Beyond the Conventional: Advanced Mass Spectrometry-Based Wastewater Analysis for Enhancing Public Health Management

The outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, has caused a global pandemic that has affected millions of people around the world. This has led to the urgent need for effective surveillance and monitoring strategies to control the spread of the virus [1]. The identification of SARS-CoV-2 peptides and acute phase response proteins in wastewater using mass spectrometry (MS) and the wastewater-based epidemiology concept is a promising tool for the surveillance of infectious diseases.

MS is a powerful analytical technique that provides high specificity and sensitivity for the identification of SARS-CoV-2 peptides in wastewater [2]. This allows for the early detection of outbreaks and real-time monitoring of disease trends. The quantification of acute phase response proteins in wastewater provides valuable information on the dynamics of the immune response to SARS-CoV-2, including the kinetics of cytokine production and the levels of acute phase response proteins in wastewater samples.

In this study, a comprehensive mass spectrometry-based framework was developed for simultaneous tracking of infectious disease spread and community response to facilitate rapid disease management at the community level. SARS-CoV-2 was used as a test pathogen and C-reactive protein (CRP) as an acute phase response protein. The high specificity and sensitivity of MS, combined with the ability to provide a population-level perspective on the spread of the virus, make it a valuable tool for the surveillance of SARS-CoV-2.

To our knowledge, this is the first report to use LC−MS/MS to measure SARS-CoV-2 and its corresponding acute phase responsive human CRP protein in wastewater. The use of MS in wastewater-based epidemiology provides a promising tool for monitoring and controlling the spread of infectious diseases, not only for SARS-CoV-2 but also for other pathogens.

In conclusion, identifying SARS-CoV-2, a highly infectious pathogen, and acute phase response proteins, such as CRP, in wastewater using mass spectrometry is a valuable tool for the surveillance of infectious diseases. This study provides a comprehensive framework for simultaneously tracking infectious disease spread and community response to facilitate rapid disease management at the community level. The use of MS in wastewater-based epidemiology provides a promising tool for monitoring and controlling the spread of infectious diseases, and further research in this area is warranted.

Acknowledgements
The support of Engineering and Physical Sciences Research Council (EP/V028499/1), Wessex Water Services Ltd and EPSRC Impact Acceleration Account (Project number: EP/R51164X/1, ENTRUST IAA) and UKWIR IPC project (Innovative Pathways Control) is greatly appreciated.

References
[1] Medema, G.; Heijnen, L.; Elsinga, G.; Italiaander, R.; Brouwer, A., Presence of SARS-Coronavirus-2 RNA in Sewage and Correlation with Reported COVID-19 Prevalence in the Early Stage of the Epidemic in The Netherlands. Environmental Science & Technology Letters 2020, 7 (7), 511-516.
[2] Lara-Jacobo, L. R.; Islam, G.; Desaulniers, J.-P.; Kirkwood, A. E.; Simmons, D. B. D., Detection of SARS-CoV-2 Proteins in Wastewater Samples by Mass Spectrometry. Environ. Sci. Technol. 2022, 56 (8), 5062-5070