COVER SERIES | Wastewater
The CDC’s Wastewater Monitoring Program
How wastewater testing can help communities stop the spread of infectious diseases.
Amy Cash Hyde | Pumps & Systems
| IMAGE 1: A map of sites participating in the CDC’s Wastewater Monitoring Program (Images courtesy of the CDC)
In September 2020, the U.S. Centers for Disease Control and Prevention (CDC) created the Wastewater Monitoring Program to track the spread of COVID-19 through wastewater testing. In 2026, the program, also known as the National Wastewater Surveillance System (NWSS), has grown, covering more sites and infectious diseases. The list of diseases tracked includes:
- Influenza A
- COVID-19
- Respiratory Syncytial Virus (RSV)
- Measles
- Monkeypox
- A(H5) Bird Flu
The program was created in hopes of alerting public agencies to outbreak trends and to focus prevention efforts in areas where the disease was surging. The program’s goal mission according to the CDC website:
“CDC’s Wastewater Program monitors infectious diseases by analyzing wastewater (sewage) from communities across the United States, providing timely, population-level data that can complement other public health information. Because wastewater monitoring can detect changes in disease trends before clinical cases are reported, it serves as an important early warning system that supports faster, data-driven decisions. These insights can be used to guide prevention and response strategies, helping policymakers and public health officials better protect communities.”
The data collected includes information from WastewaterSCAN—a partnership between Stanford University, Emory University and Verity—and state and local health departments. This data is pulled from samples of liquid influent wastewater or settled solids taken from primary clarifiers over a series of several hours. The samples then move through the preanalytical steps, such as dewatering, before moving to nucleic acid extraction and digital droplet polymerase chain reaction (ddPCR) analysis, a technique that amplifies small segments of DNA and allows researchers to note gene changes.
For the full methodology, as well as how to interpret the program’s heat maps and sequencing charts, visit data.wastewaterscan.org/about/#18.
| IMAGE 2: Wastewater-informed public health actions
| IMAGE 4: Wastewater viral activity level categories
| IMAGE 3: Wastewater monitoring fast facts
| IMAGE 5: An example of a data snapshot that gives users a quick look at the current status of respiratory illnesses during a specific time frame
Six years in, the program is making a difference. The CDC highlighted case studies from Colorado, Houston, Los Angeles County, New Mexico and West Virginia, where wastewater testing aided in public health action. In some cases, a virus was identified up to a month before the first clinical case was reported, giving facilities time to prepare for patient care, raise awareness for how to prevent the illness from spreading and increase vaccine ability in the area. There’s hope that the program will expand beyond government agencies to give individual community members actionable steps to ensure the health of those in their household. According to the CDC, “95% of adults surveyed said they would take steps to protect their health if they saw high wastewater viral activity levels in their community.”
Want to know more about the tracking happening in your community? Contact your state or local health department, and visit cdc.gov to see current numbers in your state.
References
- B. Boehm, M. K. Wolfe, A. L. Bidwell, A. Zulli, B. J. White, B. Shelden, D. Duong. Pathogen nucleic acids data in wastewater solids from 147 treatment plants in the United States: 2024-2025. Data in Brief, 2026.
- cdc.gov/wastewater/media/pdfs/2026/03/cdc_wastewater_surveillance.pdf
- data.wastewaterscan.org/about/#18
Amy Cash Hyde is the editor-in-chief of Pumps & Systems media. She may be reached at ahyde@cahabamedia.com.
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