SCORE (Sewage biomarker analysis for community health assessment) COST Action No. ES1307

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Tiffany Hampton
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1 SCORE (Sewage biomarker analysis for community health assessment) COST Action No. ES1307 Minutes of the Working Group 2 (subgroup: pathogens) Meeting, held in Kraków, Poland, February Attendees 1. Anna Lenart-Boroń Poland 2. Katarzyna Wolny-Koładka Poland 3. Piotr Boroń Poland 4. Bartłomiej Grad Poland 5. Andrew Singer UK 6. Zhugen Yang UK 7. Abidelfatah Nasser Israel Item Subject Discussion Date 1 Welcome Anna Lenart-Boroń welcomed all participants of the WG Feb. 10 th 2, subgroup: pathogens meeting 2 General Andrew Singer kindly agreed to be in charge of preparing Feb. 10 th discussion on final version of the manuscript, to decide on the final layout of and to distribute tasks between the subgroup participants 3 Updates on 3.1. Anna Lenart-Boroń - Bacterial indicators of fecal Feb. 10 th individual participant s research and potential contribution to contamination of surface water - southern Poland 3.2. Katarzyna Wolny-Koładka - Microbial pathogens isolated from water in the Nowohucki Reservoir in Kraków, Poland 3.3. Bartłomiej Grad - Detection of antibiotics in wastewater 4 Site inspection All participants took part in the excursion to the southern Feb. 11 th

2 5. Further updates on individual participant s research and potential contribution to 6. Summary of the WG2, subgroup meeting outcomes Poland s study site Białka Tatrzańska and Zakopane to visit the sampling sites and observe the fecal contamination of surface waters of protected areas 5.1. Zhugen Yang - Can community sewage sensors monitor pathogens for public health? 5.2. Abidelfatah Nasser - Monitoring Giardia lamblia in sewage as indicator for its infection rate in the community 5.3. Abidelfatah Nasser Polio eradication 5.4. Abidelfatah Nasser Impact of Wastewater Effluents on the Environmental Dissemination of Antibiotics Resistant Bacteria (ARB) Andrew Singer collected all information from the meeting participants and summarized the outcomes of the discussions, suggesting the layout of the projected paper and also suggesting that the scope of the participants research allows to plan preparation of further papers. Main items of Andrew s summary: Exploring Wastewater for the Epidemiology of Human Pathogens 1) Introduce the topic of waste water epidemiology (WWE) a. What has/is being done i. biomarkers ii. illicit drugs iii. drug compliance 2) Introduce the use of WWE for pathogens a. What has/is being done i. Polio ii. Giardia (Japan/Israel) iii. Literature on viruses (in the UK?) iv. Salmonella

3 3) Discuss the benefits of WWE and factors that make it successful a. Unbiased reporting b. Presence/absence can be informative c. Semi-quantitative (depends on our understanding of confidence/error) d. Molecular approaches make it easy to know about any pathogen (parasite, microbe, virus) e. Applicable in large sewage works, capturing important city populations i. Review: ES&T 2011, Cristof Ort (Best practice for sampling strategy) 4) Discuss the challenges of WWE and its limitations a. Estimating the shedding rate of a virus i. Examples of shedding of each pathogen 1. Rotavirus 2. Giardia b. Reproducibility of recovery from sewage influent i. Are all STP sufficiently similar to make this not an issue? c. Persistence in sewage (and reproducibility) d. Less applicable to small sewage works/small populations e. Concentration, isolation methods f. Viable & infectious pathogens versus DNA/RNA-based recovery g. Review ES&T 2013 Sara Castiglioni Drug biomarkers

4 5) How do overcome challenges 6) Potential application of the WWE approach a. Routine monitoring b. Targeted surveillance c. More informed public health epidemiology risk models d. Pandemic surveillance Other papers: 1) Measurement of pathogens using novel detection technology? a. Requires DNA sample from sewage and novel or known target of interest b. Issue of cost High throughput vs hand held biosensor vs High income vs low income 2) Fecal contamination of water and artificial snow? 3) Antibiotics/antimicrobial resistance genes in the environment can they tell us a lot about the population? Relevant to initial paper? 4) Shed rate of pathogens a. What is the minimum size of a population to get a reliable estimate of infected individuals (epi model). i. Important to optimise and understand the relationship between the number of people infected to the shedding rate to the dilution rate to the sampling rate.

5 b. Discuss reasons for discrepancy between WWEpi and traditional reporting. i. Asymptomatic, etc. ii. Not all samples sent for analysis iii. Infected not seeking medical help iv. Not all diagnosed positive samples are reported v. Is the pathogen human specific or is it shared by animals and can this contribute to the sample analysis? c. Seasonality of pathogen infections within a community, easily determined. i. Useful for determining aetiology of disease 5) Is AMR detection a good predictor of AMR in clinical setting? a. Different results depending on before or after treatment. 7 Final discussions All participants agreed that the deadline for the preparation of the manuscript should be end of June 2016 and that its final version should be ready before the next MC meeting (September 2016, Lesbos) Some journals were suggested to which could be submitted, i.e. Trends in Microbiology or Environmental Health Perspectives (in the form of the meeting report). Andrew Singer also suggested to use the Dropbox platform to exchange the materials related to and its working versions during the preparation process.

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