Citation:

Augustine, S., T. Eason, K. Simmons, S. Griffin, C. Curioso, M. Ramudit, E. Sams, K. Oshima, A. Dufour, AND Tim Wade. Rapid Salivary IgG Antibody Screening for Hepatitis A. JOURNAL OF CLINICAL MICROBIOLOGY. American Society for Microbiology, Washington, DC, 58(10):e00358-20, (2020). https://doi.org/10.1128/JCM.00358-20

Impact/Purpose:

Linking human health effects to water quality and epidemiological survey data has been a challenge for environmental researchers. The salivary antibody multiplex immunoassay presented in this paper has afforded the ability to measure human exposure to multiple waterborne pathogens simultaneously using very small volumes of non-invasive collected saliva. When applied to epidemiological studies of waterborne pathogen exposures, parameters such as immunoprevalence, incident infections (immunoconversions), co-infections and asymptomatic infections can be identified. Together with water quality and epidemiological studies, the multiplex immunoassay provides a powerful tool to assess insults to public health resulting from human activities associated with drinking or recreating in contaminated waters.

Description:

Hepatitis A virus (HAV) is a common infection that is transmitted through the fecal-oral route, shed in the stool of infected individuals and spread either by direct contact or by ingesting contaminated food or water. Each year, approximately 1.4 million acute cases are reported globally with a major risk factor for exposure being low household socioeconomic status. Recent trends show a decrease in anti-HAV antibodies in the general population, with concomitant increases in the numbers of HAV outbreaks. In line with a recreational water study, this effort aims to assess the prevalence of salivary IgG antibodies against HAV and subsequent incident infections (or immunoconversions) in visitors to a tropical beach impacted by a publicly owned treatment works (POTW). We applied a multiplex immunoassay to serially collected saliva samples gathered from study participants who recreated at Boquerón Beach, Puerto Rico. Analysis of assay results revealed an immunoprevalence rate of 16.17% for HAV with 1.43% of the cohort immunoconverting to HAV. Among those who immunoconverted, 10% reported chronic gastrointestinal symptoms and none experienced diarrhea. Tests on water samples indicated good water quality with low levels of fecal indicator bacteria, however, the collection and analysis of saliva samples afforded the ability to detect HAV infections in beachgoers. This rapid assay serves as a cost-effective tool for examining exposure to environmental pathogens and can provide critical information to policy makers, water quality experts and risk assessment professionals seeking to improve and protect recreational water and public health.

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