Wastewater is an incredibly rich, anonymized and comprehensive source of information and enables comprehensive monitoring of public health. It includes the analysis of the connected wastewater treatment plant and the associated sewer network.
All pathogens, including SARS-CoV-2, are excreted in stool and are detectable in wastewater even in very small quantities. The wastewater therefore reflects the entire population and not just people who show symptoms and/or have been tested. There are no more unreported cases. Data collection takes place without interfering with fundamental rights, is more realistic as it covers everyone and is faster as data is not only collected when parts of the population show symptoms.
Wastewater monitoring is also significantly cheaper than individual person-based testing using rapid tests or PCR.
Drug Use
One of the first cross-city applications of ABE is the measurement of drug consumption. Studies on legal (nicotine, alcohol) and illegal substances are carried out worldwide. HERE you can find out more. The data collected is used to understand where to target public health interventions or to assist law enforcement agencies in tracking down drug production sites.
Drug Concentrations
Another application of ABE is the measurement of drug concentrations in wastewater. The data is used for various purposes, including as an indicator of the spread of diseases. For example, the prevalence of gout has been estimated by measuring oxypurinol in wastewater, a metabolite of allopurinol (a treatment for gout) in urine. A similar approach was used to estimate the prevalence of type II diabetes by measuring metformin, a commonly used therapeutic agent for this disease, in wastewater.
Antibiotic Resistance
The spread of antibiotic resistance poses a significant global health threat. Antibiotic-resistant germs enter the environment mainly via wastewater. Testing wastewater for the presence and diversity of antimicrobial resistance genes for various drugs could provide information on where and to what extent resistant bacteria pose a threat to the population.
Chemical Substances
The population may be exposed to various chemical substances (pesticides, surfactants, etc.) through food, water, air or direct contact with household or personal care products. ABE can also provide information on exposure in order to take targeted measures to identify sources and reduce exposure.
Dashboard Wastewater-based Epidemiology
The ABE dashboard developed by vermicon AG for the evaluation of wastewater-based epidemiological measurements clearly displays all essential information. It is part of the VIT® Vision software, which already supports and considerably simplifies the microbiological wastewater monitoring of a large number of wastewater treatment plants in Germany. The software is continuously being developed and adapted to new parameters.
Interested in the corona early warning system from vermicon AG and HPC AG? Find out more here
Our Statement
"The world's population is growing explosively. While four billion people inhabited the blue planet in the 1970s, by 2023 there will already be eight. This means that the global population has doubled in just over 40 years. The number of bacterial and viral infections has also increased. This is only natural, because as more people live together, increasingly in mega cities, and travel around the world, the exchange of viruses and bacteria also increases.
However, humans have a weapon that has been tried and tested for hundreds of thousands of years: their immune system. In the vast majority of cases, this enables us to adapt independently to a pathogen and fight it successfully.
The task of modern health management must be to follow these developments and provide the best possible support. The focus must be on the natural support of the immune system in the form of exercise and nutrition. These are priorities that have faded into the background in our "I must have everything immediately" society. The task of the state is to create opportunities for people to get enough exercise and fresh air despite industrialization. Green islands in the cities, easier access to sports facilities, incentives for exercise, education - the state can and should provide all of this.
It is also the task of the state to ensure that as few toxins as possible end up in our food. Effective food monitoring is just as much a part of this as a ban on certain chemical additives. However, it is not the task of the state to "force-feed" people. The final decision on whether to exercise or what to eat must remain with the individual.
We therefore see wastewater-based epidemiology as a great opportunity for the state to take a back seat and still provide society with the best possible support. The measures already in place today for efficient health monitoring, such as surveys or sentinel surveillance, can be significantly strengthened or even replaced by a wastewater-based epidemiological system. Ideally, monitoring should take place in the background, without burdening the population and without interfering with fundamental rights.
As microbiologists, we see a wastewater-based epidemiological system as a real opportunity to help steer society's health in the right direction. A wastewater monitoring system running in the background provides important data on the health status of the population and, if used correctly, can have a positive impact. It is important to move away from the idea that the state must actively intervene in the personal rights of individuals. Instead, it should act as an "enabler", as an institution that enables society to achieve optimum health. This can be achieved through education, but also through the provision of appropriate resources. However, the individual must implement this themselves. This calls for personal responsibility. The state must not become too present and should serve the people - in accordance with the electoral mandate - and not command them.
The beauty of a wastewater-based epidemiological system is the ability to observe several parameters, as only then can the full strength of such a system become visible and complex correlations can be recognized. Many European countries have already implemented this.
We therefore support the introduction of nationwide wastewater monitoring throughout Germany. A complete analysis of the most important health trends enables the best possible preventive health care. In addition, we recommend dispensing with personal rapid tests - for whatever pathogens. The costs incurred by this type of testing are enormous and the environmental pollution is considerable. Sustainability looks different! If a disease is suspected, as in previous decades, a doctor should be consulted and contact with other people should be restricted as a matter of course. An additional self-test was not necessary in the past and is not necessary today. Media scaremongering is a bad advisor.
We see it as our job as microbiologists to provide the necessary information in a factual and scientifically sound manner to enable each individual to make the best possible decision to maintain their health.
Because ultimately, personal responsibility is the measure of all things when it comes to maintaining individual health."
Dr. Jiri Snaidr, CEO and founder, vermicon AG
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