Maha Alafeef1,2,3,4, Ketan Dighe1,4, Parikshit Moitra3, Dipanjan Pan1,3,4. 1. Bioengineering Department, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, United States. 2. Biomedical Engineering Department, Jordan University of Science and Technology, Irbid 22110, Jordan. 3. Departments of Diagnostic Radiology and Nuclear Medicine and Pediatrics, University of Maryland Baltimore, Health Sciences Facility III, 670 W Baltimore Street, Baltimore, Maryland 21201, United States. 4. Department of Chemical, Biochemical, and Environmental Engineering, University of Maryland Baltimore County, Interdisciplinary Health Sciences Facility, 1000 Hilltop Circle, Baltimore, Maryland 21250, United States.
Abstract
The latest epidemic of extremely infectious coronavirus disease 2019 (COVID-19) has created a significant public health concern. Despite substantial efforts to contain severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within a specific location, shortcomings in the surveillance of predominantly asymptomatic infections constrain attempts to identify the epidemiological spread of the virus. Continuous surveillance of wastewater streams, including sewage, offers opportunities to track the spread of SARS-CoV-2, which is believed to be found in fecal waste. To demonstrate the feasibility of SARS-CoV-2 detection in wastewater systems, we herein present a novel facilely constructed fluorescence sensing array based on a panel of three different lanthanide-doped carbon nanoparticles (LnCNPs). The differential fluorescence response pattern due to the counterion-ligand interactions allowed us to employ powerful pattern recognition to effectively detect SARS-CoV-2 and differentiate it from other viruses or bacteria. The sensor results were benchmarked to the gold standard RT-qPCR, and the sensor showed excellent sensitivity (1.5 copies/μL) and a short sample-to-results time of 15 min. This differential response of the sensor array was also explained from the differential mode of binding of the LnCNPs with the surface proteins of the studied bacteria and viruses. Therefore, the developed sensor array provides a cost-effective, community diagnostic tool that could be potentially used as a novel epidemiologic surveillance approach to mitigate the spread of COVID-19.
The latest epidemic of extremely infectious coronavirus disease 2019 (COVID-19) has created a significant public health concern. Despite substantial efforts to contain severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within a specific location, shortcomings in the surveillance of predominantly asymptomatic infections constrain attempts to identify the epidemiological spread of the virus. Continuous surveillance of wastewater streams, including sewage, offers opportunities to track the spread of SARS-CoV-2, which is believed to be found in fecal waste. To demonstrate the feasibility of SARS-CoV-2 detection in wastewater systems, we herein present a novel facilely constructed fluorescence sensing array based on a panel of three different lanthanide-doped carbon nanoparticles (LnCNPs). The differential fluorescence response pattern due to the counterion-ligand interactions allowed us to employ powerful pattern recognition to effectively detect SARS-CoV-2 and differentiate it from other viruses or bacteria. The sensor results were benchmarked to the gold standard RT-qPCR, and the sensor showed excellent sensitivity (1.5 copies/μL) and a short sample-to-results time of 15 min. This differential response of the sensor array was also explained from the differential mode of binding of the LnCNPs with the surface proteins of the studied bacteria and viruses. Therefore, the developed sensor array provides a cost-effective, community diagnostic tool that could be potentially used as a novel epidemiologic surveillance approach to mitigate the spread of COVID-19.
Since the onset of
the coronavirus disease 2019 (COVID-19) outbreak,
stringent public health and social measures have been implemented
to slow the spread of the virus. Substantial efforts have been devoted
to containing the virus within a specific location but considering
many uncertainties over the transmissibility and virulence of this
highly contagious virus, the success of these efforts is limited.
Moreover, it remains a highly complex technical task for medical professionals
to track suspected cases of infection practically and efficiently
from individual households. Such a massive undertaking is time-consuming
and labor-intensive and, at this highly critical time, is limited
by the availability of testing technologies. At this time, Centers
for Disease Control and Prevention (CDC) is following a logical model
for monitoring and evaluating community mitigation strategies for
COVID-19. Therefore, environmental monitoring of the existence of
the virus in wastewater, known as wastewater-based epidemiology (WBE),
may be an early warning method and an active method for quick diagnosis
of COVID-19 outbreaks irrespective of symptoms.[1,2]COVID-19 is a respiratory disease; however, growing evidence suggests
that coronavirus genomes are shed in the feces and ultimately reach
wastewater.[3−5] Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
surveillance in sewage may be considered a sensitive tool to monitor
the spread of the virus among the population.[6] A significant proportion of undiagnosed and asymptomatic carriers
shed SARS-CoV-2 in the stool.[7−11] WBE is an early warning tool of the circulation of the virus in
the population, including symptomatic and asymptomatic shedders. Studies
conducted in Europe and Australia indicated that wastewater monitoring
may provide a practical method to predict the potential spread of
SARS-CoV-2.[7−11] The presence of SARS-CoV-2 was detected in sewage samples, a while
before the public health officials reported the first case of COVID-19
in these communities. In addition, numerous studies have shown that
SARS-CoV-2 can normally survive in an appropriate environment for
up to a few days after leaving the human body.[12−14] Due to the
limited availability of rapid diagnostic tests along with the inaccessibility
of advanced instrumental techniques to all the diagnostic centers,
especially the remote ones, there is potential that the analysis of
SARS-CoV-2 in community wastewater-based systems could trace COVID-19
sources. WBE could therefore serve as an “early warning tool
(sentinel surveillance)” of the circulation of the virus in
the population, including symptomatic and asymptomatic shedders.[15−20]The importance behind the wastewater-based surveillance of
SARS-CoV-2
has thus been realized, but the rapid and early discrimination of
SARS-CoV-2 from other viruses and microorganisms using the currently
available techniques remains the major obstacle. Although polymerase
chain reaction (PCR) is excellent in terms of sensitivity and specificity,
requirements for complicated laboratory-based sample handling and
a long period of data processing and review (4–6 h) are not
conducive to real-time and effective onsite monitoring of samples.[21] Additionally, the wastewater contains a lot
of other components apart from the genetic material. For example,
the interference of other microorganisms such as Escherichia
coli (E. coli), Streptococcus mutans (S. mutans), and Bacillus subtilis (B. subtilis) in wastewater may impose different stressors
on the PCR assay and can affect the interpretation of the results.[22,23] Therefore, it is extremely valuable to establish an effective, transportable,
and reliable analytical method to detect and differentiate low-level
SARS-CoV-2 sources from other microorganisms accurately and quickly
via WBE to confirm suspected cases and to screen asymptomatic infected
cases without centralized laboratories.Nanoparticles (NPs)
have widely been utilized for detecting several
viruses and microbes,[24−36] for example, detection of SARS-CoV-2 using suitably designed gold
NPs,[37−39] influenza A virus using antibody-functionalized gold
NPs,[40]E. coli using gold NPs,[41] magnetic NP system,[42] fluorescent organic NPs,[43] upconversion NPs, and fluorescent silica NPs.[44] In this context, carbon nanoparticles (CNPs)
represent an emerging class of luminescent nanoprobes that offer multicolor,
tunable emission based on the engineered nanoscale surface.[45−48] The other attributes that make these particles attractive for sensing
applications are low photobleaching, excellent biocompatibility, and
their ability to respond rapidly to the subtle changes of the nanoscale
environment.[49−51] CNPs have therefore been successfully used for sensing
pollutants[52] and various biological targets[53] utilizing their unique environmentally sensitive
optical response.[54] To make the CNPs more
amenable to change of the environment and to construct sensor array
elements, lanthanide (Ln) metal doping can be explored. Lanthanide
NPs have inherent advantages due to narrow emission lines and long
lifetimes of lanthanide dopants in the host lattice, which could be
used for detection of chemical as well as biological molecules. Here,
lanthanide NPs are any NPs that are incorporated with lanthanide ions
resulting in luminescent emission and large anti-Stokes or Stokes
shift. The large anti-Stokes or Stokes shift
changes the absorbed light into emission lines spanning from the infrared
to ultraviolet region based on the choice of the lanthanide dopant.
