1.    Since bacteria and viruses are shed in feces, wastewater surveillance allows public health officials to track changes in community-wide infection rates without relying on patient testing. 
2.    The results of wastewater surveillance can help inform decisions that help manage the spread of disease.
3.    Wastewater surveillance is used to monitor for emerging pathogens that impact public health.  
4.    Wastewater surveillance is a proven tool. It was used in the 1940’s to monitor for polio, and recently identified a polio outbreak in New York state.
5. There are over 1300 sites in the U.S. where wastewater being tested for respiratory viruses and other pathogens, according to the CDC National Wastewater Surveillance System (NWSS).  
 

1.    It is not possible to predict the number of infected individuals reliably and accurately in a community based on sewage surveillance alone.
2.    Wastewater surveillance only pertains to households on public sewage systems and will not represent homes on septic-based systems.
3.    Community-level wastewater surveillance at a wastewater treatment plant will not represent communities or facilities served by decentralized systems, such as prisons, universities, or hospitals that treat their own waste.
4.    Low levels of infection in a community may not be captured by wastewater surveillance if the quantity of the pathogen falls below the limit of detection for laboratory analysis.
5.    Wastewater is a complex environmental sample, and inherent variability in measured concentrations are expected due to environmental variability, day-to-day difference in sewer shed and population dynamics, and laboratory variability.  As such, trends are more reliable than individual data points; concentration of any individual data point may reflect variability and should be interpreted in appropriate context and with caution.