Professor Raina MacIntyre, head of the Biosecurity Program at the Kirby Institute at UNSW Sydney, has written an editorial in Nature Medicine to accompany a paper on a global airport wastewater surveillance system.
Wastewater surveillance is a tool used for early warning of infectious diseases. People with certain infections (including COVID-19) can shed parts of the virus when they use the toilet. By testing untreated wastewater before it is processed, public health officials can monitor the spread of a virus within a community and take timely action. However, wastewater surveillance is localised, and no global system exists.
Professor MacIntyre’s editorial, titled ‘Thinking globally for pandemic early warning systems’, comments on a modelling study conducted by St-Onge et al, which modelled a global wastewater system using three busy international airports from each of the six World Health Organization (WHO) regions, plus two extra sites in South America and Oceania.
The study found that networks of 10 to 20 wastewater sentinel sites can provide timely awareness and significantly shorten the detection time for emerging pathogens.
One key advantage of using aircraft wastewater is that it is entirely of human origin, whereas community wastewater may contain contaminated items in the food supply or waste stream from animals.
Professor MacIntyre highlights the benefits of a global aircraft-based wastewater surveillance network, but emphasises the most effective early warning system would integrate multiple approaches. She points out that the logistical and political sensitivities of setting up a global system would be challenging. EPIWATCH, developed at UNSW and The Kirby Institute is an AI early warning system that overcomes such obstacles and could provide targeted sites of wastewater testing.
“Early detection provides the best prospect of eliminating or containing an emerging serious epidemic,” she writes. “The ideal early warning system would be global and would use a combination of early warning methodologies, including real-time open-source intelligence (OSINT), a global network of WWS networks and sentinel clinical syndromic surveillance with rapid point-of-care diagnostics.”
Read the full piece here.