AUTHOR=de Melo Tomas , Islam Golam , Simmons Denina B. D. , Desaulniers Jean-Paul , Kirkwood Andrea E. 

TITLE=An alternative method for monitoring and interpreting influenza A in communities using wastewater surveillance

JOURNAL=Frontiers in Public Health

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1141136

DOI=10.3389/fpubh.2023.1141136

ISSN=2296-2565

ABSTRACT=Seasonal influenza is an annual public health challenge that strains health care systems, yet population-level prevalence remains under-reported using standard clinical surveillance methods. Wastewater surveillance (WWS) of influenza A can allow for reliable flu surveillance within a community by leveraging existing SARS-CoV-2 WWS networks regardless of sample type (primary sludge versus primary influent) using a RT-qPCR based viral RNA detection method for both targets. Additionally, current influenza A outbreaks disproportionately affect the pediatric population. In this study, we show the utility of interpreting influenza A WWS data with elementary student absenteeism due to illness to selectively interpret disease spread in the pediatric population. Our results show that the highest statistically significant correlation (r = 0.93, p = 0.002) occurred between influenza A WWS data and elementary school absences due to illness. This correlation coefficient is notably higher than the correlations observed between influenza A WWS data and influenza A clinical case data (r = 0.78, p < .001). This method can be combined with a suite of pathogen data from wastewater to provide a robust system for determining the causative agents of diseases that are strongly symptomatic in children to infer pediatric outbreaks within communities.