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Continuous circulation of hepatitis E and A viruses during COVID-19 pandemic lockdowns in Munich, Germany—experience from three years of wastewater surveillance.
Microorganisms 13, 2379 - 2379 (2025)
The COVID-19 pandemic has increased interest in wastewater-based
epidemiology (WBE) as a reliable and cost-effective framework for
monitoring the spread of microbes. However, WBE frameworks have rarely
been applied to the study of fecal–oral transmissible diseases, except
for poliomyelitis. Here, we investigated the presence of hepatitis A
virus (HAV) and hepatitis E virus (HEV) in wastewater in Munich. We
collected wastewater samples between July 2020 and November 2023. A
total of 186 samples were processed using centrifugation and analyzed
for HAV- and HEV-RNA using RT-qPCR. As a reference, we used notification
data from clinically or laboratory-diagnosed hepatitis A and E cases.
Lockdown stringency levels were derived from official documentation. Our
results show that 87.6% of wastewater samples were positive for HEV at
concentrations of 9.0 × 101 to 2.5 × 105 copies/L, while HAV was only detectable in 7.5% of the samples at viral loads of 4.6 × 101 to 2.4 × 103
copies/L. We also detected differences in HEV concentrations but not in
case numbers when comparing lockdown and no-lockdown periods. This
study covers all but the first lockdowns in Bavaria. We present a unique
real-world dataset evaluating the impact of lockdown interventions on
hepatitis A and E case numbers, as well as on the concentrations of HAV
and HEV in wastewater. Person-to-person spread and eating out appear to
have contributed to the transmission of HEV. In addition, the
consistently high HEV concentrations in sewage support the findings of
serological studies, indicating a substantial burden of undetected
subclinical infections.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
hepatitis E; hepatitis A; orthohepevirus A; orthohepevirus E; sewage; lockdown; transmission; correlation; natural experiment; Enteric Viruses; Pcr Assay; France; Hev
ISSN (print) / ISBN
2076-2607
e-ISSN
2076-2607
Journal
Microorganisms
Quellenangaben
Volume: 13,
Issue: 10,
Pages: 2379 - 2379
Publisher
MDPI
Publishing Place
Basel
Reviewing status
Peer reviewed
Institute(s)
Research Unit Global Health (UGH)
Institute of Computational Biology (ICB)
Institute of Computational Biology (ICB)
Grants
Federal Ministry of Health
Bundesministerium für Forschung, Technologie und Raumfahrt
Bundesministerium für Forschung, Technologie und Raumfahrt