Wastewater Surveillance Resource Library
Wastewater surveillance is a rapidly evolving tool that can be used to test for SARS-CoV-2 and other pathogens, serving as an early warning system for local health departments and government officials to identify and respond to public health threats in their communities. This toolkit contains background information on wastewater surveillance, guidance documents, communications materials, examples of dashboards, and more.
NACCHO works closely with the Centers for Disease Control and Prevention (CDC) and local health department partners to develop resources on wastewater surveillance.
- Community of Practice: Fostering Local Wastewater Monitoring Network (FLoW-Net) Community of Practice (February 2025)
- Brief: Lessons Learned from NACCHO’s Wastewater Surveillance Mentorship Program - Local Health Departments Share Best Practices (July 2024)
- Brief: Strengthening Local Capacity for Wastewater Surveillance - How a Mentorship Program Supported Local Health Departments Responding to COVID-19 (April 2023)
- Infographic: Wastewater Surveillance: What's SARS-CoV-2 Got to Do with It? (2021)
- Webinar Recording | Slides: Through COVID-19 and Beyond: The Roles of National & Local Wastewater Surveillance Systems (August 2022)
| Resource Name | Description |
|---|---|
| Strengthening Public Health Surveillance Through Wastewater Testing: An Essential Investment for the COVID-19 Pandemic and Future Health Threats (World Bank Group) | This report explores the value, potential, and challenges of wastewater testing for SARS-CoV-2 in Latin America and the Caribbean, including in areas without a sanitary sewerage system. Providing examples from across the world, the report also outlines what countries should consider in creating a national wastewater surveillance program as part of their broader efforts to control the impacts of COVID-19. |
| Assessing SARS-CoV-2 Virus Levels in Sewage (EPA) | Information from the EPA on monitoring SARS-CoV-2 virus levels in wastewater in a community setting. The webpage has links to the Ohio Department of Health COVID-19 dashboard and a webinar about wastewater monitoring and how to link research and application to meet immediate needs. |
| Developing a Flexible National Wastewater Surveillance System for COVID-19 and Beyond (Environmental Health Perspectives journal) | This paper discusses ways to transform the principles of wastewater surveillance into a tool for epidemic response. The paper provides a summary of lessons learned from a global network of wastewater researchers for effective implementation. |
| National Wastewater Surveillance System (CDC) | The landing page for the National Wastewater Surveillance System (NWSS), developed by CDC to build wastewater surveillance capacity nationwide. |
| A Compendium of U.S. Wastewater Surveillance to Support COVID-19 Public Health Response (EPA) | This document created by the EPA summarizes the existing information on wastewater monitoring programs in the US. This document includes wastewater surveillance case studies from Indiana, Michigan, New Mexico, Ohio, Wyoming, Hampton Roads Sanitation District (Virginia), Houston (Texas), Tempe (Arizona), Clemson University (South Carolina), and University of Arizona (Tucson). |
| SARS-CoV-2 Wastewater Surveillance Testing Guide For Public Health Laboratories | This document from the Association of Public Health Laboratories outlines information for how to establish wastewater testing in public health laboratories. |
| Utility Engagement Toolkit for Health Departments & Labs (Water Environment Federation) | This toolkit provides guidance for health departments and labs to better collaborate with their utility partners to conduct wastewater surveillance. Content in this toolkit covers utility recruitment and retention as well as recommendations for effective communication. |
| New Uses of Wastewater Data on High-Risk Substances: Emerging Drug Detection, Overdose Prediction, and Drug Policy Evaluation (Mathematica) | In this publication, read about how Mathematica partnered with partnered with Biobot Analytics and the nonprofit Washington / Baltimore High Intensity Drug Trafficking Area to conduct a demonstration project in five counties across four states (California, Kentucky, New Jersey, and West Virginia) to see if wastewater data could serve as an important tool in preventing drug overdoses in a community. |
| Lessons Learned from NACCHO's Wastewater Surveillance Mentorship Program (NACCHO) | Read about the 2023 cohort of NACCHO's Wastewater Surveillance, as well as lessons learned and recommendations from both the 2022 and 2023 cohorts of the program. |
| Community-Scale Wastewater Surveillance of Candida auris during an Ongoing Outbreak in Southern Nevada (Environmental Science & Technology) | This 2023 study explores the applicability of wastewater surveillance for monitoring C. auris in a locality. |
| SARS-CoV-2 Wastewater Surveillance Testing Guide for Public Health Laboratories (Association of Public Health Laboratories) | This guide provides information on setting up a public health laboratory for conducting wastewater surveillance for SARS-CoV-2. |
