The Indian Council of Medical Research (ICMR) is taking a landmark step toward proactive public health protection by expanding its wastewater surveillance programme to 50 cities nationwide. Designed to function as an early warning system for infectious disease outbreaks, the initiative will leverage sewage epidemiology to track over ten high-risk pathogens—including viruses behind COVID-19, polio, avian influenza, and emerging zoonotic infections—before they overwhelm local healthcare systems.
Key Highlights: Why Wastewater Surveillance Matters
Wastewater surveillance, also known as Wastewater-Based Epidemiology (WBE), collects and analyzes sewage samples for fragments of viruses and bacteria shed by infected individuals, including those who are asymptomatic or not seeking treatment.
It offers a panoramic, real-time snapshot of community health, detecting surges in viral or bacterial load weeks before clinical cases soar in hospitals.
The expanded initiative aims to detect outbreaks of illnesses such as fever, acute encephalitis syndrome, diarrhea, respiratory distress, and zoonotic diseases—crucial for India’s densely populated cities with vulnerable health infrastructure.
Scaling Up—From Pilot to National Program
After successful pilots in five cities, where SARS-CoV-2 and Polio trends were accurately mapped, ICMR will broaden the scope to 50 urban centers over the next six months.
Surveillance will encompass household, industrial, and agricultural sewage sources, with advanced molecular testing by labs such as the Tata Institute of Genetics and Society, National Centre for Disease Control, and Centre for Cellular and Molecular Biology.
Pathogens monitored will include COVID-19, polio, influenza strains, antimicrobial resistance (AMR), and viruses with pandemic potential—such as avian and zoonotic influenza.
What the Early Warning System Delivers
The core workflow involves regular sample collection at municipal sewage facilities, lab-based genetic analysis, and epidemiological mapping of community infection rates.
Public health authorities can respond rapidly to upsurges in infection trends by launching alerts, targeted vaccination drives, and health interventions—weeks ahead of clinical case surges.
Surveillance includes ongoing monitoring of surface waters in outbreak-prone regions (bird sanctuaries, slaughterhouses), amplifying rapid detection capabilities for animal-origin viruses.
Broader Health and Policy Implications
The public health impact includes more resilient outbreak preparedness, optimized resource allocation, and improved hospital surge planning.
The system covers non-typhoidal salmonella, Entamoeba histolytica, E.coli, Giardia, and drug-resistant bacteria, serving as a ground-level gauge for AMR—the other emerging global health crisis.
Integrating wastewater data with national health portals like Ayushman Bharat Digital Mission could allow for neighborhood-level interventions.
Surveillance extends beyond humans to monitoring zoonotic threats at the animal-human interface, crucial as climate change drives new pathogen emergence.
Challenges and Future Prospects
National rollout requires collaboration among municipal bodies, public health institutes, and technical labs.
Ongoing training, infrastructure development, and public awareness campaigns are needed to sustain accuracy and rapid reporting.
Success could encourage replication in rural areas and other developing nations, positioning India as a global leader in sewage-based outbreak detection.
Conclusion
ICMR’s nationwide wastewater surveillance expansion marks a new era in India’s fight against infectious diseases. By turning ordinary sewage into a strategic early warning tool, scientists and public health officials can detect threats before they spiral into epidemics, safeguard vulnerable populations, and strengthen the nation's overall pandemic resilience.
Sources: CNBC-TV18, Vajiram & Ravi, Health and Me, The Print, Vaid ICS Lucknow