Furthermore, the lanthanide NPs exhibit excellent photostability that
far exceeds that of other organic (fluorescent proteins and dyes)
and inorganic fluorescent probes (quantum dots). For example, lanthanide
NPs are known to exhibit stable emission for 5 h.[55−59] Therefore, utilizing lanthanide as a dopant metal
can enhance the intrinsic photophysical properties of lanthanide-doped
carbon nanoparticles (LnCNPs) to act as an excellent candidate of
the sensor array for pathogenic virus and bacterial sensing. Lanthanides
have been shown in the past to considerably expand the scope of array-based
sensing, for example, detection of glyphosate and proteins and metal
ions in biofluids, pH detection in human MCF-7 cells, etc.[60−63] However, to the best of our knowledge, LnCNPs acting as a recognition
unit for a sensor array for detection of pathogens or bacteria is
not explored yet. Therefore, LnCNPs may act as an excellent candidate
for recognition as well as a transducer element for making a sensor
array for pathogenic virus and bacterial sensing.In this study,
we report an easily accessible sensor array that
selectively discriminates viral strains (SARS-CoV-2, SARS-CoV, and
H1N1) from bacterial species (E. coli,[64−66]S. mutans,[67,68] and B. subtilis(66)) and accurately detects SARS-CoV-2 at a sensitivity level
equivalent to real-time quantitative PCR (RT-qPCR). The sensor array
comprises three lanthanide metal-doped CNPs (LnCNPs) and a gelatinous
3D matrix (agarose). As different pathogen species have different
surface chemical and physical properties, distinct fluorescence signal
patterns are generated from counterionic–ligand interactions
with polycationic-caged CNPs, which can then be differentiated using
a carefully designed machine learning methodology.[48,69−73] The varied response of the sensor array has also been investigated
through molecular docking among the LnCNPs and the surface proteins
of the studied viruses and bacteria. The theoretical docking results
closely corroborate with the experimental sensor patterns. Overall,
a powerful sensing platform has been demonstrated herein for the rapid
and selective discrimination of COVID-19 causative virus, SARS-CoV-2,
from five other different viral and bacterial contaminants present
in still waterbodies with >95% accuracy. Scheme illustrates the conceptual demonstration
of wastewater-based surveillance for SARS-CoV-2 transmission using
our newly developed sensor array. The proposed system is straightforward
and can be applied for the identification and detection of various
other viral and bacterial strains in freshwater samples such as tap
and lake water. With a few modifications, this method can further
be introduced for the detection of other pathogens, paving the way
for new techniques for alternative, low-cost, and rapid multiplexed
detection systems.
Scheme 1
Schematic Representation of the Sensing Mechanism
of Our LnCNP Sensor
Array
The lanthanide-doped CNPs
interact differentially with the viruses and bacteria generating distinct
photoluminescence responses, which are then discriminated from each
other by a machine learning-based pattern recognition algorithm. Clear
discrimination and rapid detection of SARS-CoV-2 viral transmission
in still waterbodies have been achieved using the LnCNP-based sensor
array.
Schematic Representation of the Sensing Mechanism
of Our LnCNP Sensor
Array
The lanthanide-doped CNPs
interact differentially with the viruses and bacteria generating distinct
photoluminescence responses, which are then discriminated from each
other by a machine learning-based pattern recognition algorithm. Clear
discrimination and rapid detection of SARS-CoV-2 viral transmission
in still waterbodies have been achieved using the LnCNP-based sensor
array.
Experimental Section
The details of chemical reagents and solutions and NP characterization
are provided in the Supporting Information.
Synthesis of LnCNPs
The synthesis of doped CNPs is
based on the facile hydrothermal process. Lanthanide chloride, either
PrCl3, GdCl3, or YbCl3 (300 μL,
0.2 mmol/mL), and polyethyleneimine (PEI) (1 mL,100 mg/mL) were dissolved
in 20 mL of tannic acid solution (340 mg/mL), and the solution was
then transferred into a 50 mL Teflon autoclave. After heating at 180
°C for 5 h, the autoclave was cooled down to room temperature
naturally. The CNPs were probe-sonicated for 30 min (Q700, Qsonica
Sonicator, Newtown, CT) in an ice bath (4-amp pulse; 2 s on and 1
s off). After this, the products were filtered using a 0.2 μm
syringe filter to remove large entities and then lyophilized to obtain
a brownish-color powder.
Quantum Yield Calculation
A quinine
sulfate solution
in 0.1 M H2SO2 with a concentration of 5 mg/mL
was prepared and used as a reference solution to calculate the quantum
yield of the three LnCNPs. A volume of 100 μL of the quinine
sulfate solution was used to record the fluorescence spectra. The
absorbance spectra of the three CNPs were recorded using a diluted
sample (10 μL of the particle solution to 990 μL of deionized
(DI) water). The quantum yield (Ø) of the three LnCNPs was calculated
using the equation given below:I is the
integration of the fluorescence spectrum, A is the
absorbance of the sample at 365 nm, and η is the refractive
index of the used solvent. The variable with the “Ref”
subscript represents the values associated with the quinine sulfate.
