Development of Responsive, Reliable and Accurate Wastewater Surveillance Diagnostics of Infectious Diseases

2019年冠状病毒病(新冠肺炎)大流行给公共卫生资源带来的压力导致了严重急性呼吸综合征-2病毒废水监测(CoV-2 WWS)的开发和全球应用。CoV-2 WWS倡议在世界各地的成功，以及最近废水流行病学领域的科学进步，使WWS成为一种重要的诊断工具，可以在加拿大和世界范围内进一步推广，以获得更多的健康益处。在这方面，渥太华研究小组对第一民族医疗队、安大略省地方公共卫生单位、安大略省公共卫生局(PHO)和加拿大公共卫生局(PHAC)的合作者和同事进行了调查，以确定对推进WWS感兴趣的疾病。公共卫生单位和机构优先确定了流感病毒(流感)、呼吸道合胞病毒(RSV)和猴痘病毒(MPXV)。因此，渥太华研究小组与安大略省环境、保护和园林部(MECP)、安大略省公共卫生部(PHO)、渥太华市、渥太华公共卫生部(OPH)和约克区(约克区，包括约克区公共卫生部)合作，提议开发针对流感、呼吸道合胞病毒和MPXV的新的、响应迅速、准确、可靠和全面的WWS诊断工具。这项研究将超越开发方法来量化废水中的疾病目标，并将解决WWS中数据可变性的关键问题。具体地说，这项研究致力于推进我们目前对废水中疾病目标划分的了解，发展关于废水基础设施中这些疾病目标命运的新知识，并确定使用适当的生物标记物来标准化数据，以便将在WWS数据集中观察到的可变性降至最低。这项研究将有助于改善加拿大的社区卫生，减轻该国的卫生不平等现象，并将产生该国预防大流行战略所需的响应性诊断工具。

The pressure exerted by the coronavirus disease in 2019 (COVID-19) pandemic on public health resources resulted in the development and global application of severe acute respiratory syndrome-2 virus wastewater surveillance (CoV-2 WWS). The successes of CoV-2 WWS initiatives around the world along with a recent scientific advancement of the field of wastewater-based epidemiology positions WWS as an important diagnostic tool that can be further advanced for additional health benefits across Canada and the world. In this regard, the Ottawa team of researchers surveyed collaborators and colleagues at First Nation medical teams, local public health units in Ontario, Public Health Ontario (PHO), and the Public Health Agency of Canada (PHAC) to identify diseases of interest for the advancement of WWS. The public health units and agencies preferentially identified the influenza virus (Flu), respiratory syncytial virus (RSV) and monkeypox virus (MPXV). As such, the Ottawa research team in partnership with the Ontario Ministry of the Environment, Conservation and Parks (MECP), Public Health Ontario (PHO), City of Ottawa, Ottawa Public Health (OPH) and The Regional Municipality of York (York Region, which includes York Region Public Health) propose to develop new, responsive, accurate, reliable and comprehensive WWS diagnostic tools for Flu, RSV and MPXV. The research will move beyond the development of methods to quantify disease targets in wastewaters and will address the critical issue of data variability in WWS. Specifically, the research endeavours to advance our current knowledge of disease target partitioning in wastewaters, develop new knowledge of the fate of these disease targets in wastewater infrastructure and identify the use of appropriate biomarkers to normalize the data in order to minimize variability observed in WWS data sets. The research will serve to improve community health in Canada, to mitigate health inequities in the country and will produce responsive diagnostic tools necessary for the country's pandemic preparedness strategies.