Wastewater-Based Surveillance of Respiratory Viruses in the SARS-CoV-2 Post-Pandemic Period in Mexico.

In recent years, wastewater (WW)-based epidemiology has been increasingly used for surveillance of SARS-CoV-2 and has emerged as a potential tool for monitoring other respiratory viruses. Most evidence on the use of WW for detecting multiple respiratory viruses comes from developed countries. In this study, we assessed the feasibility of multi-respiratory virus sewage surveillance in a middle-income country and explored signals that may be potentially used as early warning signs for Public Health authorities. We examined the presence of SARS-CoV-2, influenza virus, respiratory syncytial virus (RSV), and human metapneumovirus (hMPV) in 238 WW samples collected from three treatment plants in San Luis Potosí, Mexico, over one year. The weekly detection of each virus was compared with the weekly number of hospital admissions for respiratory infections caused by that virus in pediatric patients. SARS-CoV-2, influenza, hMPV, and RSV were detected in 152 (63.9%), 108 (45.4%), 95 (39.9%), and 24 (10.1%) samples, respectively. There was no significant correlation between viral detection in WW and the number of hospitalizations during that week. However, analyses of WW viral detection with hospitalizations in subsequent weeks showed an increasing correlation reaching a maximum correlation for a lag of 12 weeks for SARS-CoV-2 (r