ØRef = 0.54 for the quinine sulfate dye.
Fabrication
of a Sensor Platform
The as-synthesized
LnCNPs (68 mg) were dispersed in 100 mL of DI water containing 800
mg of agarose at 70 °C. The solution was then deposited in 96-well
plates (100 μL for each well) and allowed to solidify naturally
under room temperature.
Experimental Procedure for Pathogen Selective
Identification
A volume of 100 μL of virus and bacteria
with various concentrations
was transferred to the sensor platform deposited in a 96-well plate,
and three repeated experiments were performed. For screening the viruses
and real-time sensing, the wastewater was spiked with 105 genome equivalent/mL of the virus under investigation. For bacterial
sensing, the wastewater was spiked with bacterial cell densities having
OD600 = 0.2, that is, ∼107 of bacterial cell populations.
All the fluorescence measurements were recorded using a microplate
reader with λex/λem = 360/460 ±
40 nm or λex/λem = 400/500 ±
40 nm. The fluorescence of the sensor without viruses and bacteria
under the same conditions was recorded as a control. The fluorescence
intensities were recorded for 15 min. From these measurements, the
relative fluorescence intensity was calculated and then introduced
to the ML algorithm to generate the viral and bacterial-specific results
using MATLAB. Each value was an average of nine independent measurements.
Results and Discussion
In this study, luminescent CNPs were
initially prepared from a
combined carbon source of tannic acid and a cationic macromolecule,
for example, long-chain branched PEI, using a hydrothermal process.
Hydrothermal-based carbonization is a convenient and rapid approach
for the formation of lanthanide-doped CNPs. Tannic acid has a low
carbonization temperature, while PEI can passivate the surface of
CNPs due to its polyamine structures. Therefore, under hydrothermal
conditions (i.e., high temperature and pressure),
the tannic acid gets carbonized along with simultaneous in-situ passivation by PEI. Lanthanide dopants were further used to yield
Ln-CNP-PEI (LnCNPs). The PEI macromolecule has been confirmed to be
stable and undergoes no carbonization process throughout the hydrothermal
treatment. PEI was found to be stable under 200 °C, and the obtained
solution from the hydrothermal process possessed an unchanged color
with no emission properties. Based on these observations, we propose
the structure of LnCNPs as shown in Figure a for lanthanide doping, and three metals
were selected, that is, Pr, Gd, and Yb. Therefore, three types of
CNPs were studied in this work, that is, praseodymium-doped CNPs (PrCNPs),
gadolinium-doped CNPs (GdCNPs), and ytterbium-doped CNPs (YbCNPs).
The successful metal doping with Pr, Gd, and Yb was confirmed by inductively
coupled plasma–optical emission spectroscopy (ICP-OES). This
technique analytically quantified the content of lanthanide dopant
as ∼3.792, 17.25, and 14.24 wt % for Pr, Gd, and Yb of the
total NP weight, respectively. Our research group and others previously
showed that tannic acid is capable of chelating metals; thus, using
tannic acid (TA) as a starting material would help in the formation
of a metal–phenolic complexed state.[74−77] Therefore, the lanthanide metals
might form metal–phenolic coordination on the LnCNPs, and also
they can be trapped in the CNP matrix during the synthesis process. Figure b shows a representative
band gap model that was developed to explain the change in the photoluminescence
(PL) due to the interaction of LnCNPs with viruses and bacteria. LnCNPs
exhibited a smooth absorption–emission transition. However,
in the presence of microorganisms, an intermediate band gap appears
to play a role in altering the electron/hole recombination processes
leading to a change in their PL.
Figure 1
(a) Schematic representation of the synthesis
of LnCNPs. TA and
branched PEI were used as carbon sources. Three LnCNPs were synthesized
by the doping of CNPs with Pr(III), Gd(III), and Yb(III), known as
PrCNPs, GdCNPs, and YbCNPs, respectively. (b) Conceptual band gap
diagram of fluorescence manipulation due to the interaction of LnCNPs
with virus or bacteria.
(a) Schematic representation of the synthesis
of LnCNPs. TA and
branched PEI were used as carbon sources. Three LnCNPs were synthesized
by the doping of CNPs with Pr(III), Gd(III), and Yb(III), known as
PrCNPs, GdCNPs, and YbCNPs, respectively. (b) Conceptual band gap
diagram of fluorescence manipulation due to the interaction of LnCNPs
with virus or bacteria.The as-synthesized LnCNPs
were found to have positive electrophoretic
potential values, which confirmed the surface abundance of positively
charged amino groups (Figure a) on the sensing element. On the contrary, the viral and
bacterial envelopes have varied lipid compositions with the abundance
of phosphatidylethanolamine and bacterial cell surfaces were profused
with anionic components, for example, long anionic polymers and teichoic
acid. The analytes are therefore expected to participate in a counterionic–ligand
interaction with the LnCNPs. We anticipate that the nonspecific interaction
between the LnCNPs and pathogens (bacteria and viruses) will eventually
lead to a differential fluorescence response. Furthermore, to reveal
the size and the morphology of the synthesized LnCNPs, we used NP
tracking analysis and TEM measurements. Through NP tracking analysis
(NTA), we found that PrCNPs (114.1 ± 11 nm) and GdCNPs (108.9
± 20 nm) have comparable hydrodynamic sizes, which are higher
than that of YbCNPs (75.4 ± 23.8 nm) (Figure b). However, by using TEM, we found that
the average diameter of the three LnCNPs was 27.42 ± 7.07, 12.81
± 4.84, and 10.9 ± 2.82 nm for Pr-, Gd-, and Yb-CNPs, respectively
(Figure c–e).
