Community wastewater parvovirus B19 signal amid rising maternal–fetal cases

Parvovirus B19 (B19V) is a small, non-enveloped DNA virus primarily transmitted via respiratory droplets, with the capacity for vertical transmission during pregnancy. B19V infection is associated with fetal anemia and perinatal death, yet it is not included in routine public health surveillance. We present statewide detection of B19V in Texas wastewater using hybrid-capture virome sequencing across 43 sites in 15 cities. Wastewater signal closely tracked clinical case trends at institutional, county, and state levels, with the strongest correlation occurring when wastewater preceded reported cases by one month. Sequencing reads provided full-genome coverage, enabling characterization of population-level genomic composition during the 2024 case surge, including changes in the VP1/VP2 region which warrants functional investigation in clinical or experimental models. These findings highlight the utility of wastewater virome sequencing for real-time detection of underreported viruses and support its application as a complementary viral surveillance approach alongside other commonly used genomic techniques. Given B19V’s clinical significance and the lack of national monitoring programs, this work establishes a framework for scalable wastewater-based detection of B19V and similar threats, particularly where diagnostic testing is limited or delayed. Such applications may be especially valuable in pregnancy, where early awareness and intervention can be critical for fetal health.