Community health updates will soon be as easy as checking the weather

In the near future, people may access their community health status much like they check the local weather forecast. This public health surveillance system uses advanced technologies to scrutinize public wastewater, revealing vital information about circulating viruses within communities.

The system involves a detailed analysis of the human virome – all known human viruses – in community wastewater. 

“Knowing the up and down patterns within the viral landscape of human wastewater, the changes in the relative proportions of the different viruses in time and by location, is increasingly proving to be a powerful tool to improve our understanding of outbreaks, transmission and the effects on overall population health,” said Dr. Anthony Maresso from the Baylor College of Medicine. 

Crucial insights

Texas stands out as the pioneer in developing a comprehensive pipeline for wastewater surveillance of the human virome. 

This initiative, led by the Texas Wastewater Consortium and supported by the Texas Epidemic Public Health Institute, involves steps from sample collection to analysis and reporting. The periodic reports, informed by detailed virome analysis, provide crucial insights to public health officials.

Early detection

Dr. Maresso and his colleagues have demonstrated that they can detect changes in viral trends in wastewater weeks before they are detected in the clinic.

“Think of it as a very fancy smoke alarm that brings to the attention of scientists, physicians and public health authorities the progressively increasing proportions of a particular virus strain in the community, one they need to follow closely, assessing its outbreak potential,” said study first author Dr. Michael Tisza. “For instance, we knew about mpox (monkeypox) well before most clinical settings knew about it because we detected it in wastewater.”

Emerging viruses 

The researchers believe that this technology is going to be one way they can get ahead of not only all known viruses that can be shed in wastewater, but also to potentially get an upper hand on the next virus that we don’t yet know about.

“Had we had this in place during the time COVID-19 was emerging, we may have seen some coronavirus sequences that alerted us of the new sequence of the COVID-19 virus that began spreading in 2019 and exploded into a pandemic,” noted Dr. Maresso.

Historical context 

The idea of using wastewater surveillance dates back to the early 1940s with the monitoring of poliovirus. Pioneered by researchers at Yale University and Baylor College of Medicine, this method provided insights into the spread and evolution of diseases at the community level. 

Dr. Joseph Melnick’s work in the 1960s at Baylor, using wastewater analysis to predict and respond to polio outbreaks, laid the foundation for modern wastewater-based epidemiology.

COVID-19 pandemic

The COVID-19 pandemic marked a resurgence in wastewater analysis. Baylor scientists were among the first to detect the COVID-19 virus in wastewater. This revived interest in wastewater surveillance has now been expanded to monitor a broader range of viruses, using more sensitive technologies like PCR and genetic sequencing.

“We also see sequence information that PCR cannot give us that allows us to identify new viruses that might lead to the next pandemic,” said Dr. Tisza. “This is very powerful; it’s quantum leaps ahead of everything else. We think this is the way everybody is going to do it in the future.”

The study is published in the journal Nature Communications.

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