Work

Moving beyond Wastewater: Perspectives on Environmental Surveillance of Infectious Diseases for Public Health Action in Low-Resource Settings

Year: 2025

Type: article

Abstract: Although testing wastewater for public health surveillance has recently received significant attention in the United States, researchers and public health professionals have long realized the tremendous promise of environmental surveillance (ES), defined as tracking pathogens of interest in fecally contaminated surface waters, soil, or fomites, in low-resource settings for public health action. The power of ES in lowresource settings is most clearly illustrated with the over 30 years of well-established and standardized polio surveillance. As part of the Global Polio Eradication Initiative, the World Health Organization (WHO) has accredited 146 laboratories within the Global Polio Lab Network (GPLN). These facilities across 92 countries process over 8,000 wastewater or fecally contaminated surface water samples per year, in addition to over 220,000 stool samples annually. The data generated from the GPLN are closely linked to clear public health action related to targeted vaccination campaigns. The investment and adoption of ES for polio eradication efforts serves as a use-case for other targets of interest. To explore the current state of the field, the National Science Foundation-funded Research Coordination Network (RCN) on Wastewater Based Epidemiology for SARS-CoV-2 and Emerging Public Health Threats held a workshop in December 2023 to discuss the opportunities and challenges for ES in low-resource settings (Figure 1). Discussions during the workshop highlighted knowledge gaps, best-practices, target selection, academic/government/private partnerships and overall public health action and sustainability of these programs.

Source: Carolina Digital Repository (University of North Carolina at Chapel Hill)

DOI: 10.17615/7k9c-gk45