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. 2023 Aug 30;11(9):2193.
doi: 10.3390/microorganisms11092193.

Using Wastewater Surveillance to Monitor Gastrointestinal Pathogen Infections in the State of Oklahoma

Katrin Gaardbo Kuhn  1 , Rishabh Shukla  2 , Mike Mannell  3 , Grant M Graves  2 , A Caitlin Miller  2 , Jason Vogel  2 , Kimberly Malloy  1 , Gargi Deshpande  1 , Gabriel Florea  2   4 , Kristen Shelton  5 , Erin Jeffries  5 , Kara B De León  5 , Bradley Stevenson  6
Affiliations

Using Wastewater Surveillance to Monitor Gastrointestinal Pathogen Infections in the State of Oklahoma

Katrin Gaardbo Kuhn et al. Microorganisms. .

Abstract

During the COVID-19 pandemic, wastewater surveillance was widely used to monitor temporal and geographical infection trends. Using this as a foundation, a statewide program for routine wastewater monitoring of gastrointestinal pathogens was established in Oklahoma. The results from 18 months of surveillance showed that wastewater concentrations of Salmonella, Campylobacter, and norovirus exhibit similar seasonal patterns to those observed in reported human cases (F = 4-29, p < 0.05) and that wastewater can serve as an early warning tool for increases in cases, offering between one- and two-weeks lead time. Approximately one third of outbreak alerts in wastewater correlated in time with confirmed outbreaks of Salmonella or Campylobacter and our results further indicated that several outbreaks are likely to go undetected through the traditional surveillance approach currently in place. Better understanding of the true distribution and burden of gastrointestinal infections ultimately facilitates better disease prevention and control and reduces the overall socioeconomic and healthcare related impact of these pathogens. In this respect, wastewater represents a unique opportunity for monitoring infections in real-time, without the need for individual human testing. With increasing demands for sustainable and low-cost disease surveillance, the usefulness of wastewater as a long-term method for tracking infectious disease transmission is likely to become even more pronounced.

Keywords: foodborne infections; gastrointestinal pathogens; monitoring; outbreaks; seasonality; surveillance; wastewater surveillance.

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Conflict of interest statement

The authors declare that we have no conflict of interest.

Figures

Figure 1
Figure 1
Reported cases, wastewater concentrations (three-week moving averages), and outbreak indicators for Campylobacter in Oklahoma, 2021–2022.
Figure 2
Figure 2
Reported cases, wastewater concentrations (three-week moving averages), and outbreak indicators for Salmonella in Oklahoma, 2021–2022.
Figure 3
Figure 3
Wastewater concentrations (three-week moving averages) and outbreak indicators for norovirus in Oklahoma, 2021–2022.
See this image and copyright information in PMC

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