CDC National Wastewater Surveillance System gives prestigious designation to North Carolina DHHS and UNC-Chapel Hill

October 2, 2024

The North Carolina Department of Health and Human Services (NCDHHS), in collaboration with the University of North Carolina at Chapel Hill, has been designated as one of six National Wastewater Surveillance System Centers of Excellence by the Centers for Disease Control and Prevention (CDC).

Wastewater surveillance involves analyzing wastewater coming into a centralized sewage treatment plant to look for viruses and bacteria that serve as metrics of disease prevalence in communities. This approach allows public health officials to better estimate disease trends within a community because it captures data in a way that is not dependent on health care access and collects information from individuals who are both symptomatic and asymptomatic.

This map from the NC Wastewater Monitoring Dashboard shows the prevalence of COVID-19 at sites across the state.

This map from the NC Wastewater Monitoring Dashboard shows the prevalence of COVID-19 at sites across the state.

The National Wastewater Surveillance System (NWSS) Centers of Excellence (CoEs) serve as regional leaders in wastewater surveillance implementation and coordination. They foster innovation, develop and conduct trainings, provide technical assistance to jurisdictions, and translate data into actionable information, messages and displays. Led by public health departments, the six CoEs (in California; Colorado; Houston, Texas; New York; North Carolina and Wisconsin) advance their mission through a collaborative partnership between public health departments, academic researchers and wastewater utility partners. CoEs were competitively selected and funded through the Epidemiology and Laboratory Capacity for the Prevention and Control of Emerging Infectious Diseases cooperative agreement, and the agreements are expected to last for the next five years.

“We are honored to be selected as a NWSS Center of Excellence in recognition of our strong partnerships and expertise in North Carolina,” said Virginia Guidry, PhD, Branch Head for the Occupational and Environmental Epidemiology Branch at NCDHHS. “We could not do this important work without our academic partners at UNC-Chapel Hill.”

Wastewater monitoring in North Carolina began in 2020 with funding from the state legislature to the North Carolina Policy Collaboratory and was championed by UNC-Chapel Hill from the beginning. Building on that foundation, North Carolina was one of the first eight states funded by the CDC to conduct wastewater surveillance for COVID-19. The North Carolina Wastewater Monitoring Network started collecting and analyzing samples in January 2021.

Dr. Rachel Noble

Dr. Rachel Noble

“In North Carolina, we realized early on the potential of wastewater surveillance,” says Rachel Noble, PhD, Mary and Watts Hill Jr. Distinguished Professor with the UNC-Chapel Hill Institute of Marine Sciences and professor of environmental sciences and engineering with the UNC-Chapel Hill Gillings School of Global Public Health.

Noble directs a laboratory in Morehead City, NC, which examines developing technology for high-throughput pathogen tracking and studies rural wastewater systems. She says that residents can use the publicly available findings from wastewater surveillance to make informed choices about masking, gatherings, travel and more. One of the most important attributes of the evolving surveillance in North Carolina has been increased attention to rural towns and cities as compared to the more urban focus of national programs.

“We regularly interact with local health departments and members of the public who are using these data on a daily basis to make informed decisions about their health and the health of their families and communities” says Ariel Christensen, MPH, lead epidemiologist with the NC Wastewater Monitoring Network at NCDHHS.

As of October 2024, the NC Wastewater Monitoring Network team continues testing for COVID-19 but also tracks influenza A and B as well as respiratory syncytial virus (RSV) at approximately 37 sites. In addition, they test for mpox at priority sites as needed.

“It is exciting for the state of North Carolina to serve as a leader in the southeast for tracking emerging pathogens of concern in an equitable way,” says Noble. “We plan to continue increasing how much we understand about the health of communities through wastewater monitoring.”


Contact the UNC Gillings School of Global Public Health communications team at sphcomm@unc.edu.

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