The Luxembourgish Ministry of Health has nominated LIST as the competent authority for Luxembourg to participate in the EU4Health Programme’s joint action to enhance, extend and consolidate wastewater surveillance for public health. The Laboratoire National de Santé (LNS) will also take part in the initiative as an affiliated entity.
This joint action aims to reinforce the European Union's capacity in preventing, preparing for, and swiftly responding to significant health threats that transcend national borders. It specifically focuses on supporting the gathering of data, exchanging information, and enhancing wastewater-based epidemiological surveillance. By doing so, it aligns with the overarching goal of the EU4Health Programme, which is to safeguard the well-being of individuals within the Union by addressing grave health risks that transcend borders. Additionally, it seeks to strengthen the resilience of health systems and foster coordination among Member States in effectively managing such cross-border health threats.
Wastewater surveillance and its associated epidemiological assessment have gained prominence during the COVID-19 pandemic. It has proven to be an effective tool for gathering timely and valuable intelligence regardless of people's behaviour (such as their willingness to get tested) and interventions (such as the implementation of containment measures).
“The method of monitoring wastewater has been used to identify and track the transmission of viruses and pathogens for decades but not at the scale we experience today,” says Dr Henry-Michel Cauchie, who leads the Environmental Microbiology group at LIST. Cauchie is representing LIST in the project. “This particular project was instigated by the pandemic, which increased the use of wastewater surveillance methods that were already in existence for tracking the poliovirus, for example, since the 50s, with the aim of monitoring the eradication of this virus through an ambitious vaccination programme.”
Wastewater is a reservoir of various microorganisms like bacteria, viruses, and parasites, excreted by humans. As a result, using wastewater-based surveillance techniques can indeed prove to be a highly valuable method for monitoring and understanding the transmission of contagious diseases. By quantitatively analysing virus particles in sewage, trends can be identified, and a strong correlation with clinical cases can be observed. Research shows that surveillance plays a crucial role in swiftly detecting pathogens and accurately assessing their prevalence within a community. Furthermore, it offers the ability to pinpoint areas with high rates of antimicrobial resistance by monitoring the levels of antibiotics present in wastewater.
“The joint action aims to set up a network of observatories in the Member States based on wastewater that can provide data on various viruses,” adds Cauchie, “and also data on antibiotic resistance and pathogenic bacteria. A major goal is to help Member States to reach the same level of expertise in wastewater-based epidemiology while sharing their field experience”.
The initiative, named EU-WISH, was officially kicked off over 5, 6 and 7 February 2024 in Athens.
The Environmental Microbiology Group at LIST has been tracking wastewater viruses for more than 15 years. The work of LIST, coupled with the data collected in samples of human faeces by the LNS, has provided a better understanding of the circulation of viruses such as noroviruses, responsible for winter gastroenteritis, or enteroviruses, responsible for a wide spectrum of benign or severe symptoms (hand, foot and mouth disease, angina, respiratory disease, diarrhoea, heart disease, acute flaccid paralysis or even meningitis).
More recently, the CORONASTEP initiative, launched in April 2020, has been a valuable tool in identifying the SARS-CoV-2 virus and its circulation in wastewater, and also in detecting novel variants of the disease in Luxembourg.
LIST's know-how in the isolation of viruses from complex matrices has also been exported to neighbouring countries, particularly in the context of direct collaboration with the teams in charge of wastewater surveillance in France or Belgium. In this context, LIST’s integration within the EU joint action makes all the more sense.
The initiative, which is expected to last three years, “will focus on promoting and supporting the implementation of wastewater-based epidemiology practices in participating countries,” concludes Henry-Michel Cauchie, “and will involve discussions, development of protocols, training courses, and the sharing of best practices.”
Incidentally, in addition to the EU-wide project, Luxembourg is also funding a similar initiative at national level, and spearheaded by LIST, which aligns with the wastewater surveillance efforts within the EU and involves coordination between the Ministry of Health and the Ministry of the Environment, Climate and Biodiversity.