Wastewater Surveillance System Faces Gaps in Clinical Integration Despite Technical Readiness
A new set of studies published in a special issue of Emerging Infectious Diseases reveals that while the U.S. National Wastewater Surveillance System (NWSS) is technically robust and capable of detecting numerous infectious disease threats across 1,500 sites in all 50 states, its data is not routinely reaching clinicians and health systems. Launched by the CDC in 2020 to track COVID-19, the NWSS has expanded to monitor influenza, mpox, and antimicrobial-resistant bacteria. The system, built with significant federal investment, involves a network of health departments, universities, laboratories, and wastewater treatment plants, standardizing sample collection, processing, and data flow to local jurisdictions and the CDC. Despite its proven technical capability to detect pathogens weeks or months before clinical cases emerge, a survey of infectious disease physicians indicates that most do not routinely review wastewater data, citing barriers such as delayed reporting, unclear clinical actionability, and la...