{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:19:31Z","timestamp":1785424771848,"version":"3.56.0"},"reference-count":21,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"unspecified","delay-in-days":95,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The COVID-19 pandemic has highlighted limitations in case-based surveillance due to inconsistent testing and reporting. Wastewater-based epidemiology (WBE) has emerged as a complementary surveillance approach for tracking SARS-CoV-2 transmission, capturing both symptomatic and asymptomatic infections. The aim of this study was to evaluate the effectiveness of WBE in estimating the effective reproduction number (\n                    <jats:inline-formula>\n                      <jats:alternatives>\n                        <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mime-subtype=\"png\" xlink:href=\"S0950268826101356_inline90001.png\"\/>\n                        <jats:tex-math>$ {R}_t $<\/jats:tex-math>\n                      <\/jats:alternatives>\n                    <\/jats:inline-formula>\n                    ) of SARS-CoV-2 in Georgia, USA. We used a Generalized Linear Mixed Model (GLMM) to analyse viral concentration data from multiple wastewater treatment plants (WWTPs) collected between 1 June 2022 and 15 December 2022. After controlling for flow rates and site-level heterogeneity, model residuals were transformed into a non-negative incidence-like series used to estimate wastewater-based\n                    <jats:inline-formula>\n                      <jats:alternatives>\n                        <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mime-subtype=\"png\" xlink:href=\"S0950268826101356_inline90002.png\"\/>\n                        <jats:tex-math>$ {R}_t $<\/jats:tex-math>\n                      <\/jats:alternatives>\n                    <\/jats:inline-formula>\n                    . Wastewater-based\n                    <jats:inline-formula>\n                      <jats:alternatives>\n                        <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mime-subtype=\"png\" xlink:href=\"S0950268826101356_inline90003.png\"\/>\n                        <jats:tex-math>$ {R}_t $<\/jats:tex-math>\n                      <\/jats:alternatives>\n                    <\/jats:inline-formula>\n                    was compared with case-based\n                    <jats:inline-formula>\n                      <jats:alternatives>\n                        <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mime-subtype=\"png\" xlink:href=\"S0950268826101356_inline90004.png\"\/>\n                        <jats:tex-math>$ {R}_t $<\/jats:tex-math>\n                      <\/jats:alternatives>\n                    <\/jats:inline-formula>\n                    estimates using Spearman correlation. The two\n                    <jats:inline-formula>\n                      <jats:alternatives>\n                        <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mime-subtype=\"png\" xlink:href=\"S0950268826101356_inline90005.png\"\/>\n                        <jats:tex-math>$ {R}_t $<\/jats:tex-math>\n                      <\/jats:alternatives>\n                    <\/jats:inline-formula>\n                    estimates showed concordant temporal patterns across most sites, with stronger correlations in areas with higher case counts (Spearman correlations ranging from 0.39 to 0.84,\n                    <jats:inline-formula>\n                      <jats:alternatives>\n                        <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mime-subtype=\"png\" xlink:href=\"S0950268826101356_inline90006.png\"\/>\n                        <jats:tex-math>$ p&lt;0.001 $<\/jats:tex-math>\n                      <\/jats:alternatives>\n                    <\/jats:inline-formula>\n                    ). Wastewater-based\n                    <jats:inline-formula>\n                      <jats:alternatives>\n                        <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mime-subtype=\"png\" xlink:href=\"S0950268826101356_inline90007.png\"\/>\n                        <jats:tex-math>$ {R}_t $<\/jats:tex-math>\n                      <\/jats:alternatives>\n                    <\/jats:inline-formula>\n                    tracked increases and decreases in transmission over similar time scales as case-based estimates, while exhibiting reduced sensitivity to short-term changes in clinical testing and reporting behaviour. These findings suggest that WBE can support estimation of transmission trends and complement traditional case-based surveillance for public health monitoring.