidemiology(WBE) has emerged as a powerful tool for public health surveillance, offering real-time insight into population health. Recently, infectious disease outbreaks have accentuated the need for this approach, as it enables community-level disease monitoring beyond traditional individual-level tracking. WBE leverages real-time monitoring systems, such as quantitative(q)PCR, to detect a broad range of pathogens accurately and promptly, including SARS-CoV-2(COVID-19), influenza viruses, respiratory viruses, and noroviruses. In this study, the potential of WBE for virus surveillance was investigated in Jeollanam-do, South Korea. Wastewater samples were collected weekly from five locations(8 points) and analyzed for viral presence by using qPCR assays targeting COVID-19 RNA, influenza viruses, respiratory viruses(adenovirus, bocavirus, parainfluenza virus, human coronavirus, metapneumovirus, respiratory syncytial virus, and rhinovirus), and both GI and GII genotypes of norovirus RNA. A total of 433 samples were analyzed. COVID-19 RNA was detected in 94.2 % of the samples, highlighting a high COVID-19 prevalence. Influenza virus RNA was present in 15.2 % of samples, whereas norovirus RNA was detected in 59.8 % and 87.3 % of samples for GI and GII genotypes, respectively. Other respiratory viruses showed an 80.8 % detection rate, with adenovirus(47.5 %) and bocavirus(35.7 %) being the most frequent. These findings demonstrate a strong correlation between viral detection in wastewater and confirmed cases of corresponding diseases. Our study underscores the valuable role of WBE in early warning of viral outbreaks. The ability to detect diverse pathogens in real time empowers public health authorities to implement targeted interventions and control measures swiftly and effectively. Further research is required to establish quantitative relationships between viral concentrations in wastewater and confirmed cases and address the impact of environmental factors and wastewater treatment processes on viral persistence and detection. In conclusion, WBE is a promising approach for real-time public health surveillance of viral respiratory pathogens. Our study demonstrates its efficacy in detecting various viruses in wastewater and highlights its potential for early outbreak warning and rapid public-health response.

Keywords: Wastewater, epidemiology, SARS-CoV-2(COVID-19), influenza,
respiratory virus, norovirus

1.  코로나19 바이러스 검사결과 전국과 전남의 확진자 발생 현황은 비슷한 경향을 보였으며, 하수 내 바이러스 농도 역시 양성자 증감 경향과 비슷한 결과를 보여 상관관계가 있음을 확인하였다. 그리고 코로나19 양성자는 방역 조치 완화 후 더욱 증가하였다.

2.  인플루엔자 검사결과 하수 내 바이러스 농도와 환자 발생은 상관관계가 있음을 확인하였으며, 동절기 이후 마스크 의무화 해제, 개학, 지역축제 등 다양한 원인들의 복합적 작용으로 동절기가 지났음에도 환자가 급증하는 현상을 보였다.

3.  하수 내 호흡기바이러스 농도와 환자 발생은 상관관계가 있음을 확인하였다. 그러나 아데노바이러스, 보카바이러스 이외의 바이러스는 농도가 낮아 단일 바이러스에 대한 상관관계를 파악하는 데는 어려움이 있었다.

4.  하수 내 노로바이러스 농도와 환자 발생건수는 상관관계가 있음을 확인하였고, 겨울철에 주로 발생하는 바이러스답게 동절기에 높게 나타났다.