Abstract
Wastewater-based epidemiology (WBE) uses concentrations of infectious agent targets in wastewater to infer infection trends in the contributing community. To date, WBE has been used to gain insight into infection trends of gastrointestinal diseases, but its application to respiratory diseases has been limited. Here, we report that respiratory syncytial virus (RSV) genomic ribonucleic acid can be detected in wastewater settled solids at two publicly owned treatment works. We further show that its concentration in settled solids is strongly associated (Kendalls tau = 0.65–0.77, p < 10–7) with clinical positivity rates for RSV at sentinel laboratories across the state in 2021, a year with anomalous seasonal trends of RSV disease. Given that RSV infections have similar clinical presentations to COVID-19, can be life threatening for some, and immunoprophylaxis distribution for vulnerable people is based on outbreak identification, WBE represents an important tool to augment current RSV surveillance and public health response efforts.
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