Report: National wastewater surveillance should be continued to prevent future pandemics

The National Wastewater Surveillance System launched to detect COVID-19 should now transition to a broader, forward-looking system detecting prevalent and emerging pathogens, according to a report from a committee chaired by Washington State University's Guy Palmer.

The report, "Increasing the Utility of Wastewater-based Disease Surveillence for Public Health Action, was recently released by the National Academies of Sciences, Engineering, and Medicine.

"Like most aspects of public health, prevention of epidemics and the next pandemic is very likely to be cheaper than the economic and social costs of responding to an infectious disease after it has spread," said Palmer, WSU professor of pathology and infectious diseases. "By addressing shortcomings of the current wastewater surveillance system, many of which originated in its rapid development under a pandemic emergency, the public value of wastewater data can be elevated and provide the foundation for more nimble public health responses to ongoing and future threats."

Wastewater-based infectious disease surveillance systems detect the presence of biomarkers of infection, such as DNA or RNA, that are shed into a municipal sewer system. These systems can be used to detect changing levels of a pathogen or to identify newly emergent variants in a community.

In a Phase 1 report released in early 2023, a study committee examined the usefulness of the system during the COVID-19 pandemic, described the potential value of a robust national wastewater surveillance system beyond COVID-19, and provided recommendations to increase the public health impact of such a system.

This Phase 2 report details the technical constraints and opportunities to improve wastewater surveillance for the prevention and control of infectious diseases in the U.S.

The report provides recommendations for the Centers of Disease Control and Prevention as well as states and localities to improve the national system including optimizing location of sampling sites, improving data analysis -and expanding the pathogens that are part of routine surveillance such as RSV and influenza viruses. It also recommends building capacity for early detection of emerging pathogens, using sentinel surveillance at locations such as airports and farming communities to enhance the ability to identify the next major threat and intervening early to stop it. Read the full press release from the National Academies of Sciences, Engineering and Medicine.