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Meta-Analysis
. 2025 Sep:119:105878.
doi: 10.1016/j.ebiom.2025.105878. Epub 2025 Aug 5.

Systematic review and meta-analysis of enteric virus shedding in human excretions

Gang Zheng  1 , Elana M G Chan  1 , Alexandria B Boehm  2
Affiliations
Free article
Meta-Analysis

Systematic review and meta-analysis of enteric virus shedding in human excretions

Gang Zheng et al. EBioMedicine. 2025 Sep.
Free article

Erratum in

Abstract

Background: Wastewater-based epidemiology can inform the understanding of infectious disease occurrence in communities. Quantitative information on shedding of pathogen biomarkers in excretions that enter wastewater is needed to link measurements of pathogen biomarkers to rates of disease occurrence.

Methods: We compile, summarise, and compare data on shedding of human norovirus, rotavirus, hepatitis A virus, and adenovirus group F in stool, vomit, urine, saliva, mucus, and sputum using a systematic review and meta-analysis approach.

Findings: We provide summaries of measured concentrations of the viruses across excretions where data exist. We provide longitudinal shedding profiles in terms of concentrations and positivity rates. Duration of shedding and day of peak shedding are also provided.

Interpretation: There are limited data available for excretions other than stool, and limited data available for adenovirus group F. The aggregated data provided herein can serve as model inputs to translate wastewater enteric virus biomarker concentrations to disease occurrence rates. The study highlights data gaps and research needs.

Funding: This study was funded by a gift from the Sergey Brin Family Foundation to ABB.

Keywords: Adenovirus; Hepatitis A virus; Human excretions; Norovirus; Rotavirus; Saliva; Shedding; Stool; Vomitus.

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Conflict of interest statement

Declaration of interests AB has received funding from the Sergey Brin Family Foundation for this work, as well as funding from the Sloan Foundation and the National Science Foundation for related work. Additionally, AB has served on a wastewater-based epidemiology advisory committee for the California Water Boards. All other authors declare no competing interests.

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