We’re beginning to get our sh*t together… with ‘Sewage Epidemiology.’

from Mark's Children's Book series about loos and no. 2s
Image copyright | Hendriksen & Hopson [illustration from the children’s book ‘It’s all about Poo.’]

Most people are aware of what a healthy poop should look like and how it can signal or warn of potential health problems. Taking a look at your daily motion is stage one, then if necessary, with poo samples doctors and scientists take that a stage further by providing detailed analysis of our health and wellbeing. But, until now, few of us had known that our collective poop can show a lot about the health of a community and in doing so help track and trace the likes of coronavirus and other diseases. We touched on the subject of testing in sewers a while back – now it’s among the weekly headlines we’ll go deeper into, ‘How sewage analysis can help track, trace and protect against viruses.’

Following on from an article on May 3rd in The Guardian, ‘Sensor taps and no door handles: Covid-19 shows it’s time to rethink public toilets.’ We got in touch with Maria Centracchio to a) to compliment her on her piece and expand on future challenges for public toilets, and b) to mention ‘the onward journey’ from public toilets in regards to another article where, “The Guardian had reported that scientists are researching how sampling our stools could offer a faster and cheaper way to pinpoint where outbreaks of COVID-19 are brewing before scores of people become seriously ill, either by tracking or detecting remnants of the virus in municipal sewage.

No sooner had I posted my reply to Maria when my (Dutch) wife popped into my office to show me where virus tests can be done without testing people directly in this explanatory video from nu.nl in The Netherlands. The accompanying dialogue basically translates as… “Why they are looking at your stool for traces of coronavirus. The coronavirus has been found in our sewers. But why are we specifically diving into our sewage to find it?‘ You can check out the video here. Interestingly, research out of The Netherlands has shown that the virus’ genetic material, or RNA [RNA is one of the three major biological macromolecules that are essential for all known forms of life, along with DNA and proteins] can be detected in wastewater (faecal matter) as much as two weeks before the first diagnosis of a sick patient by a doctor.

However, wastewater testing per sae is nothing new as it has been used for drug testing for some while. This can be seen, for example, in the work of The European Monitoring Centre for Drugs and Drug Addiction. But with COVID-19 the breadth of testing via wastewater has stepped up. An article from Applied and Environmental Microbiology illustrates how much research and potential this type of analysis holds, (provided courtesy of the American Society for Microbiology [ASM] and released back in 2014) ‘Detection of Pathogenic Viruses in Sewage Provided Early Warnings of Hepatitis A Virus and Norovirus Outbreaks.’ In fact it might beggar the question as to why governments appear not to have picked up on this somewhat earlier. Nevertheless, to get under the lid of just how impactful wastewater testing may potentially be, take a look at the media links on BioBotGlobal leaders in wastewater epidemiology, whose mission is to transform wastewater infrastructure into public health observatories, where millions of dollars are being invested to establish just how effective this particular type of test could be.

Sewage epidemiology is now being used around the world, and although The World Health Organisation (WHO) stated that the ‘COVID-19 virus, does not readily spread through sewage and wastewater systems. But like other microbes, non-infectious genetic residues of the virus can remain in wastewater systems in the locations where infected people go to the toilet. Add the work of other major organisations into the mix, such as The Water Research Foundation who held a summit on ‘Environmental Surveillance of COVID-19 Indicators in Sewersheds’ at the end of April. Then also the numerous universities around the world and you get a growing list of researchers in The NetherlandsFranceThe USA and Australia who have been testing sewage for SARS-CoV-2 for over a month now, and generally reported that the rise and fall of their results reflect officially reported local rates of infection with COVID-19.

Another resource is The Toilet Board Coalition, ‘The Toilet Board Coalition has expanded its reach to proactively call for catalysing innovations and new business models that fill the gaps needed to leapfrog to next generation sanitation systems.’ As mentioned above, using sewage to detect viruses like COVID-19 as early as possible is gathering increased interest as the chart below [copyright Toilet Board Coalition] helps to illustrate.

The important point in all this is the more studies that take place, the closer we may be to finding a truly effective way of making the difference we all seek with a new weapon against COVID-19. As part of next week’s post, we’ll look at how human faeces is being used for health, fertilizer, fuel and even ‘sh*tting bricks,’ plus get back up to date on the latest news on loos and no. 2s here at, ‘The Daily Poo!’

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