TKI project: Sewage monitoring on demand to track local outbreaks of infectious diseases

To meet this need, a consortium comprising GGD Amsterdam, GGD Rotterdam-Rijnmond, IMD BV, and NWP member KWR, has developed a system for local on-demand sewage monitoring. This system is straightforward, cost-effective, rapid, and highly flexible, enabling the tracking of trends in COVID-19 and other infectious diseases at a fine spatial scale.

Expanding applications

The consortium has successfully developed and validated a system for on-demand sewage surveillance using passive samplers for SARS-CoV-2. They worked with health and water partners to assess the system’s practical applications and research materials that provide high yield and sensitivity, alternatives to flow measurement, and the detection of new Variants of Concern, such as the Omicron variant. As COVID-19 transitioned from a pandemic to an endemic infection, it was crucial to explore other public health applications for sewage surveillance. Consequently, the project also investigated other infectious diseases.

Providing vital public health information

The project broadens the role of sewage monitoring in the water sector to include supplying vital public health information. By helping to identify infection hotspots, the approach it developed complements the current national sewage surveillance system and offers enhanced actionable insights for the GGD. There is significant international interest in sewage surveillance, and this approach has the potential to set a precedent. Dutch water technology is at the forefront of advances in sewage surveillance.

Bridging the health and water sectors 

The project has fostered a unique collaboration between the health and water sectors. As the research progressed, more GGDs got involved, adding to the number of on-demand cases. The research focus centred on the GGDs' pressing questions about using sewage monitoring as an information system to enhance their work. Their questions included whether contact tracing or quarantine are effective; whether a variant or infectious disease has already spread widely; and how underground sewage data correlates with above-ground patient data. The research also examined the effectiveness of measures taken and whether the SARS-CoV-2 virus might still be circulating undetected, potentially leading to new cases.

Beyond tracking new SARS-CoV-2 variants (including Omicron subtypes), the project demonstrated that the method is also effective for other infectious diseases such as monkeypox, hepatitis A, and mumps.

Ability to respond quickly 

Sewage surveillance is effective at the city and neighbourhood levels and can be even more precise if needed. To achieve this, robust and rapidly deployable knowledge of the sewage system is essential, as is the ability to sample effectively using passive samplers. Various materials were compared to identify the most efficient combination for virus sampling in passive samplers. Multiple qPCR analyses for detecting infectious diseases were successfully developed and tested in the project, demonstrating the ability to respond quickly to new infectious diseases.

The TKI Water Technology Programme

The TKI Water Technology Programme was established to help entrepreneurs and innovators find their way through the Dutch knowledge and innovation landscape. The Programme is tailored to entrepreneurs and innovators who offer solutions for specific challenges in the agriculture, food, and horticulture sectors or operate in the fields of energy and clean water. It provides information about financing opportunities and connects them to knowledge institutes and other SMEs.

As part of the Top Sector Water and Maritime (TSWM), TKI Water Technology is a collaborative initiative between the Netherlands Water Partnership (NWP) and Water Alliance, and is dedicated to advancing innovation and sustainability.

Source: https://www.tkiwatertechnologie.nl/ (in Dutch)