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Epidemic potentialWATER · Water MicrobiologyWWRESPPathogen-agnostic pack

Wastewater respiratory signal

Wastewater SARS-CoV-2 / influenza

Last reviewed 2026-08-13

Public health significance

A community signal, not a patient result. Used correctly, it moves a bureau chief a week earlier.

Specimen types

Influent wastewater

Method

NAA on wastewater concentrate

CLIA / validation

If results are not patient-level, say so on every page. Method validation still applies.

Interpretation

Detected / Not detected or quantified viral load with UCUM. Never attach a patient identifier.

Reflex / referral

None clinical. Epidemiology may raise clinical testing in the sewershed.

Quality control

Recovery controls and inhibition checks. Trend against a baseline, not a single point.

Reportability

Usually not patient-level ELR. Publish as a surveillance product.

HL7 / ELR

Do not send wastewater as a clinical ORU^R01. Use a surveillance feed.

Sources

CDC NWSS; state wastewater programs.