Wastewater monitoring of SARS-CoV-2 in on-grid, partially and fully off-grid Bedouin communities in Southern Israel

Background Wastewater based epidemiology (WBE) has become an important tool in SARS-CoV-2 surveillance and epidemiology. While WBE measurements generally correlate with observed case numbers large municipal areas on sewer grids, there are few studies its utility communities that off-grid (non-sewered). Methods materials To explore the applicability of wastewater our region, five Bedouin along Hebron Stream Southern Israel (Negev desert) were sampled. One point (El-Sayed) represents a community partial connection to grid system another (Um Batin) no access system. The towns Hura, Lakia, Tel Al-Sabi/Tel Sheva on-grid. A total 87 samples collected between August 2020 January 2021 using both grab composite sampling. RNA was extracted from raw sewage concentrated sewage. RT-qPCR carried out N1, N2, N3 gene targets, findings compared human data Israeli Ministry Health. Results detected consistently over time on-grid (Lakia, Sheva/Tel as-Sabi, Hura) inconsistently smaller, (El-Sayed Um Batin). trend maximum copy number/L appears be driven by population size. When comparing normalized size, amount copies/L related reported numbers. also sewage-impacted environmental waters representing grid. sampling compared, results comparable however produced superior results. Conclusions mismatch virus cases could indicate asymptomatic or “silent” transmission, under-testing within these (due factors like mistrust government, stigma, misinformation) combination therein. exact reason for signals remains unresolved, suggest surveillance, including methodologies, can critical aspect outbreak control insufficient testing communities.