Wastewater Surveillance: It Takes a Village
Signals in wastewater testing data can give hospitals and public health officials advance warning of an infectious disease outbreak. With this relatively simple "heads up," preparations can begin days before the first patient walks through the doors of a clinic.
Wastewater-based epidemiology has been in the public health toolbox for decades, but it only gained widespread recognition during the COVID-19 pandemic. As a result, many researchers, sanitation departments, and public health experts recently found themselves setting up robust wastewater monitoring programs for the first time.
Fortunately, they don’t have to do it alone. Biotechnology companies already had proven detection tools and expertise that could be leveraged for wastewater testing. Together, biotechnology service providers and local experts can run wastewater surveillance programs to provide the most useful data to scientists and communities.
Building Capacity Through Partnerships
Wastewater testing has been a valuable tool for public health monitoring since 1854. In that year, John Snow, the father of modern epidemiology, used it to track a London cholera epidemic. Although it is reliable and often more representative of population health than clinical testing, wastewater surveillance historically has been limited by cell culture methods that are time- and resource-intensive, not to mention the additional biosafety measures required.
There are multiple ways technology companies can support local utilities and research groups by supplementing their existing laboratory capacity and expertise.
Off-the-shelf test kits — For wastewater testing sites that already have molecular detection instruments in their lab, technology providers can offer complete assay sets that contain all the primers, probes, and controls needed for scientists to detect and quantify specific pathogens.
Fee-for-service sample testing — For wastewater testing sites or groups that lack the necessary molecular detection tools, biotechnology companies can provide kits that include all consumables and instructions needed for sample collection. Local scientists can use each kit to collect a sample, then send it back to the biotechnology company for reliable pathogen analysis that generates a usable data output.
Aggregated data sets — Biotechnology companies that perform fee-for-service sample testing also can aggregate data from multiple customers’ samples, offering more comprehensive local, state, and national data sets that provide a frame of reference for all wastewater testing scientists to analyze their local data.
Advanced detection technologies, such as droplet digital PCR (ddPCR) offer the gold standard in sensitivity and accuracy. This technology takes the guesswork out of infectious disease surveillance by providing exact quantification of nucleic acids in pathogens of interest.
But the benefits of ddPCR technology should be wider than just labs that can afford it. Partnerships between labs and external vendors who provide various levels of wastewater testing support can empower public health departments to make informed choices — and truly affect their communities.
During the COVID-19 pandemic, for example, GT Molecular (Fort Collins, Colorado) worked with public health officials and scientists to deliver wastewater test results within just 24 hours from sample receipt. This prompt and accurate information proved invaluable to public health departments across the U.S. for reliable tracking and swift response.
