NWSS CoE Publications
Explore the latest contributions from our team as we advance our mission to expand the knowledge base in wastewater surveillance.
Featured Publication
The National Wastewater Surveillance System’s Centers of Excellence Contributions to Public Health Action During the Respiratory Virus Season — Four U.S. Jurisdictions, 2022–23
![photo of Allison Wheeler and Shannon Matzinger](/sites/default/files/styles/copy_image_884_x_564/public/Wheeler%20Matzinger_0.png?itok=CD0bd8JV)
Colorado NWSS CoE Contributors:
- Allison Wheeler, MSPH, Colorado NWSS CoE Co-Director
- Shannon Matzinger, PhD, Colorado NWSS CoE Genomic Surveillance Program Manager
- Alexander Yu, MD, Colorado NWSS CoE Advisory Board Member
Published in MMWR Morb Mortal Wkly Rep 2023;72
Summary:
Wastewater surveillance (WWS), the systematic detection of infectious agents in wastewater, provided a valuable tool for monitoring SARS-CoV-2 circulation during the COVID-19 pandemic; surveillance has expanded from 20 to 53 jurisdictions across the United States, with increasing capacity to test for more respiratory pathogens (1,2). This report highlights the use of wastewater data by the four National Wastewater Surveillance System’s (NWSS) Centers of Excellence (California; Colorado; Houston, Texas; and Wisconsin) to guide public health action during the 2022–23 respiratory disease season. This activity was reviewed by CDC, deemed not research, and was conducted consistent with applicable federal law and CDC policy.*
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Multimodal Surveillance Model for Enterovirus D68 Respiratory Disease and Acute Flaccid Myelitis among Children in Colorado, USA, 2022
Colorado NWSS CoE Contributors:
- Allison Wheeler, MSPH, Colorado NWSS CoE Co-Director
- Kirsten Weisbeck, MPH, Colorado NWSS CoE Wastewater Analytics Supervisor
Published in Emerging Infectious Diseases. 2024;30(3)
Abstract:
Surveillance for emerging pathogens is critical for developing early warning systems to guide preparedness efforts for future outbreaks of associated disease. To better define the epidemiology and burden of associated respiratory disease and acute flaccid myelitis (AFM), as well as to provide actionable data for public health interventions, we developed a multimodal surveillance program in Colorado, USA, for enterovirus D68 (EV-D68). Timely local, state, and national public health outreach was possible because prospective syndromic surveillance for AFM and asthma-like respiratory illness, prospective clinical laboratory surveillance for EV-D68 among children hospitalized with respiratory illness, and retrospective wastewater surveillance led to early detection of the 2022 outbreak of EV-D68 among Colorado children. The lessons learned from developing the individual layers of this multimodal surveillance program and how they complemented and informed the other layers of surveillance for EV-D68 and AFM could be applied to other emerging pathogens and their associated diseases.
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Considerations for Implementing Wastewater Surveillance in Rural Communities
Colorado NWSS CoE Contributors:
- Allison Wheeler, MSPH, Colorado NWSS CoE Co-Director
Published in APHL Lab Matters. 2023; Winter
Summary:
Implementing effective wastewater surveillance for SARS-CoV-2 in rural communities requires additional considerations such as ensuring privacy while sampling in smaller populations, limited laboratory and utility capacity due to fewer personnel and resources, access to representative clinical data for interpretation, and transparent, timely and targeted communications. However, when these factors are considered and addressed, wastewater surveillance can aid in decreasing health inequities in rural communities and serve as a valuable public health tool by providing beneficial information about community health trends.
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