The Wigginton-Eisenberg Laboratory works to provide wastewater testing data on multiple pathogens across south-east Michigan. The grid below provides an at-a-glance vision of the current state of wastewater levels. For more detailed information including graphs of this data over time, please visit each organism under the Pathogens tab. For more information about this system, you can click on the information icons ( ) throughout this dashboard or visit the About Page tab.
The primer set used for Mpox testing changed on 15 August 2024. For more information, please visit the About Page.
To contact us, please email help.um.wastewatermonitoring@umich.edu.
Previously, the team’s data was displayed at the following site: https://umich-wbe.shinyapps.io/sars-cov-2_dash/.
For more information regarding the work done by the team, please visit:
Wastewater Treatment Plant Partners:
Health Departments:
This work is funded by the Michigan Department of Health and Human Services (MDHHS) and the University of Michigan.
This dashboard was created by Julie (Jules) Gilbert.
Wastewater-based epidemiology requires cooperation and coordination between many different groups and people, in order to best balance resources and data timeliness.
Daily solid and influent samples are collected from five different wastewater treatment plants (WWTPs) across southeast Michigan: Ann Arbor, Flint, Jackson, Tecumseh, and Ypsilanti. These samples are delivered to the Wigginton-Eisenberg Laboratory at the University of Michigan twice per week. SARS-CoV-2, Norovirus, and Rotavirus testing is done on the influent samples. These samples undergo a PEG precipitation step to concentrate the targets. RSV, Hepatitis A, Influenza A & B, Mpox, and SARS-CoV-2 testing is done on the solid samples. These samples undergo a total solids determination step. All samples are put through an RNA Extraction and ddPCR step. Following all laboratory work, data undergo quality assurance and control procedures and are uploaded to the dashboard.
Sample Collection & Reporting Schedule
Each day, samples are collected and held at the wastewater treatment plant (WWTP). The courier arrives twice per week, on Mondays and Thursdays (accommodations are made to account for holidays or other interruptions) and takes the samples from the WWTP and brings them to the laboratory at the University of Michigan. In general, wastewater samples from Tuesday and Wednesday arrive in the lab on Thursday, and the results from their testing appears on the dashboard the following evening. Wastewater samples from Friday, Saturday, and Sunday arrive in the lab on Monday, and the results from their testing appears on the dashboard Tuesday evening. Samples that are collected on the day of the courier arrival usually arrive that same day, but occasionally don’t arrive until the next courier day.
Note: This schedule applies primarily to our SARS-CoV-2 Influent testing. Viruses detected in solid samples as well as other organisms detected from influent samples undergo testing in such a way that reporting occurs on Fridays. <Return to Table of Contents>
About the Tertile Level System
Tertile boundaries were calculated on 9/24/2024 using PMMoV-normalized wastewater values. Levels were calculated such that a third of all samples from the selected time period fell into each category. These levels give a general sense of whether the value is high or low relative to values that have been previously detected.
