Helping rural Michigan fight the next pandemic

A collaboration between Central Michigan University researchers and a public health agency could help identify future disease outbreaks in rural communities.

The initiative began as researchers participated in the Centers for Disease Control’s National Wastewater Surveillance System, which was created during the early days of the COVID-19 pandemic.

CMU was one of 20 labs across the state that collected wastewater samples and analyzed them to gauge the presence of the SARS-CoV-2 virus. The higher the virus concentration, the more it indicated community spread.

Positioned to protect rural health

CMU’s team was uniquely positioned during the pandemic to monitor small, rural communities, said Michael Conway, a CMU microbiologist. While other network partners monitored wastewater in large municipalities, CMU was one that collected samples from smaller communities.

An unanswered question was whether samples from small communities could provide usable data. Wastewater monitoring offered significant advantages over data collected from physicians, as it didn’t rely on people seeking health care and offered earlier detection.

During the pandemic, wastewater monitoring provided a warning of disease spread, enabling detection 4-6 days before healthcare providers observed an increase in patients, according to the CDC’s wastewater surveillance webpage.

“It was important from an equity standpoint to know if wastewater monitoring works in small communities,” Conway said.

Data provided by the Central Michigan District Health Department helped make that happen.

Health department data plays a key role

CMDHD provided CMU’s researchers with case data down to the zip code level, Conway said. That made it useful in knowing whether wastewater monitoring data and reported case data produced the same result.

The pandemic wasn’t the first time that wastewater monitoring provided clues into how a virus moved through a population. In the 1940s, scientists used it to monitor the virus that causes polio.

It was also used during the early days of the COVID-19 pandemic when health officials in Italy and France reported elevated levels of SARS-CoV-2 virus in wastewater samples before the first official diagnosis.

It’s the future of wastewater monitoring that is particularly intriguing.

While the CDC started the national wastewater surveillance system for the COVID-19 pandemic, it recognizes its real potential for identifying other diseases, such as influenza, E. coli, norovirus and antibiotic-resistant bacteria and fungi. It can even be used to detect the presence of illegal drugs in wastewater.