A well-characterized understanding of virus shedding can enhance modeling of transmission dynamics and refine models linking measurements in environmental samples to the actual community burden. To date, the development of such models has been hindered by the paucity of quantitative, longitudinal pathogen shedding data in both symptomatic and asymptomatic infections. Furthermore, results from limited family cohort and challenge studies alone do not fully represent the breadth of fecal and urine shedding patterns in communities. High-quality shedding data enables the identification of infection risks and better informs intervention efforts within communities.

Understanding what viruses influence bacteria in water and wastewater systems is essential as these bacteria can make humans sick, degrade water quality, and influence the efficacy of treatment processes. 

Our team is conducting a multi-year cohort study to characterize fecal and urine shedding data across all stages of infection for multiple respiratory viruses throughout the respiratory illness season. We recruit healthy adults to provide stool and urine samples, complete an at-home antigen test for SARS-CoV-2 and Influenza A/B, and self-report influenza-like-illness symptoms. Participants collect these samples weekly through the respiratory illness season. When their rapid test is positive or when they are experiencing influenza-like illness symptoms, they increase sample collection frequency to daily for the duration of their illness. This collection scheme provides well-resolved shedding curves through optimized quantitative methods. Viral concentrations in stool and urine samples are then quantified using multiplexed digital droplet PCR assays.

The data will be used to develop models that translate wastewater-virus concentrations to community prevalence, leveraging concurrent wastewater monitoring data collected for the enrollees’ respective wastewater catchment areas.