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Q: Would you share more information on environmental surveillance data particularly with regards to waste water?

Some general information can be found using the following url:


More detailed facts on what we know and what we don’t know yet about infectivity of SARS-CoV-2 in faeces and waste water are listed below:


  • While COVID-19 is primarily a respiratory illness, the possibility of faecal-oral transmission was raised quite early (Yeo et al. 2020).

  • Approximately 2−10% of cases of confirmed SARS-CoV-2 disease present with diarrhea. Examples of detection of coronavirus in feces:

    • Holshue et al 2020: detected SARS-CoV-2 in a stool sample (United States)

    • Wang et al 2020: 44/153 samples (29%) positive (China)

    • Woelfel et al. 2020: 8/9 patients (89%) were positive (Germany)

    • Young et al 2020: 4/8 patients (50%) were positive (Singapore).

  • The magnitude of shedding varies between individuals and over the course of infection (Woelfel et al 2020; Pan et al 2020 and Lescure et al 2020)

  • There is limited indication of infectious viruses in faeces, only limited studies tried to culture SARS-CoV-2

    • Wang et al. (2020) reported successfully culturing 2 out of 4 samples, identifying the ‘live’ virus by electron microscopy.  

    • Woelfel et al. (2020) attempted to culture SARS-CoV-2 without success.

    • At RIVM we are currently trying to culture virus from feces and sewage, but currently without success.

  • No evidence to date about survival of the COVID-19 virus in sewage [Source: WHO 2020]

  • No reports of faecal−oral transmission of the SARS-CoV-2 virus (Source: WHO 2020).

  • In several countries traces of the coronavirus have been found in sewage water, e.g.:

    • The Netherlands (Lodder and De Roda Husman 2020; Medema et al 2020)

    • China (Wu et al 2020)

    • Australia (Ahmed et al 2020)

    • Italy (Randozza et al 2020; Rimoldi et al 2020; LaRosa et al 2020)

    • France (Wurtzer et al 2020)


We have the opinion that it is a very powerful way to conduct surveillance. Advantages such as capturing many inhabitants within one single sample analysis, the capture of pre and asymptomatic shedders, and all at relatively low costs. An efficient way to see whether there is circulation of the virus and whether this is increasing or decreasing.

[Dr. S.Rutjes - 06/08/2020]


NEA (Singapore) Leads Scientific Team In Wastewater Surveillance Trials For Assessment Of COVID-19 Transmission.


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