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Kuhn KG, Shukla R, Mannell M, Graves GM, Miller AC, Vogel J, Malloy K, Deshpande G, Florea G, Shelton K, Jeffries E, De León KB, Stevenson B. Using Wastewater Surveillance to Monitor Gastrointestinal Pathogen Infections in the State of Oklahoma. Microorganisms 2023; 11:2193. [PMID: 37764037 PMCID: PMC10536226 DOI: 10.3390/microorganisms11092193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/23/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
During the COVID-19 pandemic, wastewater surveillance was widely used to monitor temporal and geographical infection trends. Using this as a foundation, a statewide program for routine wastewater monitoring of gastrointestinal pathogens was established in Oklahoma. The results from 18 months of surveillance showed that wastewater concentrations of Salmonella, Campylobacter, and norovirus exhibit similar seasonal patterns to those observed in reported human cases (F = 4-29, p < 0.05) and that wastewater can serve as an early warning tool for increases in cases, offering between one- and two-weeks lead time. Approximately one third of outbreak alerts in wastewater correlated in time with confirmed outbreaks of Salmonella or Campylobacter and our results further indicated that several outbreaks are likely to go undetected through the traditional surveillance approach currently in place. Better understanding of the true distribution and burden of gastrointestinal infections ultimately facilitates better disease prevention and control and reduces the overall socioeconomic and healthcare related impact of these pathogens. In this respect, wastewater represents a unique opportunity for monitoring infections in real-time, without the need for individual human testing. With increasing demands for sustainable and low-cost disease surveillance, the usefulness of wastewater as a long-term method for tracking infectious disease transmission is likely to become even more pronounced.
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Affiliation(s)
- Katrin Gaardbo Kuhn
- Department of Biostatistics & Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (K.M.); (G.D.)
| | - Rishabh Shukla
- School of Civil Engineering and Environmental Science, University of Oklahoma, Norman, OK 73019, USA; (R.S.); (G.M.G.); (A.C.M.); (J.V.); (G.F.)
| | - Mike Mannell
- Acute Diseases Division, Oklahoma State Department of Health, Oklahoma City, OK 73102, USA;
| | - Grant M. Graves
- School of Civil Engineering and Environmental Science, University of Oklahoma, Norman, OK 73019, USA; (R.S.); (G.M.G.); (A.C.M.); (J.V.); (G.F.)
| | - A. Caitlin Miller
- School of Civil Engineering and Environmental Science, University of Oklahoma, Norman, OK 73019, USA; (R.S.); (G.M.G.); (A.C.M.); (J.V.); (G.F.)
| | - Jason Vogel
- School of Civil Engineering and Environmental Science, University of Oklahoma, Norman, OK 73019, USA; (R.S.); (G.M.G.); (A.C.M.); (J.V.); (G.F.)
| | - Kimberly Malloy
- Department of Biostatistics & Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (K.M.); (G.D.)
| | - Gargi Deshpande
- Department of Biostatistics & Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (K.M.); (G.D.)
| | - Gabriel Florea
- School of Civil Engineering and Environmental Science, University of Oklahoma, Norman, OK 73019, USA; (R.S.); (G.M.G.); (A.C.M.); (J.V.); (G.F.)
- Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
| | - Kristen Shelton
- School of Biological Sciences, University of Oklahoma, Norman, OK 73019, USA; (K.S.); (E.J.); (K.B.D.L.)
| | - Erin Jeffries
- School of Biological Sciences, University of Oklahoma, Norman, OK 73019, USA; (K.S.); (E.J.); (K.B.D.L.)
| | - Kara B. De León
- School of Biological Sciences, University of Oklahoma, Norman, OK 73019, USA; (K.S.); (E.J.); (K.B.D.L.)
| | - Bradley Stevenson
- Department of Earth and Planetary Sciences, Northwestern University, Evanston, IL 60208, USA;
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