Wastewater based surveillance for endemic pathogens: meaning for Public Health

WBE is by now well known as a valuable tool to monitor the viral circulation in a community, to track emerging viruses/variants, to give early warning for the onset outbreaks. But, to be really representative, WBE needs good quality data, coming from validated and standardized techniques, identification of biases, correction and normalization of data. Many studies have analyzed the correlations between WBE for SARS-CoV2 and clinical data for COVID, finding variable results, depending on uncertainties, coming from both kinds of surveillance (1). The lesson learned from COVID during the pandemic emergency can today be transferred to the surveillance for the COVID itself, considering its present endemicity, as well as for other already endemic pathogens. Nevertheless, to this aim several conditions must be satisfied, e.g. the pathogen elimination through feces, the availability of reliable detection methods, the persistence along the sewerage network, the relations with cases. In order to explore the possibility of applying WBE to other pathogens we analyzed sewages collected for the SARI Italian Surveillance (2), also for Human Adenovirus (HAdV), Norovirus Genogroup II (NoVGGII), Non Polio Enterovirus (NPEV), Influenza virus (IV) and Respiratory Syncitial Virus (RSV), besides SARS-CoV2. Samples were taken from 4 different Wastewater Treatment Plants (WWTPs), in the North of Tuscany (Italy), during a 12 months period and analyzed with the same methods applied for the SARI project.