Table 1. Tertile cut-off values for each site, organism, and sample type combination
Site | Organism | n | Start Date | End Date | Low-to-Medium | Medium-to-High |
---|---|---|---|---|---|---|
AA | SOLID, Influenza A | 97 | 11/18/2022 | 6/30/2024 | 3.41970633006921e-05 | 8.95109374545913e-05 |
AA | SOLID, Influenza B | 10 | 2/26/2024 | 5/3/2024 | 2.51993924355136e-05 | 3.83195992031683e-05 |
AA | SOLID, RSV | 93 | 10/28/2022 | 7/21/2024 | 2.7180600542203e-05 | 5.76904679159707e-05 |
FL | SOLID, Influenza A | 70 | 11/24/2022 | ⅚/2024 | 6.75631891068647e-05 | 0.000156308 |
FL | SOLID, Influenza B | 16 | 2/13/2024 | 4/2/2024 | 0.000104767 0.000147767 | |
FL | SOLID, RSV | 26 | 11/1/2022 | 2/14/2024 | 4.67589716360255e-05 | 8.42181368783069e-05 |
JS | SOLID, Influenza A | 87 | 9/28/2022 | 6/16/2024 | 8.09408196190823e-05 | 0.000232853 |
JS | SOLID, nfluenza B | 21 | 1/25/2024 | 5/5/2024 | 0.000105141 | 0.000169936 |
JS | SOLID, RSV | 83 | 11/1/2022 | 5/24/2024 | 6.10846248994842e-05 | 0.000110173 |
TM | SOLID, Influenza A | 49 | 11/18/2022 | 3/16/2024 | 0.00015368 | 0.000450748 |
TM | SOLID, Influenza B | 7 | 3/2/2024 | 3/30/2024 | 0.000140812 | 0.000441055 |
TM | SOLID, RSV | 48 | 10/25/2022 | 3/16/2024 | 0.000131591 | 0.00021786 |
YC | SOLID, Influenza A | 65 | 11/10/2022 | 3/22/2024 | 5.05026887095547e-05 | 0.000106744 |
YC | SOLID, Influenza B | 9 | 2/14/2024 | 3/26/2024 | 3.86427287165522e-05 | 5.46019039935452e-05 |
YC | SOLID, RSV | 66 | 11/2/2022 | 3/15/2024 | 5.39534948583985e-05 | 0.00010649 |
AA | INFLUENT, SARS-CoV-2 N1 | 1051 | 7/9/2021 | 9/18/2024 | 0.000215362 | 0.000474341 |
FL | INFLUENT, SARS-CoV-2 N1 | 868 | 7/16/2021 | 9/18/2024 | 0.000447368 | 0.000943662 |
JS | INFLUENT, SARS-CoV-2 N1 | 921 | 7/12/2021 | 9/17/2024 | 0.000396556 | 0.000975766 |
TM | INFLUENT, SARS-CoV-2 N1 | 924 | 1/13/2022 | 9/19/2024 | 0.000303463 | 0.000721156 |
YC | INFLUENT, SARS-CoV-2 N1 | 1024 | ⅞/2021 | 9/19/2024 | 0.000345348 | 0.000677717 |
AA | INFLUENT, Norovirus G2 | 90 | 11/30/2023 | 9/7/2024 | 0.005203539 | 0.013955794 |
FL | INFLUENT, Norovirus G2 | 68 | 11/27/2023 | 9/8/2024 | 0.00926363 | 0.021897898 |
JS | INFLUENT, Norovirus G2 | 86 | 11/30/2023 | 9/8/2024 | 0.011280445 | 0.036472588 |
TM | INFLUENT, Norovirus G2 | 88 | 12/1/2023 | 9/8/2024 | 0.003060806 | 0.019375112 |
YC | INFLUENT, Norovirus G2 | 77 | 11/26/2023 | 9/8/2024 | 0.008446047 | 0.029814111 |
AA | INFLUENT, Rotavirus | 336 | 4/2/2022 | 9/18/2024 | 0.000319777 | 0.001156051 |
FL | INFLUENT, Rotavirus | 242 | 3/2/2022 | 9/15/2024 | 0.000802782 | 0.003804197 |
JS | INFLUENT, Rotavirus | 311 | 4/1/2022 | 9/17/2024 | 0.001066216 | 0.004597471 |
TM | INFLUENT, Rotavirus | 268 | ⅜/2022 | 9/16/2024 | 0.000330236 | 0.005173907 |
YC | INFLUENT, Rotavirus | 330 | 4/1/2022 | 9/18/2024 | 0.000550329 | 0.002676543 |
Tertile levels set as:
About the Clinical Correlation Level System
Clinical Correlation Levels were defined based on the measured PMMoV-normalized wastewater values and the reported cases or hospitalization data available for the diseases associated with the detected viruses.
As of 11/06/2023, for Influenza A (Solids) and RSV (Solids), if the day’s sample is calculated to be below the limit of quantification, the level is re-set to 1. Values are calculated to be below the limit of quantification if the concentration of either the organism or the PMMoV measurement is below the three-plate rolling average of the Negative controls concentration or the three-plate rolling average of the high error bar for the target concentration of the Negative control wells at a 95% confidence interval, whichever is higher.
