Respiratory virus infection dynamics and genomic surveillance to detect seasonal influenza subtypes in wastewater: a longitudinal study in Bengaluru, India

Abstract

Recent global pandemics have been caused by respiratory viruses found in both humans and animals with zoonotic spillover potential. Many respiratory viruses, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), respiratory syncytial virus (RSV), influenza A virus (IAV), and influenza B virus (IBV), have overlapping ecology and share similar symptoms. However, respiratory disease surveillance is often passive and relies on testing clinical specimens. Wastewater surveillance has been widely used as an epidemiological tool for early detection of SARS-CoV-2 variants and can differentiate between respiratory virus infections and SARS-CoV-2 peaks at a community level. In this retrospective longitudinal study covering three SARS-CoV-2 Omicron waves, we conducted a monthly sampling for 28 months (812 samples) between August 2021 and December 2023 at 28 sewershed sites in Bengaluru city (∼11 million inhabitants). Using RT-qPCR kits, we quantified SARS-CoV-2 RNA concentrations, IAV, IBV and RSV to understand community viral infection occurrences. We provide evidence of changes in the relative abundance of influenza subtypes and SARS-CoV-2 variants driving emerging peaks in wastewater data. We found 86% of samples positive for SARS-CoV-2, while the positivity rates for influenza virus and RSV were lower (37% for IAV, 16 % for IBV, and 15% for RSV). We observed an increase in influenza viruses in the post monsoon season (August to December) and remained present in January and February, while being practically absent the rest of the year. RSV showed a similar trend to IAV, with comparable quantities. Furthermore, we identified all eight segments of influenza virus genomes and emerging SARS-CoV-2 variants in wastewater samples. Wastewater surveillance provides data on the abundance of respiratory viruses in urban Bengaluru that would not be reported otherwise. Under the One Health framework, wastewater surveillance can offer early warning signs and enhance the traceability of infectious diseases in both wildlife and humans.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This work has been supported by funding from the Rockefeller Foundation (grant 2021 HTH 018) and the Indian Council of Medical Research grant to (FI) Tata Institute for Genetics and Society and Tata Trusts.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

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Data Availability

Data is included in supplementary material. All raw wastewater sequencing data will be available via the NCBI Sequence Read Archive under the BioProject ID PRJNXXX.

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