Monitoring Viral Pathogens in Wastewater Systems for Applications of Early Warning Detection for the Public Health Sector.

Recent spread of viral infectious diseases has piqued interest in wastewater-based epidemiology (WBE). Concentrations of pathogens are based on symptomatic and asymptomatic cases providing facilities with data on communities with low reported cases despite high transmission rates. Efforts to report trends for viral pathogens have improved methods for identifying and quantifying different pathogens for the benefits of public health facilities. Wastewater contains complex compounds, causing low recovery rates and poor-quality RNA. Low recovery rate of pathogens results in false-negatives and inconsistent data. Early enrichment methods varied significantly and produced inconsistent data for equivalent samples, but improvements have increased the purity of total nucleic acid from environmental samples and the efficiency of downstream applications. Further development of standard procedures and kits has enhanced the quality for PCR based methods and created reproducible methods. Advancements in WBE have allowed labs to report trends in pathogen concentrations in wastewater systems to health care facilities. Therefore, we have expanded our targeted pathogens to include Norovirus, Hepatitis A, Monkeypox virus, and Poliovirus based on our previous study of SARS-CoV-2. Increasing targeted infectious pathogens allows us to provide early warnings to the public health sector and link pathogen concentrations in wastewater to reported viral cases in the community and the spread of viruses over time.