Level thresholds for SARS-CoV-2 were calculated based on correlating case rates and normalized wastewater concentration levels in Ann Arbor over the 2021-2022 year. The wastewater concentration levels correspond approximately to case rates as follows:
Level thresholds for Influenza A were calculated based on correlating hospitalization rates and normalized wastewater concentration levels over the 2022-2023 Flu Season. The wastewater concentration levels correspond approximately to hospitalization levels as follows:
Trend variables assist in defining the direction wastewater levels are moving in, whether they are increasing, decreasing, or staying steady. They are best used in consideration alongside the Quartile or Clinical Correlation levels. <Return to Table of Contents>
Modification of the CDC's Incidence Trend
For SARS-CoV-2, “Trend” is a modification of the CDC’s Incidence Trend calculation, which was presented by Matt Lozier (document originally here - retrieved via the Wayback Machine from a web scrape done on 19 November 2022 available here).
If the “Trend” metric falls into “decline”, then a counter begins to count the number of days the metric is in decline. This “Days in Decline” metric uses the derivative of a spline fit to the three sample average of the PMMoV-normalized wastewater data in combination with the Trend category determination in order to decide whether the system is still “in decline”.
This decision to exit a decline is conservative, in order to account for “wobble” (natural variation) within the system and along the decline. It is slow to turn off (it needs 5 sample days of an overall increase, “elevated plateau”, or “elevated growth” in a row to turn off the downward counter) and it doesn’t let the decline stop if the system is still in “low plateau” or the category can’t be determined due to low sampling over the previous 2 weeks. This allows the scenario of a decrease, plateau, and continuation of decrease, which is a scenario which would want to be counted as one long decline.
The trend variable calculation that is presented on the Trends & Comparison page is calculated following the methodology presented by the Sentinel Wastewater Epidemiology Evaluation Project run by the Michigan Department of Health and Human Services.
7-Day Trend = First, the seven day rolling average for the given gene is calculated. Then the seven day average value from 7 days ago is subtracted from the current seven day average. This value is divided by the seven day average from 7 days ago and multiplied by 100.
14-Day Trend = First, the fourteen day rolling average for the given gene is calculated. Then the fourteen day average value from 14 days ago is subtracted from the current fourteen day average. This value is divided by the fourteen day average from 14 days ago and multiplied by 100. <Return to Table of Contents>
Both trend values are categorized as:
Additional Dashboard Calculations
Organism | Limit of Detection |
---|---|
Norovirus | < 4 Positive droplets detected in either PMMoV or Sample merged wells |
Rotavirus | < 4 Positive droplets detected in either PMMoV or Sample merged wells |
For Norovirus** & Rotavirus, outliers (high) are calculated by testing site. Using pmmov-normalized sample values, the 7-sample rolling average is calculated, along with the 7-sample standard deviation. The lower limit and upper limit of accepted “in-range” values are calculated as the 7-sample rolling average +/- (7 * the rolling standard deviation). In data prior to implementing this change, high outliers were removed manually from the dataset based on laboratory decision-making.
** for the old Norovirus GII system
Reported case and hospitalization data for the diseases caused by the viruses we detect in the wastewater are made available as we are able. Displaying this data side by side with our wastewater detection is an important step in understanding the relationship between the two. It is important to consider the spatial aspect of this data, and how it can be different between the wastewater catchment area and the various geography levels that case or hospitalization data is available at.
Case data are from the Michigan Disease Surveillance System (MDSS), the Michigan Department of Health and Human Services’ web based communicable disease reporting system. Cases are attributed to date of illness onset. If illness onset date is unavailable, date of testing is used. If date of testing is unavailable, date of referral to MDSS is used. Date attributions are subject to change over time as better data become available. Both probable and confirmed status cases are available for display. Confirmed cases only include individuals with a positive diagnostic laboratory test for COVID-19. Probable cases include individuals with COVID-19 symptoms and an epidemiological link to a confirmed case or a positive serology test, but do not have a positive diagnostic laboratory test. <Return to Table of Contents>
Cases were assigned to a given wastewater catchment area only if they had associated location data included in their case report. This information for cases is associated with the individual’s residential address, so this does not account for any travel into or out of the catchment area.
COVID-19 case data is presented as a 7-Day Average Number of Cases per Day, per 100,000 Population. If this value for a day is < 10, then the value is not displayed (censored).
