Development of an online portal for wastewater-based surveillance of multiple pathogens: A WastPan Study

Abstract

Microbes represent a significant disease burden and can cause widespread pandemics resulting in substantial challenges to public health and economic losses. Traditionally, Finland's epidemic surveillance has been based on hospital diagnoses and their reporting to the National Infectious Diseases Register. During the SARS-CoV-2 pandemic, wastewater-based surveillance (WBS) emerged as a cost-effective method in Finland and globally, offering surveillance data without requiring clinical diagnoses and complementing individual testing data. The widespread adoption of WBS for SARS-CoV-2 stimulated the development of interactive dashboards and online resources, facilitating data sharing and trend analysis by public health officials. However, most dashboards were developed to communicate only SARS-CoV-2 data. The WastPan project developed a microbial surveillance system to monitor multiple pathogens in Finland, covering 40% of the population. From February 2021 to February 2023, ten wastewater treatments plants, supported by three laboratories, monitored 32 selected pathogens including, among others, antibiotic-resistant bacteria, the influenza A virus and the respiratory syncytial virus (RSV). In this article we introduce the WastPan project's wastewater surveillance portal for monitoring multiple pathogens. We also discuss the challenges and different aspects of WBS portal development. Based on our portal development process and experiences in WBS, we conclude that online portals are important for pandemic preparedness and to enhance awareness, engage stakeholders, and provide insights into infectious disease surveillance of multiple pathogens. Going forward, we suggest harmonizing data collection and developing standards in the field of wastewater surveillance.