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Volume 32, Supplement –Summer 2026

SUPPLEMENT ISSUE
Other

Progress and Expansion of the National Wastewater Surveillance System, United States, 2020–2024

Miguella Mark-Carew1Comments to Author , Megan Bias1, Stacie Reckling, Kaniz Madhobi, Daniel Cornforth, Igor Volkov, Andrew L. Rainey, Benjamin Lorentz, Kaitlin R. Taibl, Lisa P. Oakley, Rachel West, Rory Welsh, Jeffrey W. Mercante, Niketta Womack, Nicole Fehrenbach, and Jonathan Yoder
Author affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (M. Mark-Carew, M. Bias, K. Madhobi, D. Cornforth, A.L. Rainey, K.R. Taibl, L.P. Oakley, R. West, R. Welsh, J.W. Mercante, N. Womack, N. Fehrenbach, J. Yoder); Chenega Corporation, Anchorage, Alaska, USA (S. Reckling, I. Volkov); Goldbelt Professional Services LLC, Chesapeake, Virginia, USA (B. Lorentz)

Main Article

Table 2

Characteristics of samples submitted to the National Wastewater Surveillance System, United States, 2023, 2024, and 2020–2024*

Samples 2023 2024 2020–2024
Total no. samples tested† 155,165 148,023 456,594
Time from sample collection to testing, d, median (IQR) 3 (1–4) 2 (1–4) 2 (1–4)
Time from sample collection to reporting to 1CDP, d, median (IQR) 7 (5–14) 7 (4–10) 8 (5–22)
Time from sample testing to reporting to 1CDP, d, median (IQR)
4 (2–9)
4 (1–7)
5 (2–17)
Sample collection method, no. (%)‡
Grab 20,170 (13) 20,073 (14) 58,553 (13)
Manual composite 2,382 (2) 926 (<1) 6,106 (1)
Flow-weighted composite 58,552 (38) 57,404 (39) 189,379 (41)
Time-weighted composite 73,031 (47) 68,635 (46) 200,086 (44)
Passive
1,030 (<1)
984 (<1)
2,462 (<1)
Sample type, no. (%)
Untreated wastewater 116,347 (75) 104,958 (71) 353,935 (78)
Wastewater post–grit removal 30,286 (20) 34,702 (23) 78,122 (17)
Primary effluent 189 (<1) 186 (<1) 465 (<1)
Primary sludge
8,343 (5)
8,177 (6)
24,072 (5)
Sample management, no. (%)§
Local health department 3,614 (2) 2,745 (2) 10,429 (2)
State health department 102,602 (66) 105,578 (71) 331,293 (72)
Commercial contractor 23,692 (15) 13,413 (9) 58,332 (13)
Academic partner program
25,553 (16)
26,287 (18)
56,993 (12)
PCR type, no. (%)
qPCR 51,768 (33) 19,656 (13) 145,494 (32)
dPCR 103,114 (66) 127,891 (86) 310,011 (68)
Multiple PCR types used
283 (<1)
476 (<1)
1,089 (<1)
Endogenous wastewater control, no. (%)
Pepper mild mottle virus 98,542 (64) 96,592 (65) 277,996 (61)
CrAssphage 9,436 (6) 10,049 (7) 30,962 (7)
Other 268 (<1) 201 (<1) 670 (<1)
None
46,919 (30)
41,181 (28)
146,966 (32)
Exogenous wastewater control, no. (%)
Bovine coronavirus 88,511 (57) 109,731 (74) 270,720 (59)
Bovine respiratory syncytial virus 29,865 (19) 4,418 (3) 58,258 (13)
Other 23,011 (15) 21,821 (15) 82,648 (18)
None
13,778 (9)
12,053 (8)
44,968 (10)
No. samples sequenced for SARS-CoV-2 45,824 40,748 114,394

*1CDP, One CDC Data Platform (https://www.cdc.gov/data-modernization/php/one-cdc-data-platform/index.html); dPCR, digital PCR (including droplet digital PCR); IQR, interquartile range; qPCR, quantitative PCR. †Samples were counted based on unique sample identifications; if a sample was tested for multiple targets, the sample was only counted once. ‡Sample collection methods were determined using the most recent collection-method record associated with each sample. Collection method information may be missing for some samples, and a small number of samples were associated with multiple collection methods. §Sample management counts were not mutually exclusive. Samples could be associated with >1 management category.

Main Article

1These first authors contributed equally to this article.

Page created: September 05, 2026
Page updated: September 09, 2026
Page reviewed: September 09, 2026
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