It is worth mentioning that NTA measures the hydrodynamic diameter
of the particles with its hydration layer; therefore, the obtained
diameter is much larger than that obtained from TEM measurements,
which provides the anhydrous diameter of the NPs. Additionally, UV–vis
spectroscopic studies revealed one characteristic absorbance peak
(Figure f) at 266
nm. This peak can be attributed to the n−π* transition
of the C=O band and the π–π* transition
of the conjugated C=C band. This peak was found to be common
among all three LnCNPs. Furthermore, a comparison of the UV–vis
spectra of the three samples revealed that the absorbance in the higher
wavelength regions (>300 nm) was enhanced for PrCNPs accompanied
with
PL enhancement compared to GdCNPs. However, the fluorescence emission
for YbCNPs was found to be the maximum among all when excited at 360
nm. A possible explanation for this observation is that the dopants
get entrapped within the core of CNPs in selective quantities, disturbing
the ordered ring structure of carbon and thereby creating novel emission
energy traps, providing different fluorescence outcomes.[78−80] Fluorescence emission was therefore selected as an output signal
as it provided higher sensitivity than absorption.[74,81,82] To further investigate the surface chemistry
of the synthesized particles, FTIR spectroscopy measurements were
carried out. The FTIR spectra (Figure g) show that the metal-doped CNPs possessed abundant
hydrophilic groups on their surface such as O–H and N–H
(3260 cm–1), which confirmed their dispersibility
and stability in aqueous media. Moreover, stretching vibrations of
C=C or C=O (1602 cm–1), C–N
(1324 cm–1), and C–H (1477 cm–1) bands were also observed for each sample as highlighted by the
dotted box, indicating the formation of polyaromatic structures in
the CNPs during the reaction process. CNP-PEI shared many characteristic
peaks of PEI, such as N–H at 3260 cm–1 and
C–N at 1324 cm–1.[83,84] These results revealed that while TA got carbonized during pyrolysis,
the PEI macromolecular chains maintained their structural integrity.
This can further be substantiated from the known stability of PEI
at 200 °C.[83] The LnCNPs thus showed
remarkable aqueous dispersibility. No precipitation or aggregation
was observed in the LnCNP suspension for up to 3 months when stored
at an ambient temperature protected from light. The ζ-potential
values for LnCNPs were found to be positive and greater than +20 mV
for all three LnCNPs (Figure a), confirming sufficient colloidal stability when suspended
in water.[46] Interestingly, our synthetic
procedure resulted in LnCNPs with varying ζ-potentials. Therefore,
a differential degree of counterionic–ligand interaction between
the viruses/bacteria and LnCNPs is anticipated leading to distinct
fluorescence fingerprints for each of the microorganisms.
Figure 2
Physicochemical
characterization of LnCNPs. (a) Zeta potential
measurement of the three LnCNPs. (b) Hydrodynamic size measurement
of LnCNPs. (c–e) Transmission electron microscopy (TEM) images
of Yb-, Gd-, and Pr-doped CNPs, respectively. Individually doped CNPs
are outlined by circles. (f) Normalized absorption curves and their
respective PL spectra under 360 nm excitation. (g) Fourier transform
infrared (FTIR) spectra of the three LnCNPs.
Physicochemical
characterization of LnCNPs. (a) Zeta potential
measurement of the three LnCNPs. (b) Hydrodynamic size measurement
of LnCNPs. (c–e) Transmission electron microscopy (TEM) images
of Yb-, Gd-, and Pr-doped CNPs, respectively. Individually doped CNPs
are outlined by circles. (f) Normalized absorption curves and their
respective PL spectra under 360 nm excitation. (g) Fourier transform
infrared (FTIR) spectra of the three LnCNPs.For constructing the sensor array, the purified LnCNPs were then
embedded in agarose to fabricate a 3D gelatinous-like platform. Agarose
was chosen because of its high loading capacity and low background
fluorescence (Figure S1), making it an
ideal candidate for the fabrication of the sensor platform. Moreover,
the large pore size of agarose facilitates the interaction between
the viruses/bacteria and the nanoprobe. Figure a,b shows the representative scanning electron
microscopy (SEM) images of the LnCNP–agarose sensor platform,
confirming that the NPs are embedded within the agarose gel. The photographs
of the LnCNPs embedded within the agarose gel confirmed the presence
of the NPs within the matrix of the pristine, transparent agarose
gel (Figure c,d).
Figure 3
(a) Representative
SEM image of LnCNPs embedded within the agarose
matrix. (b) Magnified image of panel (a) depicting the distribution
of NPs within the sensor platform. (c) Photograph of the pristine
agarose gel in a well plate. The inset shows the pristine agarose
gel outside the plate. (d) Photograph of a representative sample of
LnCNPs embedded within the agarose gel inside a well plate. The inset
shows a sensor platform outside the plate. The pristine agarose gel
film is transparent in the absence of LnCNPs; however, in the presence
of LnCNPs, the color of the film became darker.
(a) Representative
SEM image of LnCNPs embedded within the agarose
matrix. (b) Magnified image of panel (a) depicting the distribution
of NPs within the sensor platform. (c) Photograph of the pristine
agarose gel in a well plate. The inset shows the pristine agarose
gel outside the plate. (d) Photograph of a representative sample of
LnCNPs embedded within the agarose gel inside a well plate. The inset
shows a sensor platform outside the plate. The pristine agarose gel
film is transparent in the absence of LnCNPs; however, in the presence
of LnCNPs, the color of the film became darker.Fluorescence emission measurements were then conducted to assess
the interaction of the embedded LnCNPs with the viruses and bacteria
studied herein. We were primarily interested in monitoring the viral
transmission of COVID-19 causative virus, SARS-CoV-2, in still waterbodies,
which is one of the major concerns behind the community spread of
this virus. We realized that mitigation of this community spread could
be achieved if we can efficiently and rapidly discriminate the virus
in still waterbodies through a suitably designed sensor platform.
In this context, the viral discrimination of SARS-CoV-2 from SARS-CoV
and influenza A (H1N1) has been realized. It was also understood that
the other interferences during the sensing of SARS-CoV-2 in still
waterbodies would be either from the medically relevant pathogenic
bacteria and regular contaminants in hospital wastewater, including E. coli and S. mutans, or from the common nonpathogenic soil bacterium, B. subtilis. These bacteria are commonly found in
the human gastrointestinal tract (GI system) and include two Gram-positive
bacteria (S. mutans and B. subtilis) and one Gram-negative bacteria (E. coli). Within this set, B. subtilis and E. coli are quite distantly related
eubacteria, providing a challenging testbed for bacterial sensing.
