SARS-CoV-2 Surveillance in Belgian Wastewaters

Raphael Janssens, Sven Hanoteaux, Hadrien Maloux, Sofieke Klamer, Valeska Laisnez, Bavo Verhaegen, Catherine Linard, Lies Lahousse, Peter Delputte, Matthieu Terwagne, Jonathan Marescaux, Rosalie Pype, Christian Didy, Katelijne Dierick, Koenraad Van Hoorde, Marie Lesenfants

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Wastewater-based surveillance was conducted by the national public health authority to monitor SARS-CoV-2 circulation in the Belgian population. Over 5 million inhabitants representing 45% of the Belgian population were monitored throughout 42 wastewater treatment plants for 15 months comprising three major virus waves. During the entire period, a high correlation was observed between the daily new COVID-19 cases and the SARS-CoV-2 concentration in wastewater corrected for rain impact and covered population size. Three alerting indicators were included in the weekly epidemiological assessment: High Circulation, Fast Increase, and Increasing Trend. These indicators were computed on normalized concentrations per individual treatment plant to allow for a comparison with a reference period as well as between analyses performed by distinct laboratories. When the indicators were not corrected for rain impact, rainy events caused an underestimation of the indicators. Despite this negative impact, the indicators permitted us to effectively monitor the evolution of the fourth virus wave and were considered complementary and valuable information to conventional epidemiological indicators in the weekly wastewater reports communicated to the National Risk Assessment Group.
Original languageEnglish
Article number1950
Pages (from-to)1950
Issue number9
Publication statusPublished - 2 Sept 2022


  • alerting indicator
  • correlation
  • public health authority
  • SARS-CoV-2
  • surveillance
  • viral load per capita
  • viral to faecal ratio
  • wastewater-based epidemiology


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