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Wastewater-based epidemiology for early warning of SARS-COV-2 circulation: A pilot study conducted in Sicily, Italy

  • Autori: Maida, Carmelo Massimo; Amodio, Emanuele; Mazzucco, Walter; La Rosa, Giuseppina; Lucentini, Luca; Suffredini, Elisabetta; Palermo, Mario; Andolina, Gina; Iaia, Francesca Rita; Merlo, Fabrizio; Chiarelli, Massimo Giuseppe; Siragusa, Angelo; Vitale, Francesco; Tramuto, Fabio; Segreto, Daniela; Schembri, Pietro; Cuffari, Giuseppe; Conti, Antonio; Casamassima, Giovanni; Polizzi, Andrea; Ferrara, Mansueta; Gullo, Giuseppina; Lo Verde, Angelo; Russo, Arianna; Casuccio, Alessandra; Costantino, Claudio; Restivo, Vincenzo; Immordino, Palmira; Graziano, Giorgio
  • Anno di pubblicazione: 2022
  • Tipologia: Articolo in rivista
  • OA Link:


There is increasing evidence of the use of wastewater-based epidemiology to integrate conventional monitoring assessing disease symptoms and signs of viruses in a specific territory. We present the results of SARS-CoV-2 environmental surveillance activity in wastewater samples collected between September 2020 and July 2021 in 9 wastewater treatment plants (WTPs) located in central and western Sicily, serving over 570,000 residents. The presence of SARS-CoV-2, determined in 206 wastewater samples using RT-qPCR assays, was correlated with the notified and geo-referenced cases on the areas served by the WTPs in the same study period. Overall, 51% of wastewater samples were positive. Samples were correlated with 33,807 SARS-CoV-2 cases, reported in 4 epidemic waves, with a cumulative prevalence of 5.9% among Sicilian residents. The results suggest that the daily prevalence of SARS-CoV-2 active cases was statistically significant and higher in areas with SARS-CoV-2 positive wastewater samples. According to these findings, the proposed method achieves a good sensitivity profile (78.3%) in areas with moderate or high viral circulation (≥133 cases/100,000 residents) and may represent a useful tool in the management of epidemics based on an environmental approach, although it is necessary to improve the accuracy of the process.