Wastewater surveillance for viral pathogens: A tool for public health

Abstract

A focus on water quality has intensified globally, considering its critical role in sustaining life and ecosystems. Wastewater, reflecting societal development, profoundly impacts public health. Wastewater-based epidemiology (WBE) has emerged as a surveillance tool for detecting outbreaks early, monitoring infectious disease trends, and providing real-time insights, particularly in vulnerable communities. WBE aids in tracking pathogens, including viruses, in sewage, offering a comprehensive understanding of community health and lifestyle habits. With the rise in global COVID-19 cases, WBE has gained prominence, aiding in monitoring SARS-CoV-2 levels worldwide. Despite advancements in water treatment, poorly treated wastewater discharge remains a threat, amplifying the spread of water-, sanitation-, and hygiene (WaSH)-related diseases. WBE, serving as complementary surveillance, is pivotal for monitoring community-level viral infections. However, there is untapped potential for WBE to expand its role in public health surveillance. This review emphasizes the importance of WBE in understanding the link between viral surveillance in wastewater and public health, highlighting the need for its further integration into public health management.

Keywords: Infectious disease; Public health; Sewage; Surveillance tool; Virus; Wastewater-based epidemiology.

Graphical abstract

Fig. 1

An illustrative representation of the analytical workflow for viral surveillance in wastewater. (a) The process initiates with targeted sampling from a designated location within the wastewater collection system; (b) subsequently, viral concentration is carried out (showing the three methods most widely used); (c) this is followed by nucleic acids isolation, and (d) the last step involves the detection of viral presence in the samples. Created with BioRender.com (accessed on November 07, 2023).