Wastewater Surveillance: A Pioneering Approach for Pandemic Monitoring and Beyond

 

Wastewater surveillance: Prayagraj’s strategy to avert another pandemic

Wastewater Surveillance: A Pioneering Approach for Pandemic Monitoring and Beyond

In the battle against pandemics like COVID-19, wastewater surveillance has proven to be an invaluable tool. This innovative approach involves monitoring wastewater to gain insights into the presence and concentration of disease-causing pathogens in communities. Wastewater samples are collected from sewage treatment plants or open drains, with a focus on pathogens that withstand stomach acidity and are excreted in feces.

While wastewater surveillance initially gained prominence during the COVID-19 pandemic, it offers a wide range of applications beyond tracking SARS-CoV-2. Pathogens like adenoviruses, hepatitis A and E viruses, rotaviruses, as well as bacteria and parasites like E. coli, Salmonella, and Giardia can be detected through wastewater analysis.

For public health authorities, wastewater surveillance serves as a powerful tool for early disease outbreak detection. It bridges the gap created by asymptomatic carriers, providing a valuable advantage in controlling the spread of diseases. By collecting samples from various locations within a city or from multiple sewage treatment plants, local authorities can monitor disease concentration trends and hotspots.

Moreover, the genomic sequencing of sewage samples allows for the identification of new and emerging disease variants. This approach, while costlier and more complex, is instrumental in staying ahead of evolving pathogens.

Prayagraj, in collaboration with the Council of Scientific and Industrial Research's Centre for Cellular and Molecular Biology (CCMB), embarked on a groundbreaking initiative. They conducted wastewater surveillance to detect SARS-CoV-2 and antimicrobial resistance in sewage samples from the city's six sewage treatment plants, processing a significant portion of the sewage.

This initiative involves monthly sample collection from all six sewage treatment plants, with samples securely transported to CCMB in Hyderabad. The data obtained from this surveillance is then correlated with daily COVID-19 caseloads, revealing a striking correlation and providing a 15-day advance warning for the disease.

Beyond tracking COVID-19, the wastewater surveillance in Prayagraj extends to tackling antimicrobial resistance (AMR). By studying antibiotic-resistant bacteria and the role of wastewater components, such as antibiotic residues, in fostering AMR, this initiative aligns with India's 'One Health' mission. Wastewater surveillance aids in understanding the AMR profile within the community and helps in the early identification of emerging diseases and antimicrobial resistance.

In preliminary biological analysis, a high concentration of antimicrobial resistance genes (ARGs) was found across all six sewage treatment plants. The insights from these studies are pivotal for source tracking, risk assessment, and AMR management in urban environments.

As wastewater surveillance continues to evolve, several challenges must be addressed, including cost-effectiveness, reducing the time lag between sample collection and results availability, and developing digital systems to analyze and interpret the data effectively. This integration of surveillance results into public health decision-making processes is crucial, and dynamic dashboards are emerging as a solution.

Wastewater surveillance's potential extends to diverse applications, from tracking illicit drug use to estimating socio-demographic characteristics and consumption patterns. Policymakers can leverage this innovative approach to address nutritional deficiencies and lifestyle diseases.

Ultimately, wastewater surveillance has the potential to transition from laboratory research to practical use in public health decision-making, as demonstrated by the successful collaboration in Prayagraj. As the world grapples with evolving health challenges, this pioneering approach offers a beacon of hope and a pathway to better disease control and prevention.