Filenews 14 December 2025 -by Marilena Panayi
Influenza, coronavirus, polioviruses, RSV, and even the monkeypox virus can be detected in urban wastewater, which is, among other things, a surveillance indicator of antimicrobial resistance. The European Centre for Infection Control has issued and published in the past few days a Guide to the Member States that are called upon to implement the new European legislation that came into force at the beginning of the year.
The monitoring and analysis of urban wastewater has been a powerful tool in the hands of national authorities, responsible for public health, during the pandemic and is now being expanded with the aim of early detection of risks and the immediate adoption of the necessary measures to protect citizens.
The European legislation on Urban Wastewater Treatment introduced, for the first time, the obligation of Member States to monitor specific pathogens (viruses/microbes) through wastewater surveillance.
In particular, Member States are required to set up national systems of coordination between public health authorities and waste water management bodies, and to monitor a range of pathogenic micro-organisms considered to be dangerous to public health. Among them are SARS-CoV-2, polioviruses, influenza viruses, as well as antimicrobial resistance (AMR) markers.
In addition to these compulsory fields, Member States have the possibility to extend, on a voluntary basis, the range of infectious diseases that they consider appropriate to monitor through waste water, taking into account the public health needs and the specificities of their own population. Thus, the selection of additional microorganisms, viruses, such as respiratory viruses can be included in the national programs, if they are considered to be national surveillance priorities.
Internationally, however, it has been proven that technically, viruses such as RSV, parainfluenza, rhinoviruses and even the monkeypox virus (MPXV) can be detected in wastewater.
After all, some states have already adopted relevant techniques. For example, the Netherlands and the United States have implemented systems to detect the monkeypox virus, which has been detected and sewage from Rome airport is also recorded as an example of early detection.
At the same time, international studies confirm that wastewater surveillance can be used to detect new strains or mutations of the influenza and avian influenza viruses.
With regard to the now mandatory monitoring of AMR through urban waste water, the European guideline provides that Member States must collect data in order to form a single picture of the dimension of antimicrobial resistance throughout the environment and not only in humans or inpatient care.
Wastewater analysis, the ECDC points out, "can act both as an early warning mechanism and as a tool for monitoring epidemiological trends, filling gaps that clinical examinations cannot always fill."
What each Member State should do from now on for wastewater surveillance – The complete roadmap
The Guidelines issued by the ECDC set out the actions that Member States must take to ensure proper monitoring of waste water.
In particular, each country must establish a formal framework for cooperation between the agencies involved and national authorities. The second stage includes the selection of infectious diseases to be monitored, in addition to the mandatory ones.
The obligation concerns SARS-CoV-2, Poliovirus, influenza A and B and antimicrobial resistance indicators. Optionally, each Member State can include RSV, meta-pneumonia and rhinoviruses in its own system.
Until now, the monkeypox virus and new variants of SARS-CoV-2 are being monitored in the Netherlands and Italy.
Monitoring can be carried out in specific places, which are called "national sampling points", for example in cities or medium-sized communities, but also in "targeted points", such as nursing homes, universities, hospitals, schools, accommodation facilities, prisons, etc. Airports, ports and the monitoring of wastewater from planes and ships are proposed as other possible sampling points.
The data collected by each member state must be available in digital form as the ECDC activates the "EpiPulse" platform as a central hub for the submission of wastewater monitoring data.
