Lessons learned from upstream wastewater sampling in response to poliovirus in New York State

Area of Science:

• Environmental microbiology
• Public health
• Epidemiology

Background:

• Emerging infectious diseases pose significant public health challenges.
• Wastewater surveillance is a valuable tool for pathogen detection and response preparedness.
• Sensitivity of wastewater surveillance can be limited in densely populated regions.

Purpose of the Study:

• To describe lessons learned from deploying upstream wastewater sampling during a poliovirus outbreak.
• To evaluate the effectiveness of upstream sampling for pinpointing disease transmission.

Main Methods:

• Implemented wastewater surveillance at sampling points upstream from wastewater treatment plants during a poliovirus outbreak.
• Reduced the sampled population from ~201,000 to sub-area populations (3,100–78,300).

Main Results:

• Upstream sampling enabled more precise identification of poliovirus transmission areas.
• Confirmed poliovirus presence across multiple upstream sub-areas, indicating wider community spread.
• Challenges included securing dedicated staff and funding for sustained sampling.

Conclusions:

• Upstream wastewater sampling is a critical tool for enhancing infectious disease surveillance and outbreak response.
• Effective implementation requires robust preparation, including sewer infrastructure data and inter-agency coordination.
• Health departments should consider upstream sampling as a vital component of preparedness for emerging infectious diseases.