A Multi-Partner Effort to Launch and Sustain Wastewater Surveillance, United States

The National Wastewater Surveillance System represents a groundbreaking initiative aimed at enhancing public health surveillance for infectious diseases through wastewater analyses. We have outlined current and planned collaborative efforts between the Centers for Disease Control and Prevention and key partners, including academic institutions, utilities, jurisdictions, and public health partner networks, to develop, implement, and sustain wastewater surveillance for infectious diseases to inform public health activities. By addressing critical challenges in assay development, community and clinician engagement, governance structures, public health ethics, data system development and integration, and innovation fostering, those partnerships lay the groundwork for a robust public health surveillance framework. Establishing this novel public health surveillance capability required developing new partnerships and skills, incorporating basic principles of public health surveillance, validating assays, and envisioning a system to meet current and future public health challenges. This capability will foster improved public health responses nationwide.