Surveillance of COVID-19 and influenza A(H1N1) prevalence in China via medicine-based wastewater biomarkers

•Simultaneously monitoring the use of medications for COVID-19 and influenza A (H1N1).•During the COVID-19, there was a significant increase in the consumption of antipyretics and cough medicines.•The prevalence of COVID-19 was higher in urban areas than in rural areas in this sampling. The simultan...

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Bibliographic Details
Published in:Water research (Oxford) 2023-12, Vol.247, p.120783-120783, Article 120783
Main Authors: Shao, Xue-Ting, Wang, Yan-Song, Gong, Zhen-Fang, Li, Yan-Ying, Tan, Dong-Qin, Lin, Jian-Guo, Pei, Wei, Wang, De-Gao
Format: Article
Language:English
Subjects:
COVID-19
Influenza A (H1N1)
Therapeutic medicines
Urban and rural area
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Summary:•Simultaneously monitoring the use of medications for COVID-19 and influenza A (H1N1).•During the COVID-19, there was a significant increase in the consumption of antipyretics and cough medicines.•The prevalence of COVID-19 was higher in urban areas than in rural areas in this sampling. The simultaneous monitoring of individual or multiple diseases can be achieved by selecting therapeutic medicines used to treat the primary symptoms of the condition as biomarkers in wastewater. This study proposes a novel approach to monitor the prevalence of COVID-19 and influenza A (H1N1) by selecting nine medicines to serve as biomarkers, including three antipyretics, three antivirals, and three cough suppressants. To verify our approach, wastewater samples were collected from seventeen urban and five rural wastewater treatment plants (WWTPs) in a Chinese city over a period of one year. The use of antipyretics increased notably during the COVID-19 pandemic, while the consumption of antivirals for influenza A (H1N1) rose in the post-COVID-19 pandemic period, indicating a minor spike in the occurrence of influenza A (H1N1) after the COVID-19 pandemic. Fever is a significant symptom of COVID-19 and can serve as a reliable indicator of disease prevalence. Our research found that the prevalence of COVID-19 in urban areas was significantly higher (at 78.5%, 95% CI: 73.4% - 83.9%) than in rural areas (with a prevalence of 48.1%, 95% CI: 42.4% - 53.8%). The prevalence of COVID-19 in urban areas in this study was consistent with the data reported by the Chinese Centre for Disease Control and Prevention (82.4%). Continuous monitoring of WWTPs in urban areas with fluctuating populations and complex demographics can provide early disease warning. Our results demonstrate the feasibility of evaluating community disease prevalence by selecting major therapeutic medicines as biomarkers in wastewater. [Display omitted]
ISSN:0043-1354
1879-2448
DOI:10.1016/j.watres.2023.120783