Drinking water and wastewater treatment are essential to the hygienic operation of modern cities. In the United States, the majority of the population is served by centralized drinking water distribution systems and centralized sewage systems. Water systems have long been recognized as potential transmission routes for infectious diseases, but two rapidly-evolving research areas will be discussed in this dissertation. First, wastewater systems can be monitored not only for their pathogen transmission potential related to waterborne illness, but also to gain insight more broadly into disease and behavior dynamics of the contributing community. This practice is referred to as wastewater-based surveillance (WBS), and candidate targets must be shed in feces or urine to be detected in wastewater but do not necessarily present a safety concern through exposure to wastewater. Second, advances in high-throughput sequencing and bioinformatics have enabled the characterization of microbial communities that naturally inhabit piped drinking water systems, beyond the detection of microbial contaminants. The development of flow cytometry methods to acquire counts of total and intact cells has enabled rapid and more comprehensive measurement of bacterial abundance in drinking water compared to existing methods. By using a combination of these techniques and other water quality measures to study drinking water and pipe biofilms, the importance of deterministic factors (e.g., changes in water use patterns) and stochastic factors (e.g., migration) on both microbial abundance and microbial community composition can be investigated.
Although WBS had been utilized prior to the pandemic, coronavirus disease 2019 (COVID-19) gave urgency to the need for additional sources of public health data and propelled the technique forward in research and practice. Wastewater is an inherently pooled sample that can be tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA, providing community-scale data on disease trends at a much lower cost than widespread individual testing and while overcoming some of the biases of clinical testing. However, wastewater is a heterogenous matrix, with sources of target signal variability including inconsistencies in sample collection and processing, nucleic acid degradation based on travel time and conditions in the sewer, and signal dilution due to rainfall and diurnal flow changes. Laboratory and analysis strategies can be employed to improve the interpretability and comparability of wastewater signal. For example, target signal can be normalized to an endogenous biomarker to account for variability in fecal content between samples. However, more research is needed to apply and develop systematic methods to interpret the true SARS-CoV-2 signal from noise introduced in wastewater samples and to increase the comparability of wastewater data across sample sites and timepoints.
The COVID-19 pandemic also highlighted the importance of understanding how water age impacts drinking water quality and microbiota as social distancing measures led to population shifts and large-scale changes in water demand. Elevated water age and stagnation of drinking water can lead to degradation of chlorine residual, bacterial growth, and changes in microbial community composition that may favor opportunistic pathogens and nitrifiers. The risks of drinking water stagnation had been established but not over the extended duration of widespread building closures that occurred during the pandemic. In addition, it was still unclear how these changes in water use patterns would impact the composition of microbial communities within drinking water pipes. Finally, water management approaches, such as repeated restorative flushing, were being recommended and implemented, warranting testing of the efficacy of this approach in buildings. COVID-19 lockdowns created a unique opportunity to study the effects of prolonged stagnation in building plumbing on drinking water quality and take preventative measures.
As a response to the COVID-19 pandemic, the goals of this research were to monitor microbiota in engineered water systems to (i) optimize quantitative surveillance of COVID-19 through wastewater testing and (ii) evaluate changes in distribution system and building drinking water quality and microbial communities due to widespread changes in water demand. Three independent research studies were conducted to achieve these aims.
First, to improve the interpretation of SARS-CoV-2 signal in wastewater, raw wastewater was collected weekly from five sewersheds and one residential facility in the San Francisco Bay Area. The concentrations of the N1 gene of SARS-CoV-2 in wastewater samples were compared to geocoded COVID-19 clinical testing data. To adjust for variation in sample fecal content, four normalization biomarkers were evaluated: crAssphage, pepper mild mottle virus (PMMoV), Bacteroides ribosomal RNA (rRNA), and human 18S rRNA. Of these, crAssphage displayed the least spatial and temporal variability. Both unnormalized SARS-CoV-2 RNA signal and signal normalized to crAssphage had positive and significant correlation with clinical testing data (Kendall's Tau-b (τ)=0.43 and 0.38, respectively), but no normalization biomarker strengthened the correlation with clinical testing data. Of the biomarkers tested, crAssphage was the most promising due to low spatial and temporal variability and because crAssphage-normalized N1 concentration had the strongest correlation with clinical testing data. PMMoV also had low spatial and temporal variability and may be appropriate as a normalization biomarker in some contexts. Conversely, Bacteroides rRNA performed poorly as a biomarker due to its higher spatial and temporal variability. Human 18S rRNA was not suitable as a normalization biomarker due to its variability in sample concentrations, high degradation rate, and ubiquity as a laboratory contaminant. This study supports that trends in wastewater surveillance data reflect trends in COVID-19 disease occurrence and presents tools that could be applied to make wastewater signal more interpretable and comparable across studies.