The PL response of the embedded LnCNPs was then monitored for all
these six variants of viruses and bacteria. It was observed that the
intrinsic fluorescence of Gd-, Yb-, and Pr-doped CNPs was enhanced
as a response to the SARS-CoV-2 virus, whereas it was either quenched
or enhanced in the presence of the other viruses (SARS-CoV and H1N1)
and different bacterial cells (Figure a, Figure S2a, and Figure S3). These observations indicate that the different species selectively
affect the inherent photophysical properties of LnCNPs. The observed
selectivity toward various viral and bacterial strains comes mainly
from their design-contributing factors.
Figure 4
Sensor array response
of three viral and three bacterial species
including SARS-CoV-2. (a) Fluorescence response pattern of three viruses,
SARS-CoV-2, H1N1, and SARS-CoV, and three bacteria, E. coli, B. subtilis, and S. mutans. Each value was an
average of nine independent measurements; error bar shows the standard
deviation of these measurements. λex = 360 ±
40 nm and λem = 460 ± 40 nm. I0 and I are the fluorescence intensity
of CNPs in the absence and presence of bacteria or viruses, respectively.
(b) The inset is the magnified view of the fluorescence response pattern
of three viruses, SARS-CoV-2, H1N1, and SARS-CoV (c) 3D canonical
score plot of the fluorescence response patterns determined by linear
discriminant analysis (LDA). The plot shows one view of the 3D plot
of the factors obtained from applying LDA to the fluorescence signal
(the concentration of the bacteria is OD600 = 0.06 and that of the
viruses is 100 genome equivalents per mL).
Sensor array response
of three viral and three bacterial species
including SARS-CoV-2. (a) Fluorescence response pattern of three viruses,
SARS-CoV-2, H1N1, and SARS-CoV, and three bacteria, E. coli, B. subtilis, and S. mutans. Each value was an
average of nine independent measurements; error bar shows the standard
deviation of these measurements. λex = 360 ±
40 nm and λem = 460 ± 40 nm. I0 and I are the fluorescence intensity
of CNPs in the absence and presence of bacteria or viruses, respectively.
(b) The inset is the magnified view of the fluorescence response pattern
of three viruses, SARS-CoV-2, H1N1, and SARS-CoV (c) 3D canonical
score plot of the fluorescence response patterns determined by linear
discriminant analysis (LDA). The plot shows one view of the 3D plot
of the factors obtained from applying LDA to the fluorescence signal
(the concentration of the bacteria is OD600 = 0.06 and that of the
viruses is 100 genome equivalents per mL).CNPs are characterized by their inherent PL properties. Our group
and others found that the surface states are the dominant factor controlling
the PL variations of CNPs.[26,45,69,85] For example, the CNP fluorescence
can be tuned by varying the degree of surface oxidation or by the
interaction with anionic or cationic objects. We hypothesized that
different viral and bacterial strains will have a unique surface chemistry,
which in turn will interact with each LnCNP differently. The electrostatic
interaction between the viral or bacterial cell and the CNPs is therefore
dominant by the particle surface charge. Each CNP has a distinct surface
charge making its interaction with each pathogen or nonpathogen different.
This difference in interaction will lead to a distinct fluorescence
signature presumably due to the changes in the surface state of the
CNPs. Second, the inspiration for the use of lanthanide for selective
viral and bacterial sensing comes from our understanding of selective
lanthanide recognition in microbial biology. A myriad of studies has
enhanced our understanding of the principles underlying biological
recognition and utilization of rare-earth metals such as lanthanides,
which may facilitate the use of lanthanides for various bionanotechnological
applications. Recent studies confirmed a strong biological correlation
of lanthanide’s stimulatory properties toward bacteria, including
strong biochemical evidence that lanthanides can act as inherent metals
in bacterial enzymes.[86] Very recently,
it has been demonstrated that the specific enzymatic reaction of methylotrophic
bacteria is highly dependent on the presence of lanthanides, emphasizing
the biological relevance of these trace metals. In this study, our
goal is to introduce three different lanthanides as dopants in CNPs
to impart their selectivity toward various viral and bacterial strains.
Once the differential interaction of bacterial cells and viruses with
LnCNPs was confirmed by obtaining distinctive fluorescence responses,
the particles were used to sense the presence of SARS-CoV-2 and separate
it from other viruses or bacteria (pathogenic or nonpathogenic).Wastewater samples containing the SARS-CoV-2 virus have been tested
using the LnCNP sensor array. The results from the sensor were benchmarked
with the gold standard RT-qPCR (GoldBio commercial kit). The sensor
array detected SARS-CoV-2 in samples with various viral loads as demonstrated
from their Ct numbers and was also capable of detecting the virus
in samples with low viral copy numbers (Ct > 35) (Table ).
Thus, the environmental contamination caused by the SARS-CoV-2 virus
can be easily detected using our sensor.
Table 1
Benchmarking
of the LnCNP Sensor Array
Results with RT-qPCR in Wastewater Samples
sample number
PrCNP sensor response, ΔI/I0
GdCNP
sensor response, ΔI/I0
YbCNP sensor response, ΔI/I0
RT-PCR, (Ct)
sample #1
0.050
0.345
0.282
13.4
sample #2
0.048
0.139
0.135
28.5
sample #3
0.112
0.313
0.0713
37.89
sample #4
0.128
0.286
0.037
36.16
To evaluate the sensor response with various concentrations
of
bacteria/pathogen, E. coli and SARS-CoV-2
were used as model organisms. We found that the relative change in
the fluorescence signal of the YbCNPs was linearly proportional (R2 = 0.903) with the SARS-CoV-2 concentration
(Ct numbers) obtained from real-time PCR
(RT-PCR) as shown in Figure S4. The limit
of detection of the sensor array was found to be 1.52 copies/μL.
Samples of E. coli with cell densities
ranging from a single cell to 107 cells were also used
to evaluate the sensitivity of the sensor array. Table S1 summarizes the array response to samples with cell
densities ranging from 1 to 107 cells. The sensor array
was found to be sensitive to bacteria up to a single cell, confirming
the sensitivity of the developed system. It is worth mentioning that
the current study proposes the development of a qualitative sensor
array with a YES/NO answer, and it is not meant for the quantitative
detection of the concentration of bacteria or viruses.The use
of the LnCNPs sensor array enables the collection and screening
to be carried out in approximately 15 min at the point of collection
of the sample. On the other hand a single patient test using RT-PCR
involves a laboratory transport time plus more than 90 min and in
some cases days in the laboratory for a full diagnosis. The availability
of a rapid, inexpensive, and easy-to-use sensor array system for the
identification of SARS-CoV-2 in still waterbodies could increase and
prioritize access to testing in many situations and communities, easing
the burden on the already stressed healthcare system.Once the
LnCNP sensor performance in detecting SARS-CoV-2 has been
established, the sensor performance in differentiating SARS-CoV-2
from other viruses or bacteria (pathogenic or nonpathogenic) was evaluated.
