Evaluating biosurveillance approaches

Understanding and comparing different approaches to large-scale disease monitoring

The biosurveillance toolbox

Biosurveillance encompasses a wide array of approaches for detecting new disease outbreaks. Proposed strategies include sampling municipal wastewater, aggregated airplane waste, air filters from planes or HVAC systems, swabs or saliva samples from various human populations, and a wide array of clinical samples that could be repurposed for disease monitoring. All of these approaches have important advantages and disadvantages; for the NAO, the challenge is to identify which are the most sensitive, reliable, and cost-effective from the perspective of pathogen-agnostic early warning.

Municipal versus airplane wastewater

So far, the NAO has primarily focused on metagenomic sequencing of human wastewater as a strategy for pathogen-agnostic threat detection, due to its logistical advantages and established ability to detect a wide variety of human pathogens. We are currently investigating several wastewater-based monitoring approaches, including solid & liquid samples from municipal treatment plants and aggregated lavatory waste from airplanes, to better characterize their properties and suitability for our biosurveillance goals.

A multi-pronged evaluation approach

To obtain a deeper and more quantitative understanding of their relative merits, NAO researchers are using a combination of epidemiological modeling, analysis of existing data, and experimentation to characterize different biosurveillance approaches. By building partnerships with local government agencies, research groups and companies interested in building better disease surveillance, and combining their insights and experience with the NAO’s in-house research, our goal is to build a comprehensive understanding of how to deploy limited resources to achieve the most effective & reliable early warning system.