UK expands sewage monitoring to strengthen outbreak warnings

The UK Health Security Agency is expanding its wastewater surveillance programme to help identify dangerous infectious diseases before they develop into larger outbreaks.

Scientists are developing methods to detect 11 high-priority pathogens in sewage collected from treatment sites across England. The programme includes threats such as Lassa fever, Crimean-Congo haemorrhagic fever and hypervirulent Klebsiella pneumoniae.

Wastewater monitoring allows health officials to identify genetic traces of viruses and bacteria shed by infected people, including those who have not been tested or developed symptoms. Changes in the amount detected can provide an early indication that an infection is spreading within a community.

The work builds on the surveillance systems developed during the Covid-19 pandemic and the UK’s existing polio monitoring network, which covers 28 sewage sampling sites. Wastewater testing helped identify poliovirus in London in 2022, prompting further investigation and public health action.

The programme is supported by £1.3 million from the UK Integrated Security Fund and will assess technologies including genetic sequencing and machine learning. Other diseases being considered include mpox, West Nile virus and Lassa fever.

UKHSA said the approach could offer a cost-effective way to detect known diseases and potentially identify emerging pathogens. The findings would complement clinical testing and other surveillance rather than replace them, helping health services respond more quickly when a threat is detected.

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