Wastewater Monitoring Could Help in Early Prediction of Influenza Outbreaks

Seasonal influenza often spreads rapidly, and timely data can help policymakers and the health care system make the right decisions on matters like resource planning. A new study conducted in Japan suggests that monitoring wastewater could be a helpful way of learning in advance how influenza outbreaks are likely to manifest a week before data on patients affected flag outbreak trends.

The study, conducted by an Osaka University-based team led by Prof. Michio Murakami, found that measuring the viral RNA of the influenza virus in wastewater can help teams to accurately estimate the incidence of influenza in communities.

Such estimates using wastewater monitoring can be obtained approximately one week before the usual picture obtained after analyzing data collected from patients that have presented with the infection. This head start can be crucial in enabling the health care system to allocate hospital beds, mobilize staff and conduct other necessary proactive measures in anticipation of an evolving outbreak so that the system isn’t overwhelmed.

For their study, the researchers analyzed wastewater samples obtained on a weekly basis from a trio of treatment plants for wastewater in Osaka Prefecture. The samples covered the period from April 2024 to April 2025. The team quantified the volume of influenza A viral RNA and influenza B RNA. They then combined their data with existing surveillance data on infectious diseases.

These two datasets were then used to build models that could help in predicting cases of influenza in the community.

The team found that their models were accurate in predicting outbreaks of influenza for the type A and type B varieties. The models were also able to come up with estimations for the trends in influenza infections, but the researchers caution that additional validation is required in cases where subtypes of the A and B influenza outbreaks are involved.

The researchers say the biggest benefit of monitoring wastewater is that it provides advance alerts about influenza outbreaks instead of the health care system waiting to respond to data on outbreaks after lots of patients have been confirmed to have been infected. The models developed only require a day or two to come up with their predictions after samples of wastewater have been obtained.

The team says their approach could also be applied to other infectious diseases, but they want to first concentrate on influenza outbreaks before testing the applicability of their models to other outbreaks.

This modeling approach is especially useful in areas where advanced diagnostic facilities aren’t readily accessible and communities aren’t adequately active in seeking medical care. As companies like Co-Diagnostics Inc. (NASDAQ: CODX) work tirelessly to bring to market more reliable diagnostic tools that can be used in the field, approaches like testing wastewater can help health care systems to take the needed proactive measures to respond to infectious disease outbreaks as they unfold.

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