Retrospective Surveillance of Wastewater To Examine Seasonal Dynamics of Enterovirus Infections

Enterovirus infections are often not tracked or reported to health officials. This makes it hard to know how many people in a community are infected with these viruses at any given time. Here, we explored enterovirus in municipal wastewater to look at this issue. We show that enteroviruses are present year-round in municipal wastewater at levels of up to 800,000 genomic copies per liter. We estimate that, on average, 2.8% of the people contributing to the wastewater shed enterovirus daily. Sequence analysis of the viral capsid protein 4 gene shows that 8 enterovirus types are key drivers of seasonal trends. Populations ofEnterovirus Amembers peak in the spring, whileEnterovirus Btypes are most prevalent during the summer and fall months andEnterovirus Cmembers influence the winter months.Enterovirus Dwas observed sporadically and did not influence seasonal trends.