Wastewater Surveillance for Infectious Disease: A Systematic Review

Pruthvi Kilaru, Dustin Hill, Kathryn Anderson, Mary B. Collins, Hyatt Green, Brittany L. Kmush, David A. Larsen

Research output: Contribution to journalReview articlepeer-review

26 Scopus citations


Wastewater surveillance for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been shown to be a valuable source of information regarding SARS-CoV-2 transmission and coronavirus disease 2019 (COVID-19) cases. Although the method has been used for several decades to track other infectious diseases, there has not been a comprehensive review outlining all of the pathogens that have been surveilled through wastewater. Herein we identify the infectious diseases that have been previously studied via wastewater surveillance prior to the COVID-19 pandemic. Infectious diseases and pathogens were identified in 100 studies of wastewater surveillance across 38 countries, as were themes of how wastewater surveillance and other measures of disease transmission were linked. Twenty-five separate pathogen families were identified in the included studies, with the majority of studies examining pathogens from the family Picornaviridae, including polio and nonpolio enteroviruses. Most studies of wastewater surveillance did not link what was found in the wastewater to other measures of disease transmission. Among those studies that did, the value reported varied by study. Wastewater surveillance should be considered as a potential public health tool for many infectious diseases. Wastewater surveillance studies can be improved by incorporating other measures of disease transmission at the population-level including disease incidence and hospitalizations.

Original languageEnglish (US)
Pages (from-to)305-322
Number of pages18
JournalAmerican Journal of Epidemiology
Issue number2
StatePublished - Feb 1 2023


  • environmental surveillance
  • infectious disease surveillance
  • wastewater surveillance

ASJC Scopus subject areas

  • General Medicine


Dive into the research topics of 'Wastewater Surveillance for Infectious Disease: A Systematic Review'. Together they form a unique fingerprint.

Cite this