Wastewater Watch: Can our sewers in Bangalore predict the next outbreak?

Overview of Module: This module introduces students to wastewater-based epidemiology (WBE) through a real-world case study in a tropical setting in Bangalore, India. Students explore how wastewater surveillance can detect and track infectious diseases such as COVID-19 by interpreting RT-PCR cycle threshold (Ct) values, environmental variables, and sampling strategies. Through guided data analysis, case discussions, and interpretation of real-world datasets, students learn how wastewater monitoring can complement clinical surveillance systems. Activities include examining viral RNA detection trends, evaluating environmental factors influencing measurements, and interpreting public health implications. The module helps students understand the interdisciplinary nature of environmental microbiology, molecular diagnostics, and public health surveillance. Instructors may use this module to introduce modern epidemiological tools and illustrate how environmental monitoring can support early detection of disease outbreaks.   Learning Objectives: Explain the principles of wastewater-based epidemiology Describe the biological basis of SARS-CoV-2 RNA detection in wastewater Explain sampling strategies, protocols and local environmental considerations for detection of pathogen transcripts in open-water sewage canals Interpret surveillance data for public health action Evaluate the role of open-water sewage canal surveillance beyond COVID-19   Support was provided by: A grant from the United States National Science Foundation (DBI-RCN-UBE 2120141).