Wastewater monitoring rose to prominence during the pandemic, when states like Arizona used it to detect the emergence of the omicron variant.
Now, concerns over polio and monkeypox have inspired 18 scientists to call for scaling up the surveillance.
A commentary in the journal Nature Medicine says wastewater surveillance offers a powerful early warning system for disease outbreaks, but must be scaled up and fully integrated into health systems.
Public health surveillance currently relies too much on information from health care providers, which doesn’t mesh well with wastewater data.
What’s more, wastewater results are rarely shared in real time, which weakens its usefulness as a coalmine canary.
The authors emphasize the need for more funding, experts and community engagement — including the need to work with tribal partners to find alternatives to prohibited methods like genetic sequencing.