Next, we aimed to evaluate the impacts of pandemic-related building occupancy reductions (>2 months) and weekly restorative flushing on bulk drinking water quality parameters, bacterial communities, and the occurrence of undesirable microorganisms in tap water. Water samples were collected from fixtures (showers, faucets, and drinking fountains) in three university buildings on the University of California, Berkeley campus, which is served by a drinking water treatment facility using protected surface water and chloramine as a residual disinfectant. Reduced occupancy led to diminished chloramine and elevated intact cell counts, but values remained stable after additional weeks of limited water use. Flushing temporarily improved water quality, with chlorine and cell counts remaining stable for at least one day but returning to levels measured prior to flushing within one week. Alpha diversity of microbial communities was lower under more stagnant conditions, and fixture identity, not flushing, was the most influential factor on bacterial community composition, suggesting a strong influence from local biofilm. Although the genera Mycobacterium, Legionella, Pseudomonas, Nitrosomonas, and Nitrospira were detected in samples via amplicon sequencing, concentrations measured via qPCR of the pathogenic species M. avium complex, L. pneumophila, and P. aeruginosa as well as amoA, a functional gene of ammonia-oxidizing bacteria, were very low or below the detection limit, supporting that stagnation alone did not lead to high occurrence of undesirable microorganisms. Under the conditions of this case study, repeated flushing on a weekly timescale during low occupancy periods was not sufficient to maintain chlorine residual and prevent bacterial growth in fixtures. Building managers need to weigh the temporary water quality benefits of flushing against the labor and water resources required considering local context.
Finally, using bench-scale simulated distribution systems fed with municipal tap water (treated surface water with chloramine as a residual disinfectant), we aimed to characterize the impacts of elevated water age on microorganisms in bulk water and pipe wall biofilms. The reactors allowed for more controlled conditions than a full-scale study and enabled collection of biofilm samples. Reactors were operated for six months prior to building closures and seven months after, providing an opportunity to study how elevated water age entering the reactors impacted microbial communities. During the months after building closures, chloramine levels in the reactors dropped below the detection limit, while cell counts and ATP concentrations increased over an order of magnitude in both the bulk water and biofilms. Microbial communities shifted after building closure, and key taxa were identified that influenced the shift. Many metagenome-assembled genomes that were enriched after building closures contained functional genes related to the degradation of histidine, leucine, phthalate, and pyrimidine, supporting that microorganisms with the functional potential to degrade amino and nucleic acids may be favored in the higher water age conditions. Throughout the experiment, the bacterial community in the bulk water of the reactors was dominated by microorganisms that grew in the reactor (i.e., growth in the bulk water or transfer from the biofilm) and not microorganisms from the influent tap water. Additionally, communities clustered by reactor, which were operated in parallel as replicates, supporting the strong influence of historical contingency in shaping drinking water microbial communities.
Large-scale outbreaks and disruptions to typical operations of society are not unique to the COVID-19 pandemic, and the spread of infectious diseases is expected to increase due to increasing global populations and connectivity, human activities, and human-induced changes to the environment. Drinking water supplies need to be resilient to these disruptions in typical operation. This research informs drinking water system management approaches that can lead to stable water microbiomes and water quality. Building on this research, future studies should go beyond characterization and investigate intentional engineering of drinking water microbiomes. Additionally, municipal wastewater systems need to be fully utilized to provide insight into managing outbreaks, increasing the resiliency of public health systems. Based on this research, approaches are recommended to increase the translatability of wastewater monitoring data that could be used for targets beyond SARS-CoV-2.