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NOROSENSOR - A real-time monitoring system for airborne norovirus

Final Report Summary - NOROSENSOR (NOROSENSOR - A real-time monitoring system for airborne norovirus)

Executive Summary:
Every winter, Sweden’s Karolinska Hospital experiences a large norovirus (i.e. flu) outbreak. As a result, hundreds of staff and thousands of patients are incapacitated for several days and entire wards are closed down. This in turn costs hundreds of thousands of euros, significantly delays lifesaving operations and severely diminishes the healthcare capacity of the greater Stockholm area.

Of course this phenomena isn’t limited to Karolinska Hospital, but is a recurring theme in hospitals, day-cares, retirement homes and workplaces across the globe. Without effective countermeasures put in place, these crippling outbreaks will continue winter after winter after winter.

The challenge to combating and containing an outbreak is a significant lack of precise information on the location of high virus concentrations. To bridge this gap, the NOROSENSOR project is developing core technology for an advanced virus sensor prototype. The aim is that the sensor should be used to measure the concentration of airborne Norovirus in high risk areas, such as hospitals, retirement homes, cleaning companies and cruise ships. The overall objective is to develop core technologies to facilitate and lower the cost of detection or airborne Norovirus and in the long run also other airborne pathogens.

Traditional air sampling methods rely on highly specialised equipment and subsequent transportation of the samples to a central lab for analysis – which is not cost efficient and takes time. Although effective, such a system is ill-suited for monitoring multiple locations or screening outside a laboratory.

The NOROSENSOR project combines low-power electrostatic air to liquid sampling, compact microfluidics sample preparation and novel molecular tools to attain low detection limits of virus particles in the air. We have evaluated two sensor platforms for detection: high sensitive quartz crystal technologies and digital ELASA. Although both platforms were able to detect norovirus, we selected the digital ELASA platform to develop the assay and use it for the final prototype because of its more advance technological maturity.

Although the project was unable to test a fully integrated sensor we managed to show the presence of airborne Norovirus in hospital settings using the air capturing technology as well as detection of Norovirus in a fully integrated cartridge with microfluidic sample preparation and molecular tools for signal amplification. Until further testing is completed, it looks like the sensors first use may be as a companion to the many air purification systems currently on the market. Although these systems can clean the air, they cannot measure what they cleaned and how much.

Project Context and Objectives:
The overall objective is to develop core technologies to facilitate and lower the cost of detection or airborne Norovirus and in the long run also other airborne pathogens.

Project Results:
In WP1: the work concentrated to update and rewrite the specification based on the introduction of the alternative ELASA detection technology. In WP2: the work concentrated on producing NoV VLPs, characterise the ADT in terms of specificity, sensitivity and reproducibility and protocols for bioassay implementation were developed, developing and implementing a sandwich-type, bead-based bioassay for detection of NoV VLPs on the alternative ELASA detection platform, and establish a PLA-RCA protocol for signal amplification. Additionally much work was performed on reducing the unspecific binding of NoV VLPs to the bead surface. WP3: The work concentrated on further develop and test new versions of the hi-QCM and ADT. New prototypes of the QCM was developed and tested, with model systems and RCA. The parameters of the ADT instrument were optimised to implement model systems as well as NoV VLP assays. In WP4: the work concentrated to integrate sample preparation for the alternative ELASA system. in WP6: the work concentrated to evaluate and fine tune the capture of bioaerosols from the environment to a lab-on-a-chip, using the EHD technology developed previously. In WP7: the work concentrated to integrate the aerosol sampling, bioassay, cartridge and readout of an airborne virus sensor using a digital ELASA bioassay format. WP8: the work concentrated on validating the aerosol sampling technology. WP9: The work concentrated on determining NoV concentration in air during outbreaks and the optimal placement of an aerosol capturing device.

Potential Impact:
The NOROSENSOR project successfully demonstrated and detected the presence of Norovirus in the air during and after an outbreak (WP9) using the electrostatic precipitation technology. We successfully demonstrated a small and portable sampling device to capture airborne particles from air to liquid sample with an efficiency of 40-60% (WP6,8). We showed a microfluidic chip coupled with an assay to concentrate and detect NoV VLP particles on a single chip with detection limit of down to 10 pM of Norovirus VLP using ELASA sensing platform (WP2,3,4). Furthermore, the project integrated these technologies into a breadboard version and evaluated these using a model system (WP7)
The project significantly advanced the QCM and ADT detection technologies towards high sensitivity biological detection applications (WP3) but could not reach a TRL that made them feasible to integrate with the biological assay and the breadboard version of NOROSENSOR. The ADT technology has showed semi-quantatively and specific detection of NoV VLPs.
On the exploitation side we received great commercial interest from both service and hardware companies, foremost in application where the sensor is accompanied with an air purifying technology (actionable) to monitor air quality and the functionality of these devices, for example hospital ventilation installations, cruising ships installations but also in facility maintenance (WP10). Getinge, our exploitation partner, is investigating a continued development of the biosensor concept using some of the technologies and partners from the Norosensor projects, and have already made deals for complementary technologies around air and water decontamination.

List of Websites:
www.norosensor.eu