Water Research

Wastewater-based epidemiology (WBE) is an effective surveillance approach for monitoring viruses of public health relevance at the community level, complementing clinical surveillance systems. Molecular methods such as PCR/qPCR are widely used for targeted detection, while next-generation sequencing (NGS) with targeted enrichment panels has emerged as a complementary strategy for broader viral detection and genomic characterization. This study comparatively evaluated conventional PCR/qPCR and a ...

After the COVID-19 pandemic, wastewater monitoring is increasingly used for infectious disease surveillance. Using the data from a controlled experimental hospital setting, this paper examines the association wastewater SARS-CoV-2 with COVID-19 hospital admission and mortality, and whether this association varies by patients characteristics. Weekly wastewater samples were collected from the University of Miami (UM) hospitals where COVID-19 patients were admitted from February 2020 to October 202...

Digital PCR (dPCR) is increasingly used for SARS-CoV-2 wastewater surveillance due to its precision, absolute quantification, and reduced sensitivity to inhibition compared to quantitative PCR. Although the Bio-Rad ddPCR and QIAGEN QIAcuity dPCR platforms are widely adopted, their performance has not been directly compared for wastewater applications. We conducted a blinded comparison of these platforms using 95 archived wastewater influent samples from North Carolina collected in 2021-2022, spa...

Wastewater monitoring enables non-invasive, population-scale tracking of community infections independent of healthcare-seeking behavior and clinical diagnosis. Metagenomic sequencing extends this capability by enabling broad, pathogen-agnostic detection, genomic characterization, and identification of novel or unexpected threats. Here, we present data from CASPER (the Coalition for Agnostic Sequencing of Pathogens from Environmental Reservoirs), a U.S.-based wastewater metagenomic sequencing ne...

Antibiotic resistance genes (ARGs) circulating among clinically relevant bacteria pose serious challenges to public health. Given the ancient and environmental bacterial origins of ARGs, a better understanding of the carriers of ARGs beyond the clinically most relevant species is urgently needed for more farsighted resistance monitoring and intervention measures. While the risks of emerging ARGs from environmental sources have been recognized, the identification bottlenecks stem from the limitat...

Antimicrobial resistance (AMR) is a growing global public health threat projected to cause up to 10 million deaths annually by 2050 if no immediate action is taken. While misuse and overuse of antibiotics are the main drivers of increasing AMR, the eco-evolutionary dynamics of AMR in the environment - particularly across the urban-rural continuum - remain poorly understood. Using shotgun sequencing, we investigated urban, farm, and rural water sources in the Berlin-Brandenburg region to explore ...

IntroductionWastewater-based epidemiology (WBE) was implemented at the 2024 Republican and Democratic National Conventions (RNC and DNC, respectively)--two prominent large-scale events, each with estimated attendances of >50,000 persons. In preparation for event monitoring, the Wisconsin and Chicago WBE programs (associated with the RNC and DNC public health response, respectively) developed site-specific monitoring strategies and response plans, prioritized additional pathogens for event survei...

Wastewater based epidemiology offers a valuable population level signal for monitoring respiratory virus activity, but its routine use in public health practice requires alerting methods that are transparent, interpretable, and comparable across locations. In this study, we propose a simple early warning framework that transforms wastewater viral RNA measurements into actionable alerts using a standardized statistical process control approach. The method relies on variance stabilization, site sp...

Wastewater surveillance has been widely adopted since the COVID-19 pandemic, but non-sewered or onsite sanitation is a common form of sanitation in cities of low- and middle-income countries. Environmental surveillance in these settings requires expanding analyses beyond wastewater. We collected 81 soil samples adjacent to public waste bins inside the sewered and non-sewered areas of Maputo and a 150-meter-wide buffer zone between the two areas, as well as from subsistence farms near the wastewa...

The Province of Ontario (Canada) experienced a generational scale outbreak of measles in 2025. We applied wastewater surveillance concurrently with clinical-based surveillance to track measles incidence in southwestern Ontario adjacent to the United States. Measles virus (MeV) signal in wastewater was positively associated with clinical cases but did not provide early alert of changes in measles incidence when resolved by epidemiological week. Assessment of virus partitioning showed MeV RNA was ...

