ENVIRONMENTAL HEALTH
NWSS Centers of Excellence Live Up to Their Name
By Erin Morin , MHS , specialist , Environmental Health
In 2021 , to support nationwide wastewater surveillance capability and capacity , the US Centers for Disease Control and Prevention ’ s ( CDC ’ s ) National Wastewater Surveillance System ( NWSS ) established Wastewater Surveillance Centers of Excellence ( CoE ) at the California Department of Public Health , Colorado Department of Public Health and the Environment , Houston Health Department and Wisconsin State Laboratory of Hygiene .
The four CoEs share common goals including introducing additional targets , improving laboratory processes , enhancing genomic sequencing and collaborating with public health partners for network optimization . Each CoE brings their unique perspective to address these challenges in a way that will best meet their program and NWSS region needs .
Looking Beyond SARS-CoV-2
All four CoEs are working to include additional targets beyond SARS-CoV-2 to expand the current range and utility of wastewater surveillance . Targets range from respiratory diseases such as influenzas A ( including H5N1 ) and B , RSV and Enterovirus Disease 68 ( EV-D68 ), to other vaccine-preventable diseases , fungal and enteric pathogens , multi-drug- , antimicrobial- and carbapenem-resistant genes , and vectorborne diseases ( Table 1 ).
Improving Laboratory Processes
Wisconsin is leading an all-CoE collaborative effort to develop a best practice guide for additional target validation . Colorado is working to increase protocol efficiency by determining which pathogens can be multiplexed and which are best tested seasonally versus year-round . Houston is developing new multiplexed assays ( e . g ., COVID-19 , influenza and RSV ) to continue increasing testing coverage and efficiency . They are also comparing detection levels and consistency between facility-level and wastewater treatment plant sampling sites to better understand wastewater surveillance data across different testing scales . California continues to develop assays and work with disease programs and subject matter experts to pilot new pathogen targets . Wisconsin is developing a laboratory performance assessment program that will help ensure analytical consistency across all NWSS jurisdictions .
Enhancing Genomic Sequencing
All four CoEs plan to provide sequencing guidance due to considerable differences in clinical and wastewater sample type and preparation . California is developing a sequencing center to scale up testing , while Colorado continues to be a resource for laboratories navigating wastewater sequencing . Houston is working on laboratory sequencing validation , has developed a computational pipeline to improve and automate tiled amplicon primer design to increase target specificity , and has multiplexed sequencing of several pathogens . Wisconsin is optimizing concentration and extraction methods to achieve the highest quality and concentration of a sample ’ s genetic material . This will enable successful sequencing of
Additional CoE Wastewater Surveillance Targets
Target Respiratory ( R ) and / or Vaccine-preventable ( VP ) Diseases
CoE
Enterovirus Disease 68 ( EV-D68 ) ( R , VP ) California , Colorado , Wisconsin
Hepatitis A ( VP ) Influenza A ( including H5N1 ) ( R , VP ) Influenza B ( R , VP ) Measles-Mumps-Rubella ( MMR ) ( R , VP ) Mpox ( VP ) Respiratory Syncytial Virus ( RSV ) ( R , VP )
Candida auris
Norovirus Rotavirus Salmonella Shiga Toxin-Producing E . Coli ( STEC )
Dengue West Nile Virus Zika Virus
Fungal Pathogen
Enteric Pathogens
Vector-borne Diseases
Multi-drug- , Antimicrobial- and Carbapenem-resistant Genes
Table 1 .
All Colorado , Houston , Wisconsin Colorado , Houston , Wisconsin All All Colorado , Houston , Wisconsin
All
All All All All
California , Colorado , Houston California , Colorado , Houston California , Colorado , Houston Houston , Wisconsin
22 LAB MATTERS Fall 2024
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