Table 3. Estimated Populations of Wastewater Catchment Areas
Wastewater Catchment Area | Estimated Population | Source |
---|---|---|
Ann Arbor | 121093 | ACS 5Y Estimate 2020 - City |
Flint | 95999 | ACS 5Y Estimate 2020 - City |
Jackson | 90000 | State of Michigan SWEEP |
Tecumseh | 8680 | State of Michigan SWEEP |
Ypsilanti | 330000 | State of Michigan SWEEP |
Influenza Hospitalization Data
Influenza hospitalization data is provided by the Michigan Department of Health and Human Services (MDHHS) once per week. Hospitals are assigned to a county based upon their physical location/address. “Percent of Inpatient Beds filled with Influenza Patients” is calculated as the total number of inpatient beds filled with influenza patients divided by the total number of inpatient beds for all hospitals in the reported county each day.
This data does not differentiate between Influenza A and Influenza B infections. To begin to contextualize the current circulating percentages of Influenza A and Influenza B, visit https://www.cdc.gov/flu/weekly/index.htm.
Google Trend information is pulled periodically as a potential correlate of disease occurrence.
This information is presented at a weekly, state-wide level only. The organism specific search terms used are:
Adenovirus “adenovirus”, “adenovirus symptoms”
Hepatitis A “hepatitis a”, “hepatitis a symptoms”
Influenza “flu symptoms”, “influenza”, “flu”, “influenza symptoms”
Mpox “mpox symptoms”, “mpox”, “monkeypox symptoms”, “monkeypox”
Norovirus “norovirus symptoms”, “norovirus”, “stomach flu”, “stomach flu symptoms”
RSV “rsv symptoms”, “rsv”
SARS-CoV-2 “covid”, “covid symptoms”
Rotavirus “rotavirus”, “rotavirus symptoms”
Data regarding RSV hospitalizations is pulled from the CDC’s Data API at https://data.cdc.gov/Case-Surveillance/Weekly-Rates-of-Laboratory-Confirmed-RSV-Hospitali/29hc-w46k. For additional information regarding this data, visit https://www.cdc.gov/rsv/research/rsv-net/index.html
The reported data is collected as part of the Respiratory Syncytial Virus Hospitalization Surveillance Network (RSV-NET) and includes data on both children under the age of 18 and adults. The data presented on our dashboard is for Michigan state-wide, and includes the rate of hospitalization per 100,000 population for the week ending on the date indicated. Data is subject to reporting lags. As data are received each week, prior case counts and rates are updated accordingly. <Return to Table of Contents>
Data regarding test positivity is web-scraped from the table at https://www.cdc.gov/surveillance/nrevss/images/rota/ROT1PP_Reg3.htm. For additional information regarding this data, visit https://www.cdc.gov/surveillance/nrevss/rotavirus/region.html
Participating laboratories report weekly to CDC the total number of rotavirus tests performed that week, and the number of those tests that were positive. The data presented on our dashboard is for the midwest region, which includes Michigan, Ohio, Indiana, Illinois, Wisconsin, Minnesota, Iowa, Missouri, Kansas, Nebraska, South Dakota, and North Dakota. The data presented is the average percent of those tests that were positive from three adjacent weeks: the specified week, and the weeks preceding and following it (centered 3-week moving average). Data is subject to reporting lags. As data are received each week, prior data is updated accordingly.
Flyer-type downloads are available for each of the five wastewater treatment plant catchment areas for SARS-CoV-2 levels. These infographics display a line chart that plots the PMMoV-normalized SARS-CoV-2 Influent N1 measurements and seven-sample rolling average for a five month period. The levels displayed on the infographic are the Clinical Correlations levels for SARS-CoV-2 detection. The date displayed in the upper right-hand corner is the most recent sample date avaiable at the time the infographic was made. The current Clinical Correlation level and Trend is displayed, and the 10 Day projection for what the Clinical Correlation level and Trend will be is also included. The 10 Day projection is determined based on an unweighted linear regression model. The map of the wastewater treatment plant catchment area is also included on the graphic. <Return to Table of Contents>
We use the following methods to extract, concentrate, and quantify SARS-CoV-2 in wastewater.