| Houston Wastewater Epidemiology - Schools and Neighborhoods | Houston Health Department is a CDC NWSS Center of Excellence that has launched a pilot program to share alerts with the local school district for viral levels of pathogens detected at school campuses. This webpage shares research and communications materials related to this. |
| Phase 1 Report: Wastewater-based Disease Surveillance for Public Health Action (National Academies of Sciences, Engineering, and Medicine) | NASEM's Phase 1 Consensus Study Report reviews the usefulness of community-level wastewater surveillance during the pandemic and assesses its potential value for control and prevention of infectious diseases beyond COVID-19. Report was commissioned by NACCHO. |
| Phase 2 Report: Community Wastewater-based Infectious Disease Surveillance (National Academies of Sciences, Engineering, and Medicine) | NASEM's Phase 2 Consensus Study Report examines the technical constraints and opportunities to improve wastewater surveillance for the prevention and control of infectious diseases in the U.S. |
| Resource Name | Description |
|---|---|
| Chautauqua County Wastewater Surveillance Press Release | A template of a press release from Chautauqua County detailing wastewater surveillance process and updates.* |
| Monitoring Wastewater to Inform COVID-19 Public Health Response (Healthy Davis Together) | Guidance and sample communications to support the implementation of wastewater monitoring and prevent the spread of the SARS-CoV-2 virus. |
| "Poop Don't Lie" Wastewater Surveillance Marketing Campaign (Santa Clara County Public Health) | View an example of how Santa Clara County Public Health developed a marketing campaign to engage their local community in wastewater surveillance. This campaign won California Water Environment Association's Program of the Year Award. |
| Resource Name | Description |
|---|---|
| Chautauqua County SARS-CoV-2 Wastewater Analysis Dashboard | ArcGIS dashboard for wastewater surveillance updates. |
| SARS-CoV-2 RNA Levels in Wastewater in the United States (CDC) | Maps, charts, and data representing all wastewater data submitted by health departments to CDC's National Wastewater Surveillance System's DCIPHER platform in efforts to identify, prevent, and control the spread of COVID-19. |
| City of Tempe Wastewater Dashboard | In an effort to prevent and reduce the spread of COVID-19, the City of Tempe and Arizona State University have worked on creating a dashboard that displays emerging research about the "COVID-19 gene copies per liter" measured within collection areas throughout the city. |
| California Wastewater Surveillance Network Dashboard | California Department of Public Health is a CDC NWSS Center of Excellence. View their statewide dashboard for COVID-19 as an example of data visualization, and explore their other resources, including an FAQ and toolkit. |
| CDC's Respiratory Illnesses Data Channel | CDC's data channel for respiratory virus activity in the United States. The Wastewater Viral Activity Level (WVAL) data for SARS-CoV-2, influenza A and Respiratory Syncytial Virus (RSV) indicate whether the amount of virus in wastewater for specific respiratory illnesses is minimal, low, moderate, high, or very high for a community. |
| Resource Name | Description |
|---|---|
| Fostering Local Wastewater Monitoring Network (FLoW-Net) | NACCHO's Community of Practice engaging local health departments (LHDs) interested in wastewater monitoring, regardless of their experience level. FLoW-Net provides a platform for LHDs to request and offer technical assistance, share resources, and collaborate on addressing existing and emerging public health concerns. NACCHO will host virtual monthly meetings for FLoW-Net members to hear from local jurisdictions and subject-matter experts. |
| APHL Wastewater Surveillance Laboratory Community of Practice | This community of practice is for laboratory scientists to discuss best practices, share questions, and learn from partners on topics related to wastewater surveillance. |
| Water Environment Federation Utilities Community of Practice | The National Wastewater Surveillance System (NWSS) Utilities Community of Practice provides a forum for utilities conducting wastewater surveillance to come together and share best practices and lessons learned. |
| Resource Name | Description |
|---|---|
| Chautauqua County Weekly Wastewater Surveillance Update | An example of a weekly wastewater surveillance report for SARS-CoV-2 in Chautauqua County* |
| Chautauqua COVID-19 Weekly Update | An example of a weekly update document containing the latest COVID case numbers, hospitalizations, vaccination numbers, etc.* |
| Resource Type | Resource Name | Description |
|---|---|---|
| Legislation | Chautauqua Legislature Meeting on Wastewater Surveillance | Video of meeting where Chautauqua Co Legislature passed a resolution allowing wastewater surveillance, featuring voices of opposition and support for the resolution.* |
| Webpage | NYS Wastewater Surveillance Network (New York State Department of Health Wastewater Surveillance Network) | As one of CDC's Centers of Excellence in the National Wastewater Surveillance System, the NYSDOH's Wastewater Surveillance Network webpage includes dashboards, resources and publicly available datasets. |
*Data shown is already available publicly.
Library last updated February 2025.
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