Wastewater monitoring can provide insights into respiratory
disease
occurrence in communities that contribute to the wastewater system.
Using daily measurements of RNA of influenza A (IAV), respiratory
syncytial virus (RSV), and human metapneumovirus (HMPV), as well as
SARS-CoV-2 in wastewater solids from eight publicly owned treatment
works in the Greater San Francisco Bay Area of California between
July 2022 and early July 2023, we identify a “tripledemic”
when concentrations of IAV, RSV, and SARS-CoV-2 peaked at approximately
the same time. HMPV was also widely circulating. We designed novel
hydrolysis probe RT-PCR assays for different IAV subtype markers to
discern that the dominant circulating IAV subtype was H3N2. We show
that wastewater data can be used to identify the onset and offset
of wastewater disease occurrence events. This information can provide
insight into disease epidemiology and timely, localized information
to inform hospital staffing and clinical decision making to respond
to circulating viruses. Whereas RSV and IAV wastewater events were
mostly regionally coherent, HMPV events displayed localized occurrence
patterns.
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