AUTHOR=Clark Justin R. , Terwilliger Austen , Avadhanula Vasanthi , Tisza Michael , Cormier Juwan , Javornik-Cregeen Sara , Ross Matthew Clayton , Hoffman Kristi Louise , Troisi Catherine , Hanson Blake , Petrosino Joseph , Balliew John , Piedra Pedro A. , Rios Janelle , Deegan Jennifer , Bauer Cici , Wu Fuqing , Mena Kristina D. , Boerwinkle Eric , Maresso Anthony W. TITLE=Wastewater pandemic preparedness: Toward an end-to-end pathogen monitoring program JOURNAL=Frontiers in Public Health VOLUME=11 YEAR=2023 URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1137881 DOI=10.3389/fpubh.2023.1137881 ISSN=2296-2565 ABSTRACT=

Molecular analysis of public wastewater has great potential as a harbinger for community health and health threats. Long-used to monitor the presence of enteric viruses, in particular polio, recent successes of wastewater as a reliable lead indicator for trends in SARS-CoV-2 levels and hospital admissions has generated optimism and emerging evidence that similar science can be applied to other pathogens of pandemic potential (PPPs), especially respiratory viruses and their variants of concern (VOC). However, there are substantial challenges associated with implementation of this ideal, namely that multiple and distinct fields of inquiry must be bridged and coordinated. These include engineering, molecular sciences, temporal-geospatial analytics, epidemiology and medical, and governmental and public health messaging, all of which present their own caveats. Here, we outline a framework for an integrated, state-wide, end-to-end human pathogen monitoring program using wastewater to track viral PPPs.