We utilized a microplate reader, an easy-to-use technique with a high
throughput, to record the fluorescence intensities of LnCNPs at 460
± 40 nm with an excitation of 360 ± 40 nm after the deposition
of viral and bacterial samples. In the initial sensing study, a sample
containing different concentrations of SARS-CoV-2 virus with a volume
of 100 μL was deposited on the surface of the sensor array platform,
whereas the fluorescence of the LnCNP sensor platform alone in the
absence of any pathogen incubation was measured as a control. The
relative fluorescence intensities of each LnCNP before and after adding
the viral or bacterial sample, (I – I0)/I0, were used
to characterize the fluorescence signature for each LnCNP against
the pathogenic and nonpathogenic species of both bacteria and viruses.
In addition to recording the signal output for SARS-CoV-2, the responses
for two other viruses (SARS-CoV and H1N1) together with three other
bacterial species were also recorded. The viral load of SARS-CoV-2
was determined using RT-PCR, whereas the bacterial cell densities
were estimated using the turbidity method, a widely used measurement
to quantify the cell number in a culture of growing bacteria.[87,88] As shown in Figure a, the three LnCNPs showed diverse fluorescence response signals
against the samples, which presumably indicated different multivalent
interactions between LnCNPs and bacteria or viruses (Figure b).This result clearly
illustrates the plausible utilization of these
LnCNPs to identify the community spread of SARS-CoV-2 in still waterbodies
and separate it from other similar viruses like SARS-CoV, H1N1, and
other microorganisms. According to the fluorescence response patterns,
the sensor array consists of three groups based on the variation of
the dopant metals (Figure S2b). The color
depth of the heat map was used to describe the relative fluorescence
intensity. With the increase of the color depth and color change from
blue to red, the relative fluorescence intensity increases. The 2D
plot of the sensor response against three bacterial strains is shown
in Figure S3. The autofluorescence from
the bare agarose gel and the bacteria was found to be minimal compared
to the LnCNP sensor response as shown in Figure S1. Once the distinct optical signature of the sensor array
against different viral and bacterial strains has been established,
the ability of the LnCNP sensor to separate SARS-CoV-2 from other
pathogens was explored.Distinct fluorescence patterns were
found for each CNP for each
sample, which motivates us to further explore the possibility to separate
these responses using a computational algorithm to selectively detect
the presence of SARS-CoV-2. The fluorescence response patterns of
the viral and bacterial strains produced by the sensor array were
analyzed using the LDA, a powerful pattern recognition algorithm.[70,89] The fluorescence pattern of these viruses and bacteria could then
be transformed into a 3D canonical score plot by LDA (Figure c). LDA is an algorithm that
transfers the data into a linear combination
of variables or canonical functions to best explain the data by maximizing
the component axis separation. The data set observation can be classified
using canonical functions assigned to discrimination percentage as
shown in the canonical score plot (Figure c). The percentage assigned to each canonical
function indicates the total discriminatory power of the data set
variables associated within each canonical function. The cumulative
percentage of all canonical functions sums to 100%, where the higher
percentage is associated with the maximum differentiation among an
axis. The six strains, three viruses including SARS-CoV-2 and three
bacteria, were well-clustered into six groups and thus can rapidly
be discriminated from each other. The six classes of the selected
pathogens were differentiated from each other with 95.6% accuracy,
whereas SARS-CoV-2 was separated from other pathogens with 100% accuracy.
By applying the LDA algorithm, we successfully grouped the bacteria
and viruses into the group they belong. In Figure c, we choose the 3D view that shows the maximum
differentiation. However, this does not affect the results of the
LDA algorithm, which we demonstrated using statistical measures (i.e., classification accuracy). Moreover, the discrimination
was achieved and confirmed by “leave-one-out” cross-validation
using LDA, demonstrating that our LnCNP-based sensor array is efficient
for viral and bacterial identification. We challenged the model to
discriminate the samples containing SARS-CoV-2 from SARS-CoV, which
have been classified and separated from each other with almost 100%
accuracy. Furthermore, the model was challenged to discriminate the
bacterial samples (pathogenic and nonpathogenic) from each other,
which were also classified with nearly 100% accuracy. To further confirm
the ability of our sensor array to predict unknown samples, we randomly
selected 10 samples containing either viruses or bacteria from the
six targeted species. Fluorescence signatures of these 10 samples
were recorded using the sensor array and transformed to the canonical
scores by the discriminant functions established from the training
of the samples as shown in Figure c. In this algorithm, the Mahalanobis distances of
each pathogen sample to their respective centroids of six groups were
computed in a 3D space (canonical factors 1–3). The shortest
Mahalanobis distance value determines the spatial arrangement of the
tested sample. In this way, the 10 unknown samples were completely
identified with high accuracy, demonstrating the high reliability
of our sensor array. Spiked samples with known concentrations were
used routinely by researchers to validate the sensor performance.[90,91] These samples are considered blind samples because the concentration
of these samples was not known prior to the classification during
the testing process and they were only used to evaluate the sensor's
performance after obtaining the results.Additionally, the differential
response of the LnCNP sensor array
toward the microbial strains made us interested to investigate the
mode of interaction of LnCNPs with the macromolecular systems in question.
