Dissertations & Theses (Open Access)

Date of Award


Degree Name

Master of Public Health (MPH)


Kristina D. Mena

Second Advisor

Baojiang Chen


Wastewater is an underutilized resource for recognizing the epidemiology of pathogen transmission and infections within a community that has the potential to mitigate disease outbreaks. Pathogens of public health concern, such as adenovirus, norovirus, and SARS-CoV-2, occur in wastewater from excretion of infected individuals. Despite the potential for wastewater pathogen data to predict future outbreaks, the relationship between viral shedding patterns in wastewater and case counts of infectious disease remains unclear. An evaluation of the peer-reviewed literature was conducted to compile characteristics of adenovirus, norovirus, and SARS-CoV-2 in the wastewater environment. These characteristics were considered in prioritizing the key pathogens for wastewater monitoring programs. SARS-CoV-2 is recommended to have the highest priority due to the recent pandemic, in addition to high caseload, shedding volumes, and contagiousness. Adenovirus receives the next highest priority because the positive PCR detections have been increasing (indicating there may be an increase in cases), the large case burden, and pathogen hardiness in wastewater. Norovirus receives the final ranking of the three but should still be a priority due to high caseload, shedding volume, and contagiousness. Wastewater-based epidemiology is gaining recognition as a substantial sector of epidemiology and public health research. This work provides a criteria platform to inform future quantitative microbial risk assessments that will build a framework for interpreting wastewater pathogen monitoring data. This framework will aid community leaders in public health decision-making based on the occurrence of specific pathogens detected in sewage.

Available for download on Wednesday, July 03, 2024