From Signal to System: Operationalizing Wastewater-Based Epidemiology for Infectious Disease Surveillance

Wastewater-based epidemiology (WBE) expanded rapidly during the COVID-19 response and demonstrated value as a complementary, population-level surveillance input for infectious diseases. As public health agencies advance long-term data modernization, the focus is on what it takes to operate wastewater surveillance routinely, reliably, consistently, and at scale. These requirements include data quality and method comparability, interoperability with existing public health and healthcare data systems, clear governance and responsible-use practices, coverage limitations in rural/tribal and decentralized sanitation contexts, and financing stability to maintain core operational capacity.

In this session, we will summarize key gaps and policy levers identified in current WBE implementation and translate them into an actionable framework for federal, state, local, and tribal leadership. The session will focus on what is feasible now: standardizing minimum datasets and QA/QC expectations, improving integration into routine surveillance workflows, clarifying roles across public health agencies, utilities, and laboratories, and identifying implementation considerations for expanding coverage and sustaining capacity. Participants will leave with a structured way to evaluate WBE programs and prioritize next steps aligned with public health data modernization goals.

Learning Objectives

Learning Objective #1

Identify major operational gaps that limit the routine use of wastewater-based epidemiology for infectious disease surveillance.

Learning Objective #2

Describe practical policy levers available to federal, state, local, and tribal leadership to improve WBE implementation.

Learning Objective #3

Apply a tiered implementation roadmap to prioritize near-term actions for institutionalizing wastewater data within routine surveillance workflows and aligning it with broader public health data modernization efforts.