It was hypothesized that LnCNPs will primarily interact with the surface-exposed
proteins of the systems to generate differential sensing patterns.[92−96] Accordingly, we considered a transmembrane β-barrel protein
and ferric citrate transporter FecA for E. coli (PDB ID: 1PO3); a transport protein and a triscatecholate siderophore
binding protein FeuA for B. subtilis (PDB ID: 2WHY); a cell adhesion protein and a C-terminal domain
surface protein SpaP for S. mutans (PDB
ID: 3OPU); a hemagglutinin structure of an avian H1N1 influenza A
virus (PDB ID: 3HTO); and a SARS-CoV spike glycoprotein (PDB ID: 5XLR)
and a SARS-CoV-2 spike glycoprotein (PDB ID: 6VXX) (Figure S5).On the other hand, the model structures
of the LnCNPs were energy-minimized
using the B3LYP/3-21G* method (Figure S6). These energy-minimized LnCNPs were then docked against the surface-exposed
proteins of the studied viruses and bacteria and the results were
closely monitored. Table S2 shows the comparative
free energies of binding and clustering efficiencies of LnCNPs with
the surface proteins.It was observed that while GdCNP interacted
more strongly with E. coli, B. subtilis, and SARS-CoV-2 surface proteins, PrCNP
interacted more preferentially
with S. mutans, H1N1 influenza A, and
SARS-CoV surface proteins.This differential and superior binding
of GdCNP and PrCNP over
YbCNP with the viral and bacterial proteins was also corroborated
from the experimental fluorescence assay (Figure a). Thus, the theoretical docking results
were found to have a one-to-one correspondence with the experimental
sensing results. Further from the theoretical calculations, it was
understood that LnCNPs might detect not only active pathogens but
also trace of the target pathogens if the pathogenic protein remained
in the sample even after inactivation. However, this needs further
experimental investigation, where the interaction of LnCNPs even with
the trace amount of pathogenic proteins could establish the higher
sensitive and beneficial structure–activity relationship of
the lanthanide center in LnCNPs.[97,98] Binding energies
of the different conformations of the bacterial protein–ligand
complexes are presented in Figure S7 and
those
of viral protein–ligand complexes are shown in Figure S8. The most stable docked geometries
of these protein–ligand complexes are shown in Figure where the interacting amino
acids and functional groups from the LnCNPs are listed in Table S3 for each of the complexes. It is to
be noted that the current theoretical model might not be a complete
representation of the studied system. The complete model would be
lanthanide coordinated with hydroxyl groups tethered on ovalene and
surface-coated with PEI. Simple docking studies cannot consider the
PEI-coated NP where its inner core will be made up of an aromatic
carbon skeleton coordinated to lanthanides and predict the differential
interaction of LnCNPs with different types of pathogens. This type
of elaborative model would be computationally expensive and can only
be handled by molecular dynamics simulation studies. We would therefore
consider performing the molecular dynamics simulation on these LnCNPs
in a separate study.
Figure 5
Pictorial representation of the most stable docked geometries
of
(a) 1PO3 (E. coli)/GdCNP; (b) 2WHY
(B. subtilis)/GdCNP; (c) 3OPU (S. mutans)/PrCNP; (d) 3HTO (H1N1 influenza A)/PrCNP;
(e) 5XLR (SARS-CoV)/PrCNP, and (f) 6VXX (SARS-CoV-2)/GdCNP protein–ligand
complexes. The white ball indicates Gd and the red ball indicates
Pr. The dotted line indicates the hydrogen bonding interaction between
the ligand and the protein.
Pictorial representation of the most stable docked geometries
of
(a) 1PO3 (E. coli)/GdCNP; (b) 2WHY
(B. subtilis)/GdCNP; (c) 3OPU (S. mutans)/PrCNP; (d) 3HTO (H1N1 influenza A)/PrCNP;
(e) 5XLR (SARS-CoV)/PrCNP, and (f) 6VXX (SARS-CoV-2)/GdCNP protein–ligand
complexes. The white ball indicates Gd and the red ball indicates
Pr. The dotted line indicates the hydrogen bonding interaction between
the ligand and the protein.Regarding the cross-reactivity of the LnCNP-based sensor, the sensor
showed a negligible response when tested with a bovine serum albumin
(BSA) protein (Figure S9). These results
confirmed that the LnCNP sensor has negligible cross-reactivity toward
proteins originating from nonpathogenic species. To further investigate
the effect of the sample media on the sensor response (e.g., saliva, serum, and urine), S. mutans were spiked in both artificial medical-grade saliva and phosphate-buffered
saline (PBS). We found that the fluorescence from the sensor array
elements, that is, GdCNPs, PrCNPs, and YbCNPs, as a response to S. mutans exhibited no statistically significant
difference (P > 0.05) between PBS and saliva samples
(Figure S10). These data confirmed that
the source of the distinct fluorescence readout is mainly the interaction
of the bacteria or viruses with the CNPs, with no significant effect
of the sample medium on the sensor array response. Furthermore, the
data used for detection are the fluorescence signal normalized to
the control, that is, in the absence of virus or bacteria, which further
reduces the effect of the different media on the sensor output. Figure a shows a photograph
image of the developed LnCNP-based sensor array in 96-well plates.
The associated fluorescence map of each well at λEx = 360 nm and λEm = 460 nm is shown in Figure S11.
Figure 6
(a) Picture of the 96-well plate LnCNP
sensor array. (b) 2D space
plot of the first two canonical LDA factors. The LDA output of the
SARS-CoV-2-spiked water was entirely distinguished from the other
virus and bacterial species using the LnCNP-based sensor platform
for real-world sample detection. Wastewater samples were tested without
any further modifications and after spiking each sample with SARS-CoV-2,
H1N1 (viral concentration of 105 genome equivalents per
ml), E. coli, orB. subtilis (OD600 = 0.2, i.e., ∼107 bacterial cells).
(a) Picture of the 96-well plate LnCNP
sensor array. (b) 2D space
plot of the first two canonical LDA factors. The LDA output of the
SARS-CoV-2-spiked water was entirely distinguished from the other
virus and bacterial species using the LnCNP-based sensor platform
for real-world sample detection. Wastewater samples were tested without
any further modifications and after spiking each sample with SARS-CoV-2,
H1N1 (viral concentration of 105 genome equivalents per
ml), E. coli, orB. subtilis (OD600 = 0.2, i.e., ∼107 bacterial cells).Wastewater monitoring
platforms can provide an effective method
to predict the potential spread of SARS-CoV-2 across a community.
