Continuous Circulation of Hepatitis E and A Viruses During COVID-19 Pandemic Lockdowns in Munich, Germany-Experience from Three Years of Wastewater Surveillance

Javanmardi, Jasmin and Schemmerer, Mathias and Wallrafen-Sam, Karina and Neusser, Jessica and Rubio-Acero, Raquel and Hoelscher, Michael and Kletke, Thomas and Boehm, Bernhard and Schneider, Michael and Waldeck, Elisabeth and Hoch, Martin and Bohmer, Merle M. and Geldmacher, Christof and Hasenauer, Jan and Wenzel, Jürgen J. and Wieser, Andreas (2025) Continuous Circulation of Hepatitis E and A Viruses During COVID-19 Pandemic Lockdowns in Munich, Germany-Experience from Three Years of Wastewater Surveillance. MICROORGANISMS, 13 (10): 2379. ISSN , 2076-2607

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Abstract

The COVID-19 pandemic has increased interest in wastewater-based epidemiology (WBE) as a reliable and cost-effective framework for monitoring the spread of microbes. However, WBE frameworks have rarely been applied to the study of fecal-oral transmissible diseases, except for poliomyelitis. Here, we investigated the presence of hepatitis A virus (HAV) and hepatitis E virus (HEV) in wastewater in Munich. We collected wastewater samples between July 2020 and November 2023. A total of 186 samples were processed using centrifugation and analyzed for HAV- and HEV-RNA using RT-qPCR. As a reference, we used notification data from clinically or laboratory-diagnosed hepatitis A and E cases. Lockdown stringency levels were derived from official documentation. Our results show that 87.6% of wastewater samples were positive for HEV at concentrations of 9.0 x 101 to 2.5 x 105 copies/L, while HAV was only detectable in 7.5% of the samples at viral loads of 4.6 x 101 to 2.4 x 103 copies/L. We also detected differences in HEV concentrations but not in case numbers when comparing lockdown and no-lockdown periods. This study covers all but the first lockdowns in Bavaria. We present a unique real-world dataset evaluating the impact of lockdown interventions on hepatitis A and E case numbers, as well as on the concentrations of HAV and HEV in wastewater. Person-to-person spread and eating out appear to have contributed to the transmission of HEV. In addition, the consistently high HEV concentrations in sewage support the findings of serological studies, indicating a substantial burden of undetected subclinical infections.

Item Type: Article
Uncontrolled Keywords: ENTERIC VIRUSES; PCR ASSAY; FRANCE; HEV; hepatitis E; hepatitis A; orthohepevirus A; orthohepevirus E; sewage; lockdown; transmission; correlation; natural experiment
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Medizinische Mikrobiologie und Hygiene
Depositing User: Dr. Gernot Deinzer
Date Deposited: 30 Mar 2026 13:12
Last Modified: 30 Mar 2026 13:12
URI: https://pred.uni-regensburg.de/id/eprint/67915

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