\n                  <\/jats:p>","DOI":"10.1017\/s0950268826101356","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T08:00:48Z","timestamp":1775462448000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Comparing wastewater-based and case-based\n                    <i>\n                      R\n                      <sub>t<\/sub>\n                    <\/i>\n                    estimates of SARS-CoV-2 transmission in Georgia using generalized linear mixed models"],"prefix":"10.1017","volume":"154","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6997-5859","authenticated-orcid":false,"given":"Seth","family":"Edmunds","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02k40bc56","id-type":"ROR","asserted-by":"publisher"}],"name":"Indiana University - Bloomington School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Landsittel","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02k40bc56","id-type":"ROR","asserted-by":"publisher"}],"name":"Indiana University - Bloomington School of Public Health"},{"id":[{"id":"https:\/\/ror.org\/01y64my43","id-type":"ROR","asserted-by":"publisher"}],"name":"State University of New York at Buffalo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ajelli","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01kg8sb98","id-type":"ROR","asserted-by":"publisher"}],"name":"Indiana University - Bloomington School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Litvinova","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02k40bc56","id-type":"ROR","asserted-by":"publisher"}],"name":"Indiana University - Bloomington School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,4,6]]},"reference":[{"key":"S0950268826101356_r11","first-page":"1766","article-title":"Wastewater-based protocols for SARS-CoV-2: Insights into virus concentration, extraction, and quantitation methods from two years of public health surveillance","volume":"10","author":"Antkiewicz","year":"2024","journal-title":"Environmental Science: Water Research and Technology"},{"key":"S0950268826101356_r20","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2023.169028"},{"key":"S0950268826101356_r21","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofae719"},{"key":"S0950268826101356_r5","doi-asserted-by":"publisher","DOI":"10.1016\/j.epidem.2022.100560"},{"key":"S0950268826101356_r1","first-page":"e1","article-title":"COVID-19 surveillance after expiration of the public health emergency declaration\u2014United States, May 11, 2023","volume":"72","author":"Silk","year":"2023","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"S0950268826101356_r4","doi-asserted-by":"publisher","DOI":"10.1021\/acsestwater.2c00053"},{"key":"S0950268826101356_r13","doi-asserted-by":"publisher","DOI":"10.1016\/j.csda.2021.107319"},{"key":"S0950268826101356_r14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jece.2024.112485"},{"key":"S0950268826101356_r8","unstructured":"[8] Ungar, L (2022) Pandemic Gets Tougher to Track as COVID Testing Plunges. Associated Press."},{"key":"S0950268826101356_r18","doi-asserted-by":"publisher","DOI":"10.3201\/eid2808.220220"},{"key":"S0950268826101356_r12","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2024.29.8.2300277"},{"key":"S0950268826101356_r15","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2023.163599"},{"key":"S0950268826101356_r6","doi-asserted-by":"publisher","DOI":"10.1016\/j.epidem.2025.100839"},{"key":"S0950268826101356_r10","unstructured":"[10] Sablon, O , et al (2022) Nanotrap\u00ae KingFisher Concentration\/Extraction & MagMAX KingFisher Extraction. protocols.io."},{"key":"S0950268826101356_r16","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwt133"},{"key":"S0950268826101356_r3","doi-asserted-by":"publisher","DOI":"10.1016\/j.eng.2024.01.016"},{"key":"S0950268826101356_r17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pcbi.1011439"},{"key":"S0950268826101356_r19","doi-asserted-by":"publisher","DOI":"10.1016\/j.isci.2023.107019"},{"key":"S0950268826101356_r9","doi-asserted-by":"publisher","DOI":"10.1093\/femsmc\/xtad004"},{"key":"S0950268826101356_r2","doi-asserted-by":"publisher","DOI":"10.1289\/EHP10050"},{"key":"S0950268826101356_r7","doi-asserted-by":"publisher","DOI":"10.1016\/j.epidem.2024.100803"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268826101356","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T07:05:05Z","timestamp":1784271905000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268826101356\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":21,"alternative-id":["S0950268826101356"],"URL":"https:\/\/doi.org\/10.1017\/s0950268826101356","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e63"}}