Flush with data: harnessing emergency department wastewater as an innovative approach for surveillance of infectious diseases

Abstract Wastewater surveillance was widely adopted during the COVID-19 pandemic, where it proved useful in providing timely, actionable public health information. However, reliance on data from large wastewater treatment plants can be inadequate when rapid, local insights are needed. In this article, we propose integrating routine wastewater surveillance for transmissible infectious diseases within United States emergency department settings. Monitoring wastewater from the emergency department is a promising innovation which could allow for more rapid generation of actionable data, deepen our understanding of community-level infectious disease burden, and better inform public health efforts.