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SARS-CoV-2 wastewater surveillance testing guide for public health laboratories
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03/01/2022
[PDF-1.86 MB]
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Description:The purpose of this document is to provide an overview of the SARS-CoV-2 wastewater laboratory setup and analytical process to orient public health laboratories as they implement testing. This guidance provides details on the management system and controls needed to produce quality, robust wastewater testing data that can be reported to health officials and to the US Centers for Disease Control and Prevention (CDC) National Wastewater Surveillance System(NWSS) for public health decision making. Topics covered include the role of the public health laboratory in wastewater surveillance, wastewater surveillance testing methods, laboratory infrastructure needed for wastewater testing and program performance evaluation.
Wastewater surveillance is the strategic sampling and testing of wastewater to detect pathogens or other health targets to better understand disease burden and spread within a community. Wastewater surveillance is a promising tool for the COVID-19 response because the virus is shed in the feces of up to 80% of infected individuals—both symptomatic and asymptomatic. Wastewater data are also unique from case-based surveillance because wastewater surveillance captures subclinical infections and data are independent of healthcare-seeking behavior and testing access. Since a large portion (~75%) of feces in the United States will be flushed into sewers and arrive at a wastewater treatment facility within hours, untreated wastewater can be seen as an efficient pooled fecal sample representing community level or sub-community level infections if strategically sampled from within the piped network. Finally, wastewater data have shown to be a leading indicator of trends in new reported cases by anywhere from four days to even a few weeks. With these benefits, it is important to note wastewater cannot determine the most effective mitigation strategies for reducing transmission within a community. Consequently, wastewater-based disease surveillance is not a solution to be used in isolation, but instead a tool used to complement other public health measures and indicators.
This project was 100% funded with federal funds from a federal program of $500,000. This publication was supported by Cooperative Agreement number # NU60OE000104, funded by the US Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC or the Department of Health and Human Services.
EH-2022-SARSCoV2-Wastewater-Surveillance-Testing-Guide.pdf
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Pages in Document:23 numbered pages
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