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. 2024 Feb 20:912:169551.
doi: 10.1016/j.scitotenv.2023.169551. Epub 2023 Dec 20.

Correlation of wastewater surveillance data with traditional influenza surveillance measures in Cook County, Illinois, October 2022-April 2023

Emily A G Faherty  1 , Deniz Yuce  2 , Colin Korban  2 , Kelley Bemis  3 , Rishi Kowalski  3 , Stephanie Gretsch  2 , Enrique Ramirez  2 , Rachel Poretsky  4 , Aaron Packman  5 , Katelyn Plaisier Leisman  5 , Melissa Pierce  6 , Alyse Kittner  2 , Richard Teran  7 , Massimo Pacilli  2
Affiliations

Correlation of wastewater surveillance data with traditional influenza surveillance measures in Cook County, Illinois, October 2022-April 2023

Emily A G Faherty et al. Sci Total Environ. .

Abstract

Influenza is a respiratory illness that can result in serious outcomes, particularly among persons who are immunocompromised, aged <5 years or aged >65 years. Traditional influenza surveillance approaches rely upon syndromic surveillance of emergency departments and public health reporting from clinicians and laboratories. Wastewater surveillance infrastructure developed to monitor SARS-CoV-2 is being used for influenza surveillance in the Chicago area. The goal was to evaluate timeliness and correlations between influenza virus detected through wastewater surveillance and traditional influenza surveillance measures to assess utility of wastewater surveillance for influenza at the county level. Specifically, we measured correlations between influenza virus gene copies in wastewater samples and 1) the number of intensive care unit admissions associated with a diagnosis of influenza, 2) the percentage emergency department (ED) visits for influenza-like-illness, and 3) the percentage of ED visits with influenza diagnosis at discharge2 in Cook County. Influenza concentrations in wastewater were strongly correlated with traditional influenza surveillance measures, particularly for catchment areas serving >100,000 residents. Wastewater indicators lagged traditional influenza surveillance measures by approximately one week when analyzed in cross-correlations. Although wastewater data lagged traditional influenza surveillance measures in this analysis, it can serve as a useful surveillance tool as a complement to syndromic surveillance; it is a form of influenza surveillance that does not rely on healthcare-seeking behavior or reporting by healthcare providers.

Keywords: Influenza; Wastewater surveillance; Wastewater-based epidemiology.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Aaron Packman reports that financial support was provided by Chicago Department of Public Health. Rachel Poretsky reports that financial support was provided by Chicago Department of Public Health. Melissa Pierce reports that financial support was provided by Chicago Department of Public Health. Katelyn Leisman reports that financial support was provided by Chicago Department of Public Health. Emily AG Faherty reports that administrative support was provided by Chicago Department of Public Health. Alyse Kittner reports that financial support was provided by the Centers for Disease Control and Prevention. Deniz Yuce reports that financial support was provided by the Centers for Disease Control and Prevention. Colin Korban reports that financial support was provided by the Centers for Disease Control and Prevention. Rishi Kowalski reports that travel was provided by the Council of State and Territorial Epidemiologists. Alyse Kittner reports that travel was provided by Water Environment Federation. Rachel Poretsky reports that equipment, drugs, or supplies was provided by the National Institutes of Health. Stephanie Gretsch reports that financial support was provided by the Centers for Disease Control and Prevention. Aaron Packman reports that financial support was provided by Illinois Department of Public Health. Katelyn Leisman reports that financial support was provided by Illinois Department of Public Health. Melissa Pierce reports that financial support was provided by Illinois Department of Public Health. Aaron Packman reports a relationship with Integrated Bioscience and Built Environment Consortium that includes: board membership.

Figures

Fig. 1.
Fig. 1.
Wastewater flow-population normalized influenza a loess-smoothed comparisons with: 1a) % influenza-like illness (ili) in total emergency department (ed) visits; 1b) % emergency department visits with influenza discharge diagnosis; and 1c) number of influenza intensive care unit (icu) admissions for all wastewater treatment plant catchment areas in Cook County, Illinois, October 1, 2022–April 15, 2023.
Fig. 2.
Fig. 2.
Cross-correlation values by week for wastewater flow-population normalized influenza A rate compared with: 2A) % influenza-like illness in total emergency department visits; 2B) % emergency department visits with influenza discharge diagnosis; and 2C) number of influenza intensive care unit admissions for all wastewater treatment plant catchment areas in Cook County, Illinois, October 1, 2022–April 15, 2023.
See this image and copyright information in PMC

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