ArticleBMC infectious diseases2026
Designing effective SARS-CoV-2 wastewater surveillance system: lessons learnt from sustained monitoring in Delhi, India.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Wastewater based surveillance (WBS) is an effective tool for monitoring community-level transmission of SARS-CoV-2, particularly where clinical testing is limited. We report results from long-term wastewater surveillance study (2.25 years, November 2021-February 2024) in India. Sample collection sites included sewage pumping station and open drains across Delhi. Weekly grab wastewater samples were analysed for SARS-CoV-2 RNA using quantitative RT-PCR targeting N1, N2, and E genes. Time-lag study was performed to evaluate wastewater viral titres as early warning indicators of clinical case trends. Assay sensitivity and site-specific viral titre patterns across different drainage systems were statistically analysed. Of the 819 samples analysed, 488 tested positive for SARS-CoV-2 RNA for at least one target gene, corresponding to an overall positivity rate of 59.58%. SARS-CoV-2 RNA titres ranged from 1.83 to 1.19 × 106 genome copies/L (g.c./L) for N1, 1.46 to 1.51 × 106 g.c./L for N2, and 3.29 × 103 to 2.24 × 106 g.c./L for the E gene across sites. Time lag analysis showed peak correlations at a one-week lead in January 2022 (N1: r = 0.867, p = 0.002; N2: r = 0.830, p = 0.004) and two-week lead in April 2023 (N1: r = 0.879, p = 0.001). Paired Ct analysis revealed lower mean Ct values for N2 (38.51) than N1 (39.01; p = 0.0013). The sewage pumping station consistently exhibited higher viral titres than open drains (1.7–3.2-fold for N1 and 1.7–3.9-fold for N2). In conclusion, WBS provides a sensitive, population-level early warning system for tracking SARS-CoV-2 transmission dynamics and strengthening routine public health surveillance.
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