{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:51:47Z","timestamp":1777510307307,"version":"3.51.4"},"reference-count":40,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T00:00:00Z","timestamp":1672876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","award":["40118"],"award-info":[{"award-number":["40118"]}],"id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","award":["96829"],"award-info":[{"award-number":["96829"]}],"id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","award":["138011"],"award-info":[{"award-number":["138011"]}],"id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000880","name":"Michael &amp; Susan Dell Foundation","doi-asserted-by":"publisher","award":["40118"],"award-info":[{"award-number":["40118"]}],"id":[{"id":"10.13039\/100000880","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000880","name":"Michael &amp; Susan Dell Foundation","doi-asserted-by":"publisher","award":["96829"],"award-info":[{"award-number":["96829"]}],"id":[{"id":"10.13039\/100000880","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000880","name":"Michael &amp; Susan Dell Foundation","doi-asserted-by":"publisher","award":["138011"],"award-info":[{"award-number":["138011"]}],"id":[{"id":"10.13039\/100000880","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Research Foundation of South Africa","award":["40118"],"award-info":[{"award-number":["40118"]}]},{"name":"National Research Foundation of South Africa","award":["96829"],"award-info":[{"award-number":["96829"]}]},{"name":"National Research Foundation of South Africa","award":["138011"],"award-info":[{"award-number":["138011"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Wastewater surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has shown to be an important approach to determine early outbreaks of infections. Wastewater-based epidemiology (WBE) is regarded as a complementary tool for monitoring SARS-CoV-2 trends in communities. In this study, the changes in the SARS-CoV-2 RNA levels in wastewater during Easter holidays in 2021 and 2022 in the City of Cape Town were monitored over nine weeks. Our findings showed a statistically significant difference in the SARS-CoV-2 RNA viral load between the study weeks over the Easter period in 2021 and 2022, except for study week 1 and 4. During the Easter week, 52% of the wastewater treatment plants moved from the lower (low viral RNA) category in 2021 to the higher (medium to very high viral RNA) categories in 2022. As a result, the median SARS-CoV-2 viral loads where higher during the Easter week in 2022 than Easter week in 2021 (p = 0.0052). Mixed-effects model showed an association between the SARS-CoV-2 RNA viral loads and Easter week over the Easter period in 2021 only (p &lt; 0.01). The study highlights the potential of WBE to track outbreaks during the holiday period.<\/jats:p>","DOI":"10.3390\/v15010162","type":"journal-article","created":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T05:29:48Z","timestamp":1672896588000},"page":"162","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Using Wastewater Surveillance to Compare COVID-19 Outbreaks during the Easter Holidays over a 2-Year Period in Cape Town, South Africa"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8655-2794","authenticated-orcid":false,"given":"Nomfundo","family":"Mahlangeni","sequence":"first","affiliation":[{"name":"Environment & Health Research Unit, South African Medical Research Council (SAMRC), Johannesburg 2028, South 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Africa"},{"name":"Environmental Health Department, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2028, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noluxabiso","family":"Mangwana","sequence":"additional","affiliation":[{"name":"Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council (SAMRC), Tygerberg 7505, South Africa"},{"name":"Department of Microbiology, Stellenbosch University, Stellenbosch 7600, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3008-4279","authenticated-orcid":false,"given":"Stephanie","family":"Dias","sequence":"additional","affiliation":[{"name":"Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council (SAMRC), Tygerberg 7505, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0170-7342","authenticated-orcid":false,"given":"Jyoti Rajan","family":"Sharma","sequence":"additional","affiliation":[{"name":"Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council (SAMRC), Tygerberg 7505, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pritika","family":"Ramharack","sequence":"additional","affiliation":[{"name":"Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council (SAMRC), Tygerberg 7505, South Africa"},{"name":"Discipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban 4001, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan","family":"Louw","sequence":"additional","affiliation":[{"name":"Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council (SAMRC), Tygerberg 7505, South Africa"},{"name":"Department of Biochemistry and Microbiology, University of Zululand, KwaDlangezwa 3886, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tarylee","family":"Reddy","sequence":"additional","affiliation":[{"name":"Biostatistics Research Unit, South African Medical Research Council (SAMRC), Durban 4091, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1081-8549","authenticated-orcid":false,"given":"Swastika","family":"Surujlal-Naicker","sequence":"additional","affiliation":[{"name":"Scientific Services, Water and Sanitation Department, City of Cape Town Metropolitan Municipality, Cape Town 8000, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sizwe","family":"Nkambule","sequence":"additional","affiliation":[{"name":"Environment & Health Research Unit, South African Medical Research Council (SAMRC), Johannesburg 2028, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Candice","family":"Webster","sequence":"additional","affiliation":[{"name":"Environment & Health Research Unit, South African Medical Research Council (SAMRC), Johannesburg 2028, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mongezi","family":"Mdhluli","sequence":"additional","affiliation":[{"name":"Chief Research Operations Office, South African Medical Research Council (SAMRC), Tygerberg 7050, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenda","family":"Gray","sequence":"additional","affiliation":[{"name":"Office of the President, South African Medical Research Council (SAMRC), Tygerberg 7050, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6821-2120","authenticated-orcid":false,"given":"Christo","family":"Muller","sequence":"additional","affiliation":[{"name":"Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council (SAMRC), Tygerberg 7505, South Africa"},{"name":"Department of Microbiology, Stellenbosch University, Stellenbosch 7600, South Africa"},{"name":"Division of Medical Physiology, Faculty of Medicine and Health Sciences, Centre for Cardio-Metabolic Research in Africa, Stellenbosch University, Stellenbosch 7600, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6328-0789","authenticated-orcid":false,"given":"Rabia","family":"Johnson","sequence":"additional","affiliation":[{"name":"Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council (SAMRC), Tygerberg 7505, South Africa"},{"name":"Division of Medical Physiology, Faculty of Medicine and Health Sciences, Centre for Cardio-Metabolic Research in Africa, Stellenbosch University, Stellenbosch 7600, South 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