Antimicrobial resistance (AMR) is a growing problem, with annual deaths set to pass 10 million by 2050 if current trends continue. Wastewater surveillance has been proposed as a strategy to understand population-level resistance, and water reclamation facilities (WRFs) have been identified as a control point for environmental dissemination of resistant bacteria. Understanding dynamics of AMR across WRFs requires advanced molecular tools that elucidate host bacteria, especially for mobile resista...

Antimicrobial resistance (AMR) in ESKAPE pathogens represents a major global health threat. Although these organisms are well established as causes of healthcare-associated infections, aquatic environments may function as reservoirs and transmission pathways for resistance. This systematic review aimed to estimate the prevalence of AMR in ESKAPE pathogens isolated from water and wastewater and to compare resistance patterns with those observed in human clinical isolates. The review followed PRIS...

Carbapenem-resistant (CR) bacteria have emerged and been spreading beyond healthcare-associated facilities into the environment. It is recognized that toilet bowl water in patient rooms of healthcare-associated facilities can be one of internal reservoirs of CR bacteria. In accordance with this idea, toilet bowl water samples were collected from patient rooms in a tertiary healthcare-associated facility in North Macedonia, and meropenem (MEM)-resistant bacterial isolates were obtained from the t...

The global increase in microbial infections is strongly linked to the widespread dissemination of antibiotic resistance genes in the environment, posing a serious challenge to public health. In the present study, surface water samples were collected from multiple locations along the Daya River near Bhubaneswar, including sites impacted by untreated municipal sewage discharge. The predominant bacterial isolate was identified as Acinetobacter baumannii-exhibited resistance to commonly used antibio...

We present findings from the first known pilot study of transatlantic airplane wastewater monitoring, conducted over six months at two connected international airports in the United States and the United Kingdom. This study demonstrates the feasibility of implementing bilateral wastewater-based pathogen surveillance at international travel hubs. We outline the operational and analytical methodologies employed, highlight key challenges encountered in transnational coordination, and provide recomm...

Hepatitis E virus (HEV) is considered a predominantly foodborne pathogen in developed settings. During COVID-19 lockdown periods, however, HEV concentrations in wastewater at a treatment plant in Munich, Germany decreased, suggesting that pandemic-related behaviour changes inadvertently influenced transmission. In contrast, reported cases and wastewater data from a smaller catchment showed no comparable decline. To assess whether the observed reduction is compatible with a near-exclusively foodb...

Measles outbreaks have surged globally in recent years, but current surveillance systems have limited capacity to monitor measles virus (MeV) transmission and evolution at population scale. Although MeV can be detected in wastewater, the public health potential of wastewater genomic surveillance for MeV remains largely unexplored. Here, we deploy sensitive, low-cost MeV wastewater genomic surveillance combining virus concentration, whole-genome amplicon sequencing, and bioinformatic analysis alo...

BackgroundSea fish traditionally serves as a protein source and plays a crucial and indispensable role in providing nutrition for the people of Bangladesh. However, frequent consumption may potentially indicate health risks through contamination with toxic heavy metals. The main purpose of this study is to evaluate the levels of heavy metal concentrations (Cr, Fe, Ni, Mn, Cu, and Pb) in selected sea fish from Chattogram and Coxs Bazar districts in Bangladesh. MethodsA wet digestion technique wa...

Wastewater-based surveillance (WBS) is widely used to monitor respiratory viruses, yet uncertainties remain regarding how viral RNA concentrations in wastewater reflect infection dynamics. Specifically, diurnal variation in shedding and RNA losses during in-sewer transport can impact measured signals. We conducted a field study in a 5-km trunk sewer (travel time of one hour). Wastewater was sampled at the sewer inlet and outlet using autosamplers collecting time-proportional one-hour composite s...

Infectious disease forecasts can inform public health decision-making. Wastewater monitoring is a relatively new epidemiological data source with multiple potential applications, including forecasting. Incorporating wastewater data into epidemiological forecasting models is challenging, and relatively few studies have assessed whether this improves forecast performance. We present and evaluate a semi-mechanistic wastewater-informed forecasting model. The model forecasts COVID-19 hospital admissi...