Influent Methodology from Flood, M. T., D’Souza, N., Rose, J. B., & Aw, T. G. (2021). Methods evaluation for rapid concentration and quantification of SARS-CoV-2 in raw wastewater using droplet digital and quantitative RT-PCR. Food and environmental virology, 13(3), 303-315. (with modifications)
NNorovirus GII and Rotavirus species A are detected using influent samples prepared using the method described above, but with the primers from the following papers.
Further information regarding norovirus GII monitoring is available online: https://doi.org/10.1101/2023.04.10.23288357
Extraction from settled solids is used to detect Adenovirus, Hepatitis A, RSV, Influenza A, Influenza B, and Mpox. The method for sample processing is described in the paper below. Kim, Sooyeol, et al. “SARS-CoV-2 RNA is enriched by orders of magnitude in primary settled solids relative to liquid wastewater at publicly owned treatment works.” Environmental science: water research & technology 8.4 (2022): 757-770.
The primers used for Adenovirus, Influenza A, Influenza B, RSV, Mpox, and Hepatitis A are from the following papers.
Heim, Albert, et al. “Rapid and quantitative detection of human adenovirus DNA by real‐time PCR.” Journal of medical virology 70.2 (2003): 228-239 and mentioned in Lu X, Trujillo-Lopez E, Lott L, Erdman DD.2013.Quantitative Real-Time PCR Assay Panel for Detection and Type-Specific Identification of Epidemic Respiratory Human Adenoviruses. J Clin Microbiol51:.https://doi.org/10.1128/jcm.03297-12
Xagoraraki IKuo DH, Wong K, Wong M, Rose JB.2007.Occurrence of Human Adenoviruses at Two Recreational Beaches of the Great Lakes. Appl Environ Microbiol73:.https://doi.org/10.1128/AEM.01239-0
Influenza A & B: https://www.cdc.gov/coronavirus/2019-ncov/lab/multiplex.html
Wolfe, Marlene K., et al. “Wastewater-based detection of two influenza outbreaks.” Environmental Science & Technology Letters 9.8 (2022): 687-692.
Hughes, Bridgette, et al. “Respiratory syncytial virus (RSV) RNA in wastewater settled solids reflects RSV clinical positivity rates.” Environmental Science & Technology Letters 9.2 (2022): 173-178.
Previous Primers: Wolfe, Marlene K., et al. “Use of Wastewater for Mpox Outbreak Surveillance in California.” New England Journal of Medicine (2023).
Primers as of 15 August 2024 (samples after 19 August 2024): https://www.cdc.gov/poxvirus/mpox/pdf/non-variola-orthopoxvirus-generic-real-time-pcr-test.pdf
Costafreda, M. Isabel, Albert Bosch, and Rosa M. Pintó. “Development, evaluation, and standardization of a real-time TaqMan reverse transcription-PCR assay for quantification of hepatitis A virus in clinical and shellfish samples.” Applied and environmental microbiology 72.6 (2006): 3846-3855.
Solid and influent samples are collected from all five wastewater treatment plant locations. However, each plant has different features in both mechanics and populations served. Influent samples are 24-hour composite samples, and samples are taken from untreated wastewater.
Plant | Area Type | Avg. Flow Rate (in Million Gallons per Day) |
---|---|---|
Ann Arbor | Urban | 18.5 |
Flint | Urban | 17.4 |
Jackson | Urban | 12.79 |
Tecumseh | Rural | 0.7 |
Ypsilanti | Rural | 27 |
About Wastewater Testing - General
Pathogenic microorganisms that infect humans are commonly shed in feces, urine, saliva, and skin. The shed organisms can eventually end up in municipal wastewater, where they can be detected and quantified. Such measurements can provide helpful information for public health officials regarding community health.
In the 1960s, epidemiologists began using wastewater to track and contain polio outbreaks. These early efforts relied on culture-based methods to detect polioviruses in the wastewater. In the 1980s, Hepatitis A was monitored in wastewater using hybridization techniques with radioactive cDNA probes. Broader wastewater pathogen detection techniques began in the 1990s with the advent of polymerase chain reaction (PCR) technology. PCR-based methods have been widely used for SARS-CoV-2 surveillance.
