Skip to main content

NOTICE: Due to a lapse in annual appropriations, most of this website is not being updated. Learn more.

Form submissions will still be accepted but will not receive responses at this time. Sections of this site for programs using non-appropriated funds (such as NVLAP) or those that are excepted from the shutdown (such as CHIPS and NVD) will continue to be updated.

U.S. flag

An official website of the United States government

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

Optimizing Wastewater Surveillance: The Necessity of Standardized Reporting and Proficiency for Public Health

Published

Author(s)

Ishi Keenum, Nancy Lin, Alshae Logan, Adam Gushgari, Nishita D’Souza4, Joshua Steele, Devrim Kaya, Lydia Gushgari

Abstract

Wastewater-based surveillance (WBS) has emerged as a valuable tool for public health, allowing a greater understanding of disease prevalence in communities. With historical significance in monitoring polio transmission,1 WBS gained further prominence in 2020 by enhancing the population-level monitoring of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) trends.2,3 Since then, WBS has been used to track diseases such as influenza,4 respiratory syncytial virus,5 norovirus,6 and mpox. The global implementation of WBS signifies its movement from a research initiative to a staple public health tool, which is especially critical for virus monitoring. However, the diverse methodologies adopted for WBS present challenges. Although each method may address specific stakeholder needs, the lack of standardized reporting guidelines and external validation limits the scope and utility of the data. A key advantage of WBS is that it enables public health authorities at the state and federal levels to determine where to allocate resources, ideally before a wider spread outbreak. Data aggregation is possible only when metrics such as target concentration and recovery are reported in the same concentrations and with similar driving calculations. This concern is amplified when data from a variety of methods are aggregated at a state, national, or global scale. Therefore, our objective is to promote standardized reporting guidelines in WBS as a critical part of a public health framework.
Citation
American Journal of Public Health
Volume
114
Issue
9

Keywords

Biosurveillance, wastewater-based surveillance, standardized reporting, proficiency testing, reporting guidelines

Citation

Keenum, I. , Lin, N. , Logan, A. , Gushgari, A. , D’Souza4, N. , Steele, J. , Kaya, D. and Gushgari, L. (2024), Optimizing Wastewater Surveillance: The Necessity of Standardized Reporting and Proficiency for Public Health, American Journal of Public Health, [online], https://doi.org/10.2105/AJPH.2024.307760, https://tsapps.nist.gov/publication/get_pdf.cfm?pub_id=957138 (Accessed October 9, 2025)

Issues

If you have any questions about this publication or are having problems accessing it, please contact [email protected].

Created August 7, 2024, Updated September 10, 2025
Was this page helpful?