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This study found various quantities of viral RNA in wastewater samples. Human coronavirus comprised the highest concentration, followed by rhinovirus, respiratory syncytial virus B, human metapneumovirus, and influenza A.

Wastewater epidemiology studies use biological samples to monitor the trends of disease occurrence in a particular community, irrespective of the symptoms or the medical care provided. Although it cannot predict disease severity in individuals, it has been useful for poliovirus, enteroviruses, and, very recently, during the COVID-19 pandemic. 

A study published in The Lancet. Microbe was conducted to test the usefulness of wastewater epidemiology for several viral respiratory diseases. 

Study Design and Methods

The comprehensive surveillance study used hydrolysis-based RT-PCR assays tailored to detect respiratory viral genomes, which were later applied to wastewater solids collected over an extensive period of 17 months from the San Jose–Santa Clara Regional wastewater facility. The collected samples went through an extensive protocol before testing. 

Wastewater Surveillance Reveals Varying Viral Concentrations

The results of this study revealed that all the targeted viral RNAs were detected in the wastewater samples, but at varying concentrations. The highest concentration was recorded for human coronavirus, followed by human rhinovirus, respiratory syncytial virus B, human metapneumovirus, and influenza A.

Correlation Between Wastewater RNA and Clinical Positivity Rates

Upon comparison with clinical data, there was a significant association between wastewater RNA concentrations and clinical positivity rates for most cases except for influenza B. The distribution of different human parainfluenza virus and human coronavirus types was also examined. Human parainfluenza 3 was the most common among human parainfluenza viruses, while human coronavirus OC43 was the most prevalent, followed by human coronavirus 229E, which was dominant at the local level at the end of the study, though not in state-aggregated data.

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Positive correlations were observed among the concentrations of viral RNA in the samples, highlighting similar patterns of occurrence. It must be noted that the concentrations of human coronavirus RNA did not show significant correlations with the other viral targets. 

Wastewater-Based Epidemiology for Respiratory Virus Surveillance

This study highlights the importance of wastewater-based surveillance for monitoring viral respiratory illnesses. It provides important insight into the circulation and presence of various respiratory viruses in the community, complementing the clinical data. 

Wastewater-based epidemiology demonstrated significant potential as a valuable tool for public health surveillance in understanding the trends and spread of respiratory viruses. 


Boehm, A. B., Hughes, B., Duong, D., Chan-Herur, V., Buchman, A., Wolfe, M. K., & White, B. J. (2023). Wastewater concentrations of human influenza, metapneumovirus, parainfluenza, respiratory syncytial virus, rhinovirus, and seasonal coronavirus nucleic-acids during the COVID-19 pandemic: a surveillance study. The Lancet. Microbe, 4(5), e340–e348. https://doi.org/10.1016/s2666-5247(22)00386-x