As hundreds of communities have found wastewater-based disease surveillance is a valuable tool for timely public health action, a growing number of communities in the U.S. and abroad are bolstering their infrastructure so more communities can benefit from this innovative approach to monitor population health.
Now, a team of Rice University engineers and officials from the Houston Health Department are working to harness this momentum and expand wastewater surveillance to test for a range of additional targets, including seasonal influenza and norovirus, protozoa, harmful bacteria and fungi, and genes that cause antibiotic resistance.
Supporting the science and innovation behind the project is a new grant from the Centers for Disease Control and Prevention (CDC) to develop laboratory and computational methods for comprehensive, sensitive and real-time wastewater disease surveillance.
Lauren Stadler, an assistant professor of civil and environmental engineering, will lead the project with collaborators Todd Treangen, an assistant professor of computer science, Katherine Ensor, the Noah G. Harding Professor of Statistics, and Loren Hopkins, the chief environmental science officer at the Houston Health Department.
All five team members, who have combined expertise in wastewater microbiology, bioinformatics, statistics, and public health, collaborated to establish the wastewater surveillance system for SARS-CoV-2 and modified the infrastructure to determine levels of monkeypox in August 2022.
Methods the team has been using to measure the viral load in the wastewater include targeted molecular assays, such as digital droplet polymerase chain reaction (ddPCR), which are similar to well-established PCR methods that are used by many health department laboratories across the U.S.
“Adapting existing methods for concentrating and quantifying a suite of targets in wastewater could be immediately applicable for routine surveillance programs,” said Stadler. “We will also be looking to develop additional standard operating procedures, and quality control and quality assurance recommendations for method initialization and routine monitoring efforts.”
To expand the looking glass to broadly screen for other pathogens in wastewater, the team will also apply untargeted methods such as metagenomic sequencing and develop bioinformatic pipelines to screen for pathogens circulating in communities.
“While this type of omics research has been applied to environmental samples, standard methods for its application in public health surveillance to detect pathogens have not been developed or assessed,” added Stadler. “We are at a pivotal moment in wastewater analysis and how extensively it can be used as a cost-effective approach to speed innovative responses to population health risks.”
Results of the research and protocols in pathogen detection and quantification could further facilitate the rapid and broad adoption of wastewater disease monitoring and will be shared widely. Houston Wastewater Epidemiology is a National Wastewater Surveillance System Center of Excellence, and a member of the National Wastewater Surveillance System (NWSS).