Considerations in Testing and Evaluation
Normalizing the sample - Human inputs within a single community’s wastewater can be diluted during storm-water events or other changes in wastewater inputs. Likewise, comparing pathogen concentrations in the wastewaters between different community sewersheds can be complicated by different wastewater compositions, such as the amount and types of industries in the sewershed. Normalizing ultimately helps account for the number of individuals that contribute to the wastewater sample and thus facilitates comparing organism concentrations measured over time in the same sewershed and between sewersheds. Potential normalization factors include concentrations of of Pepper Mild Mottle virus, crAssphage, Bacteroides HF183, or Lachnospiraceae Lachno3 in the wastewater. Normalizing by wastewater flow rate and sewershed population, as well as chemical concentrations, have also been proposed. <Return to Table of Contents>
Sample collection method and frequency - Wastewater collected as a grab sample represents a single point in time, whereas composite samples represent wastewater levels over a specified period of time (often 24 hours). Sample collection frequency can affect the ability to observe trends in wastewater–samples collected and analyzed at a higher frequency (e.g., daily samples) provide more information on disease dynamics in a community than samples collected and analyzed at a lower frequency collection (e.g, weekly samples).
The laboratory detection method used - Methods used to quantify organisms in wastewater can be culture-based or molecular-based. Culture-based methods require a live, or infectious organism to be detected and quantified. PCR-based methods require the targeted regions of the genome to be intact so that they can be detected and quantified. PCR methods do not relay information about the infectiou state of the organism, but they are relatively quick and specific. With PCR-based methods, pathogen wastewater concentrations can be measured and reported within 1-2 days of when the organisms were shed. Different methods have different limits of detection.
The persistence of the organism in the environment - The temperature of the environment, along with the presence of other chemicals and organisms in the environment, may impact the amount of the infectious/live organism or its genome that can be detected.
Wastewater-based epidemiology methods have detection limits that depend on the amount of organisms people shed during an infection and the methods used to recover and detect the organism.
SARS-CoV-2, or the virus that causes COVID-19, is shed in stool during infections. We can therefore quantify SARS-CoV-2 RNA in wastewater to get a sense of a community’s COVID-19 burden. Most efforts to quantify SARS-CoV-2 concentrations in wastewater focus on the liquid fraction of wastewater. Methods have also been developed to measure SARS-CoV-2 RNA in the solid fractions of wastewater and there is evidence that solids fractions contain higher concentrations of SARS-CoV-2 than the liquid fraction (see links below). Focusing on solids can therefore improve detection limits.
https://pubs.rsc.org/en/content/articlehtml/2022/ew/d1ew00826a - Solids Vs Influent (example 1)
https://pubmed.ncbi.nlm.nih.gov/33283515/ - Solids Vs Influent (example 2)
Sinclair RG, Choi CY, Riley MR, Gerba CP. Pathogen surveillance through monitoring of sewer systems. Adv Appl Microbiol. 2008;65:249-269. doi:10.1016/S0065-2164(08)00609-6
Centers for Disease Control and Prevention - Wastewater Testing Methods
Centers for Disease Control and Prevention - Sampling Strategy
Icons Used in Descriptions of Lab Processes & Timelines:
Other Wastewater Detection Dashboards
State of Michigan Sentinel Wastewater Epidemiology Evaluation Project (SWEEP) - SARS-CoV-2
Centers for Disease Control and Prevention Tracking SARS-CoV-2 in the United States
Record of the changes made to this dashboard (history starting March 2023).
17 March 2023
21 March 2023
27 March 2023
28 March 2023
31 May 2023
19 June 2023
27 June 2023
17 July 2023
9 August 2023
11 August 2023
15 August 2023
16 August 2023
5 September 2023
5 September 2023
1 October 2023
2 October 2023
13 October 2023
26 October 2023
6 November 2023
28 November 2023
12 December 2023
18 December 2023
2 February 2024
5 February 2024
9 February 2024
14 February 2024
15 February 2024
19 February 2024
28 March 2024
30 May 2024
10 June 2024
5 August 2024
27 September 2024
07 October 2024
05 December 2024