Community-Scale Molecular Surveillance for Human Viruses

Environmental surveillance, including wastewater and air sampling, has emerged as a powerful complement to traditional clinical surveillance for monitoring viral circulation. Advances in sampling and detection technologies, many spurred by the COVID-19 pandemic, have enabled more sensitive and comprehensive characterization of viruses in diverse types of commingled samples from multiple individuals. Expanding environmental monitoring globally presents challenges and opportunities, particularly in low- and middle-income countries where centralized sewage infrastructure may be limited. Ethical implementation will require balancing privacy and transparency through community engagement. Future directions include using environmental surveillance to detect emerging zoonoses, fill gaps when clinical testing wanes, and inform public health actions. While logistical, regulatory, and ethical challenges remain, coordination across scientific and public health stakeholders can enable environmental monitoring to transform epidemic intelligence. This review summarizes recent developments in environmental surveillance systems and discusses how they can mitigate the introduction and spread of viruses in communities.