Abstract:
Wastewater surveillance has long been used to aid the global public health effort to eradicate poliovirus. More recently, wastewater surveillance has been implemented to help understand the SARS-CoV-2 pandemic. Shortly after it was discovered to be shed in stools, the virus was detected in sewage around the world. While there is no evidence of SARS-CoV-2 transmission through contact with feces or sewage, wastewater surveillance has helped the public health response. It has been used to study trends, emergence into a community, and the specific variants spreading. The rapid expansion of wastewater surveillance for SARS-CoV-2 has led to numerous calls to include additional targets such as influenza viruses and antimicrobial-resistant bacteria. Antimicrobial resistance is of added concern because it is not well known how the SARS-CoV-2 pandemic itself contributed to rising resistance. The wastewater surveillance methods being used for SARS-CoV-2 and antimicrobial resistance are not well characterized for these targets because they were developed for enteric pathogens. Additionally, there are no standardized data reporting formats to provide those results to public health officials. This has resulted in confusion about how to do wastewater surveillance and what results from those projects mean in the larger context of public health. This dissertation aims to validate and optimize wastewater surveillance methods for SARS-CoV-2 and antimicrobial resistance. While not all methods will work for all targets, the methods laid out in this project can help validate protocols for additional pathogens.