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The rise in Covid cases in wastewater has led some scientists to consider whether the virus is now heading to people’s intestines.
Traditionally, Covid infects people through the nose and mouth and multiplies as it spreads through the body.
But some virologists believe the Covid virus has altered its requirements for entering cells, meaning it may have more easily infect the intestine.
Scientists around the world, including the United States, are detecting traces of Covid in much larger quantities in wastewater.
Stomach viruses are shed in large quantities in the fecal waste of infected people.
Wastewater surveillance was pioneered during the pandemic to track new variants and gave officials early warning about outbreaks.
Scientists around the world, including the United States, are detecting traces of Covid in much larger quantities in wastewater.
Marc Johnson, molecular virologist and professor of Molecular Microbiology and Immunology at the University of Missouri, told DailyMail.com: “There were some huge spikes in wastewater in Europe, and many of us were reflecting on what the possible explanations might be: Yes, there are only many cases or if there is some other explanation.
In Austria, for example, Covid levels in wastewater have soared from almost zero in July this year to around 700 gene copies per person, indicating viral load.
One idea is that the new JN.1 variant has altered its requirements for entering cells and tends to prefer stomach cells. Researchers believe that changes in the virus’s behavior may be caused by vaccines and previous infections, which prime the immune system to destroy the virus before it reaches the lungs.
Professor Johnson said it is “possible” that the newly dominant JN.1 variant of Covid is more centered in the gut, but said there was no direct evidence for the theory so far.
But many other coronaviruses infect the gut, Professor Johnson said, “so it wouldn’t be that surprising.”
He said: “Many of the coronaviruses cause gastrointestinal problems. They are found in cats, pigs and bats. They are not respiratory infections, they are gastrointestinal infections.
JN.1, the strain behind the latest spike in cases, is currently the fastest growing variant.
Wastewater surveillance in Austria has shown an increase in the virus
The virus is also becoming more prevalent in wastewater in the Netherlands.
It now accounts for up to 29 per cent of Covid cases, a sharp increase from less than one per cent in early November.
The variant is more infectious and better able to evade the immune system than other strains. But there is no evidence that it causes more severe disease than other variants circulating.
The latest data from the CDC shows that almost all states report at least “high” levels of Covid in wastewater.
There has also been a steady increase in viral activity in wastewater over the past six months.
Meanwhile, sewage detections have skyrocketed in countries including Austria, Germany, Switzerland and Singapore.
Wastewater surveillance was pioneered during the pandemic to track new variants and gave officials early warning about outbreaks.
Studying wastewater samples was essential to finding certain Covid variants, since even if someone had no symptoms, the virus would still be present in their wastewater.
Anyone infected with a virus sheds small fragments of their DNA in their stool.
Australian virologist Stuart Turville believes JN.1 is taking a new route into cells and preferring intestinal cells.
JN.1 shows a greater preference for an uncleaved version of the cell surface protein ACE-2, which could cause different tissue infections, such as in the intestine.
Professor Johnson said: ‘Dr Turville has an observation that newer lineages prefer a slightly different version of the receptor that is more common in the gastrointestinal tract, which is possibly supporting evidence.
“But a more likely explanation is that we are seeing compound waves right now,” he added.
The World Health Organization flagged JN.1 as a variant of concern this week, and the CDC said it could force U.S. hospitals and emergency rooms to ration care.
“Intense gastrointestinal infections can occur from Covid,” Professor Johnson said.
“We found evidence of people who have been infected for years and are excreting enormous amounts of virus that we can detect in sewer sheds with more than 100,000 people.”
However, there is still no corresponding increase in hospitalizations or stomach-related symptoms to support the idea that JN.1 is more stomach-focused.