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2023 | Rural Wastewater Surveillance and Epidemiology

Students in the field

FACULTY SEED GRANT | Global Change Center

Advancing Wastewater Surveillance and Epidemiology in Rural Communities


  • Dr. Alasdair Cohen, Population Health Sciences
  • Dr. Amy Pruden, Civil and Environmental Engineering
  • Dr. Peter Vikesland, Civil and Environmental Engineering
  • Dr. Leigh-Anne Krometis, Biological Systems Engineering

The repeated collection and analysis of sewage or wastewater samples – an approach commonly referred to as wastewater-based surveillance (WBS) - offers a powerful tool for monitoring and understanding community health trends. Starting early in the COVID-19 Pandemic, WBS was used to monitor SARS-CoV-2 (the virus that causes COVID-19) trends, and wastewater-based epidemiology (WBE) was used to estimate associated caseloads – including WBS/WBE research we conducted here at Virginia Tech.

While promising for informing public health decision making and resource allocation, the use of WBS for community health monitoring is challenging. Shedding dynamics vary by pathogen and infected individual characteristics, and wastewater constituents can inhibit the detection of viruses such as SARS-CoV-2. The timing, frequency, and method of sample collection can also impact pathogen detection. Extending WBS to WBE is also challenging, and requires case outcome data at appropriate temporal and spatial resolutions. More broadly, the pandemic-driven increase in WBS has focused almost exclusively on urban and peri-urban areas. Relatively little is known about the application and reliability of WBS in rural communities, where additional challenges for WBS can arise, particularly for smaller and older rural systems.

Building on our collaborative research here at Virginia Tech, as well as other associated research, in the fall of 2022 we initiated a pilot project in a small rural town in southwest Virginia in collaboration with staff at the town’s wastewater treatment plant, the county’s Public Service Authority, and UVA. For this project, we will build on our experience and partnerships to refine our sampling and analysis methods to collect repeated, methodologically consistent, sub-sewershed samples. Results from this study will be shared with staff at the wastewater treatment plant, the Public Service Authority, and the Virginia Department of Health, and are expected to help advance understandings of how to reliably and ethically implement WBS in smaller rural systems.