The Hydro Nation International Centre (HNIC) commissioned a project to review the utility of wastewater surveillance for detecting and monitoring emerging and re-emerging pathogens and endemic infections, including blood-borne viruses and enteric viruses. Wastewater-based epidemiology (WBE) was successfully used to monitor infectious disease markers at population level, exemplified by SARS-CoV-2, obtaining near real-time population level data. To merit further investment, policy teams need assurance that improved surveillance benefits health protection in Scotland.
The main objective of Scotland’s Wastewater Monitoring Programme Strategic Plan 2025-2028 is to deliver a quality assured WBE program that fulfils the following needs:
- Delivers on the One Health agenda
- Is at the forefront of developments in WBE applied to
public health practice - Contributes to Scotland’s future pandemic preparedness
The project team included the James Hutton Institute and Biomathematics and Statistics Scotland. The project had four specific objectives as follows:
O1. The effectiveness of wastewater surveillance compared to traditional surveillance methods, key factors influencing detection sensitivity and specificity, particularly in environments with multiple pathogens.
O2. The cost-effectiveness of wastewater surveillance compared to traditional surveillance methods (e.g., clinical testing, active case finding).
O3. Ethical/legal considerations.
O4. Gaps in the research, recommendations including additional studies needed to improve global health monitoring.
Objectives were addressed through systematic literature review, evidence synthesis, and engagement of key stakeholders and experts through informal discussion.
The full report and appendices are available online: https://www.hnic.scot/reports