Wastewater Surveillance for Identifying SARS-CoV-2 Infections in Long-Term Care Facilities, Kentucky, USA, 2021-2022

James W. Keck; Reuben Adatorwovor; Matthew Liversedge; Blazan Mijotavich; Cullen Olsson; William D. Strike; Atena Amirsoleimani; Ann Noble; Soroosh Torabi; Alexus Rockward; Mohammad Dehghan Banadaki; Ted Smith; Parker Lacy; Scott M. Berry

doi:10.3201/eid3003.230888

Wastewater Surveillance for Identifying SARS-CoV-2 Infections in Long-Term Care Facilities, Kentucky, USA, 2021-2022

James W. Keck, Reuben Adatorwovor, Matthew Liversedge, Blazan Mijotavich, Cullen Olsson, William D. Strike, Atena Amirsoleimani, Ann Noble, Soroosh Torabi, Alexus Rockward, Mohammad Dehghan Banadaki, Ted Smith, Parker Lacy, Scott M. Berry

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Abstract

Persons living in long-term care facilities (LTCFs) were disproportionately affected by COVID-19. We used wastewater surveillance to detect SARS-CoV-2 infection in this setting by collecting and testing 24-hour composite wastewater samples 2-4 times weekly at 6 LTCFs in Kentucky, USA, during March 2021-February 2022. The LTCFs routinely tested staff and symptomatic and exposed residents for SARS-CoV-2 using rapid antigen tests. Of 780 wastewater samples analyzed, 22% (n = 173) had detectable SARS-CoV-2 RNA. The LTCFs reported 161 positive (of 16,905) SARS-CoV-2 clinical tests. The wastewater SARS-CoV-2 signal showed variable correlation with clinical test data; we observed the strongest correlations in the LTCFs with the most positive clinical tests (n = 45 and n = 58). Wastewater surveillance was 48% sensitive and 80% specific in identifying SARS-CoV-2 infections found on clinical testing, which was limited by frequency, coverage, and rapid antigen test performance.

Original language	English
Pages (from-to)	530-538
Number of pages	9
Journal	Emerging Infectious Diseases
Volume	30
Issue number	3
DOIs	https://doi.org/10.3201/eid3003.230888
State	Published - Mar 2024

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© 2024 Centers for Disease Control and Prevention (CDC). All rights reserved.

ASJC Scopus subject areas

Epidemiology
Microbiology (medical)
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3201/eid3003.230888

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Keck, J. W., Adatorwovor, R., Liversedge, M., Mijotavich, B., Olsson, C., Strike, W. D., Amirsoleimani, A., Noble, A., Torabi, S., Rockward, A., Banadaki, M. D., Smith, T., Lacy, P., & Berry, S. M. (2024). Wastewater Surveillance for Identifying SARS-CoV-2 Infections in Long-Term Care Facilities, Kentucky, USA, 2021-2022. Emerging Infectious Diseases, 30(3), 530-538. https://doi.org/10.3201/eid3003.230888

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abstract = "Persons living in long-term care facilities (LTCFs) were disproportionately affected by COVID-19. We used wastewater surveillance to detect SARS-CoV-2 infection in this setting by collecting and testing 24-hour composite wastewater samples 2-4 times weekly at 6 LTCFs in Kentucky, USA, during March 2021-February 2022. The LTCFs routinely tested staff and symptomatic and exposed residents for SARS-CoV-2 using rapid antigen tests. Of 780 wastewater samples analyzed, 22% (n = 173) had detectable SARS-CoV-2 RNA. The LTCFs reported 161 positive (of 16,905) SARS-CoV-2 clinical tests. The wastewater SARS-CoV-2 signal showed variable correlation with clinical test data; we observed the strongest correlations in the LTCFs with the most positive clinical tests (n = 45 and n = 58). Wastewater surveillance was 48% sensitive and 80% specific in identifying SARS-CoV-2 infections found on clinical testing, which was limited by frequency, coverage, and rapid antigen test performance.",

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Keck, JW, Adatorwovor, R, Liversedge, M, Mijotavich, B, Olsson, C, Strike, WD, Amirsoleimani, A, Noble, A, Torabi, S, Rockward, A, Banadaki, MD, Smith, T, Lacy, P & Berry, SM 2024, 'Wastewater Surveillance for Identifying SARS-CoV-2 Infections in Long-Term Care Facilities, Kentucky, USA, 2021-2022', Emerging Infectious Diseases, vol. 30, no. 3, pp. 530-538. https://doi.org/10.3201/eid3003.230888

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AU - Keck, James W.

AU - Adatorwovor, Reuben

AU - Liversedge, Matthew

AU - Mijotavich, Blazan

AU - Olsson, Cullen

AU - Strike, William D.

AU - Amirsoleimani, Atena

AU - Noble, Ann

AU - Torabi, Soroosh

AU - Rockward, Alexus

AU - Banadaki, Mohammad Dehghan

AU - Smith, Ted

AU - Lacy, Parker

AU - Berry, Scott M.

PY - 2024/3

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N2 - Persons living in long-term care facilities (LTCFs) were disproportionately affected by COVID-19. We used wastewater surveillance to detect SARS-CoV-2 infection in this setting by collecting and testing 24-hour composite wastewater samples 2-4 times weekly at 6 LTCFs in Kentucky, USA, during March 2021-February 2022. The LTCFs routinely tested staff and symptomatic and exposed residents for SARS-CoV-2 using rapid antigen tests. Of 780 wastewater samples analyzed, 22% (n = 173) had detectable SARS-CoV-2 RNA. The LTCFs reported 161 positive (of 16,905) SARS-CoV-2 clinical tests. The wastewater SARS-CoV-2 signal showed variable correlation with clinical test data; we observed the strongest correlations in the LTCFs with the most positive clinical tests (n = 45 and n = 58). Wastewater surveillance was 48% sensitive and 80% specific in identifying SARS-CoV-2 infections found on clinical testing, which was limited by frequency, coverage, and rapid antigen test performance.

AB - Persons living in long-term care facilities (LTCFs) were disproportionately affected by COVID-19. We used wastewater surveillance to detect SARS-CoV-2 infection in this setting by collecting and testing 24-hour composite wastewater samples 2-4 times weekly at 6 LTCFs in Kentucky, USA, during March 2021-February 2022. The LTCFs routinely tested staff and symptomatic and exposed residents for SARS-CoV-2 using rapid antigen tests. Of 780 wastewater samples analyzed, 22% (n = 173) had detectable SARS-CoV-2 RNA. The LTCFs reported 161 positive (of 16,905) SARS-CoV-2 clinical tests. The wastewater SARS-CoV-2 signal showed variable correlation with clinical test data; we observed the strongest correlations in the LTCFs with the most positive clinical tests (n = 45 and n = 58). Wastewater surveillance was 48% sensitive and 80% specific in identifying SARS-CoV-2 infections found on clinical testing, which was limited by frequency, coverage, and rapid antigen test performance.

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Wastewater Surveillance for Identifying SARS-CoV-2 Infections in Long-Term Care Facilities, Kentucky, USA, 2021-2022

Abstract

Bibliographical note

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UN SDGs

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