Wastewater testing of infectious diseases is expected work for just about every infectious disease that affects humans, including monkeypox and polio. According to a research team led by epidemiologist David Larsen from Syracuse University, more research is needed to apply the science for public health benefit.
The team’s work published on Oct. 13 in the American Journal of Epidemiology examined all peer-reviewed scientific articles on wastewater surveillance published through July 2020. The team identified various pathogens found in wastewater. They included almost all infectious diseases that the World Health Organization classified as a Public Health Emergency of International Concern (PHEIC), such as Ebola and Zika.
Despite this positive finding, few studies relate what is found in wastewater to public health and the amount of disease circulating.
“Testing the wastewater is only one component of this powerful science,” says Larsen, an associate professor of public health at the Falk College of Sport and Human Dynamics. “Understanding the results and implications for public health is just as challenging. We need interdisciplinary teams working together to maximise the benefit of wastewater-based epidemiology.”
Wastewater-based epidemiology is the science of taking what is found in wastewater. The data from those studies is then use to understand population-level health trends. Most of the articles that Larsen and his colleagues reviewed looked at what they could find in the wastewater. They omitted the second step of relating the findings to other measures of population-level health. Those measures include the number of cases, test positivity, or hospitalisations.
What is wastewater testing?
Wastewater-based epidemiology of COVID-19 has enjoyed substantial availability of clinical COVID-19 data. Results from wastewater surveillance are more easily understood in terms of COVID-19 transmission. The research team determined that more work is needed for other pathogens to increase the utility of wastewater surveillance to benefit public health.
At the outset of COVID in 2020, Larsen led an interdisciplinary team of experts. The team coordinated with the New York Department of Health to create a wastewater surveillance system throughout New York State. Today, the New York State Wastewater Surveillance Network is testing for COVID in at least one wastewater treatment plan in 60 counties, covering a population of more than 15 million. The New York State Wastewater Surveillance Network dashboard provides the most recent statistics regarding the network.
“New York State’s wastewater surveillance network continues to provide estimates of COVID-19 transmission. It has aided the response to polio and monkeypox,” Larsen says. “We are also working on modelling other seasonal infectious diseases in the future.”
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