This approach has been approved as an effective way to trace illicit
drugs and obtain information on health, disease, and pathogens. In
addition, numerous studies have shown that SARS-CoV-2 can normally
survive in an appropriate environment for up to a few days after leaving
the human body. Due to the limited availability of rapid diagnostic
tests along with the inaccessibility of modern equipment to all the
pathology centers, especially the remote ones, there is a potential
threat of underdetermination of positive COVID-19 cases, and hence,
the community wastewater could be tested for SARS-CoV-2 virus. In
some cases, these wastewaters are outsourced to still waterbodies
like lake water. Thus, we propose that a community spread of SARS-CoV-2
can potentially be mitigated by the efficient utilization of our sensor
array. This could be accomplished by monitoring sewage pipe networks
and by assessing the possible carriers of SARS-CoV-2 in some local
areas and limiting the movements of that local population to reduce
the spread of pathogens and the risk to public health. The developed
LnCNP sensor array was successful in differentiating SARS-CoV-2 spiked
in wastewater samples from various bacterium and virus species including B. subtilis, E. coli, S. mutans, and Influenza A H1N1. Figure b shows the 2D canonical
plot applying the LDA analysis on the fluorescence data collected
from testing SARS-CoV-2 and several bacterium and virus species spiked
in wastewater samples.The fast response time of the LnCNP-based
sensor (∼15 min)
outperforms the response time of the previously published approaches,
which need ∼2–6 h for pathogen identification.[99−101] The total assay time including sample pretreatment and preparation
is less than 20 min. Furthermore, the LnCNP sensor operates in a label-free
manner by exploiting the inherent sensitivity of the CNP optical properties
toward their multivalent interaction. And so, we could build an affordable
and cost-effective system, leading to reducing the system complexity
compared with previous microorganism sensors that need ligand conjugation
such as an antibody or an aptamer to guarantee selectivity.[102−107] In comparison with the whole-cell enzyme-linked immunosorbent assay
(ELISA), the LnCNP-based biosensing method provides advantages of
selectivity at high sensitivity and requires no antibody in the assay.
To the best of our knowledge, this is the first study to illustrate
the approach of LnCNPs that can selectively detect SARS-CoV-2 and
discriminate them from other types of pathogens and nonpathogens by
the assistance of the pattern recognition algorithm. Taking it all
together, we proposed a label-free system for selective detection
of viruses and bacteria even with high sensitivity and relatively
a small sample volume (100 μL). In addition, the sensor showed
low cytotoxicity and long stability (>30 days). The fluorescence
of
the sensor array was found to be stable up to 1 month when stored
at room temperature away from light. Figure S12 shows the relative change in the fluorescence signal after a month
post the date of the sensor fabrication. A relative change in the
fluorescence signal of less than 25% was observed after a month of
fabricating the sensor array.Furthermore, combining the power
of pattern recognition tools and
nanotechnology, different viral types including COVID-19 causative
virus, SARS-CoV-2, and bacterial strains were discriminated with high
accuracy, thus enabling the sensor to provide fast and reliable pathogen
information for clinical decisions and allow continuous monitoring
of infectious disease trends. The performance characteristics of the
developed sensor array as a single system are superior in comparison
with previously reported biosensors as it selectively discriminates
pathogens and nonpathogens and accurately predicts the bacterial staining
properties (Gram-positive or Gram-negative) as detailed in Table S4.Environmental monitoring of the
presence of virus in wastewater
maybe an early warning method and an effective method for quick diagnosis
of clusters of COVID-19 cases irrespective of symptoms. The importance
behind the water-based surveillance of SARS-CoV-2 has thus been realized,
but the rapid and early discrimination of SARS-CoV-2 from other viruses
and microorganisms using the available techniques remains the major
obstacle. Recently, several techniques such as targeted mass spectrometry
assay, multiplexed amplicon-based sequencing, and RT-PCR have been
deployed for detection of SARS-CoV-2 in wastewater.[108,109] However, the practicality and measurement duration of these techniques
for point-of-care detection of SARS-CoV-2 in wastewater systems still
remain a challenge. In this study, we developed a biosensor that allows
rapid testing to detect the extent of SARS-CoV-2 presence in wastewater
systems as well as distinguish SARS-CoV-2 from other microbial species
in real-time, which can be potentially transformative and supplement
the clinical efforts on containing the virus. Bacteriophages are a
type of virus that infects bacteria, and they are more relevant in
effluents and sludge coming out of the wastewater treatment plants.[110−112] The current focus of the study is to test the presence of pathogenic
viruses and bacteria in the wastewater. The sensitivity of LnCNPs
with effluents and sludge collected from wastewater treatment plants
will be evaluated in a separate fully executed study. We intend to
study the presence of MS2 and F-specific RNA (FRNA) phages as biocontrol
agents in the wastewater treatment plants and monitor their effect
on the sensitivity of LnCNPs toward pathogenic microorganisms. Lanthanide
(Ln+3)-doped NP-based sensor arrays have been utilized
herein for their luminescent properties, excellent photostability,
narrow emission spectrum, lower toxicity as well as cost-effectiveness,
higher resistance to photobleaching, ease of preparation, and functionalization
needs. To the best of our knowledge, the adoption of Ln+3-doped CNPs for the creation of a sensor array and also their application
in label-free sensing of SARS-CoV-2 and other viruses and bacteria
in complex samples have not yet been explored. The LnCNP array developed
here showed excellent sensitivity (1.5 copies/μL) and a short
sample-to-results time (15 min). The sensor performance was evaluated
using wastewater sewage samples to confirm its effectiveness in detecting
SARS-CoV-2 and differentiating it from other viruses or bacteria.
Interestingly, the proposed sensor’s capability is not just
limited to the environmental application, and it can be further expanded
to cover the clinical diagnosis of individuals without requiring RNA-extraction
or nucleic acid amplification.[37−39,113]
Conclusions
We have successfully constructed a fluorescence
sensor array made
from three CNPs, where each one is doped with one lanthanide metal,
that is, either Pr, Yb, or Gd. LnCNPs share the same organic source
but are different in metal composition.Our results indicated
excellent selectivity of the LnCNP-based
sensor array toward SARS-CoV-2 and various other viral and bacterial
strains. By examining the fluorescence patterns of SARS-CoV-2, SARS-CoV,
H1N1, E. coli, S. mutans, and B. subtilis using LDA, SARS-CoV-2
was separated from the six different strains with 100% accuracy and
the six strains were identified effectively with nearly 95.6% accuracy.
Moreover, the detection procedure is rapid (∼15 min) with high
throughput and does not need any external requirements for washing.
This method could also provide real-time and uninterrupted data to
function as an early warning system to enable municipal communities
and organizations to take appropriate steps to identify suspected
virus carriers and mitigate the spread of an outbreak.
Authors: David L Jones; Marcos Quintela Baluja; David W Graham; Alexander Corbishley; James E McDonald; Shelagh K Malham; Luke S Hillary; Thomas R Connor; William H Gaze; Ines B Moura; Mark H Wilcox; Kata Farkas Journal: Sci Total Environ Date: 2020-07-31 Impact factor: 7.963