{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:50:14Z","timestamp":1787161814208,"version":"build-2736575974"},"reference-count":37,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Consejo Potosino de Ciencia y Tecnolog\u00eda","award":["FME\/2023\/SE-08\/20"],"award-info":[{"award-number":["FME\/2023\/SE-08\/20"]}]},{"name":"Consejo Potosino de Ciencia y Tecnolog\u00eda","award":["Fideicomiso 23871"],"award-info":[{"award-number":["Fideicomiso 23871"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>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 Potos\u00ed, 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 (rs = 0.63, p = 0.001), 9 weeks for influenza (rs 0.62, p = 0.0001), 2 weeks for RSV (rs = 0.30, p = 0.05), and 3 weeks for hMPV (rs = 0.39, p = 0.009). In addition, we identified time-periods of SARS-CoV-2, influenza, and RSV widespread circulation (several consecutive weeks in which viruses were detected in the three treatment plants); most hospitalizations caused by these viruses occurred after widespread circulation was detected in WW, suggesting this may be used as an early alert for public health systems. Overall, our results show that WW-based surveillance of multiple respiratory viruses is feasible and has potential applications as an early warning system in middle-income countries.<\/jats:p>","DOI":"10.3390\/v18020254","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T09:22:46Z","timestamp":1771320166000},"page":"254","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Wastewater-Based Surveillance of Respiratory Viruses in the SARS-CoV-2 Post-Pandemic Period in Mexico"],"prefix":"10.3390","volume":"18","author":[{"given":"Oscar Uriel","family":"Ulloa-Medina","sequence":"first","affiliation":[{"name":"Centro de Investigaci\u00f3n en Ciencias de la Salud y Biomedicina, Universidad Aut\u00f3noma de San Luis Potos\u00ed, Av. Sierra Leona 550, Lomas de San Luis, San Luis Potos\u00ed 78210, SLP, Mexico"},{"name":"Facultad de Medicina, Universidad Aut\u00f3noma de San Luis Potos\u00ed, Av. Venustiano Carranza 2405, Lomas los Filtros, San Luis Potos\u00ed 78210, SLP, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6094-2575","authenticated-orcid":false,"given":"Pedro Gerardo","family":"Hern\u00e1ndez-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n en Ciencias de la Salud y Biomedicina, Universidad Aut\u00f3noma de San Luis Potos\u00ed, Av. Sierra Leona 550, Lomas de San Luis, San Luis Potos\u00ed 78210, SLP, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7619-860X","authenticated-orcid":false,"given":"Gabriel","family":"Mata-Moreno","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n en Ciencias de la Salud y Biomedicina, Universidad Aut\u00f3noma de San Luis Potos\u00ed, Av. Sierra Leona 550, Lomas de San Luis, San Luis Potos\u00ed 78210, SLP, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Rub\u00e9n","family":"Jaime-Rocha","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n en Ciencias de la Salud y Biomedicina, Universidad Aut\u00f3noma de San Luis Potos\u00ed, Av. Sierra Leona 550, Lomas de San Luis, San Luis Potos\u00ed 78210, SLP, Mexico"},{"name":"Facultad de Ciencias, Universidad Aut\u00f3noma de San Luis Potos\u00ed, Av. Parque Chapultepec 1570, Privadas del Pedregal, San Luis Potos\u00ed 78295, SLP, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara del Carmen","family":"Alatorre-Camacho","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n en Ciencias de la Salud y Biomedicina, Universidad Aut\u00f3noma de San Luis Potos\u00ed, Av. Sierra Leona 550, Lomas de San Luis, San Luis Potos\u00ed 78210, SLP, Mexico"},{"name":"Facultad de Ciencias, Universidad Aut\u00f3noma de San Luis Potos\u00ed, Av. Parque Chapultepec 1570, Privadas del Pedregal, San Luis Potos\u00ed 78295, SLP, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2053-5671","authenticated-orcid":false,"given":"Ignacio","family":"Lara-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n en Ciencias de la Salud y Biomedicina, Universidad Aut\u00f3noma de San Luis Potos\u00ed, Av. Sierra Leona 550, Lomas de San Luis, San Luis Potos\u00ed 78210, SLP, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7733-5138","authenticated-orcid":false,"given":"Mauricio","family":"Comas-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n en Ciencias de la Salud y Biomedicina, Universidad Aut\u00f3noma de San Luis Potos\u00ed, Av. Sierra Leona 550, Lomas de San Luis, San Luis Potos\u00ed 78210, SLP, Mexico"},{"name":"Facultad de Ciencias, Universidad Aut\u00f3noma de San Luis Potos\u00ed, Av. Parque Chapultepec 1570, Privadas del Pedregal, San Luis Potos\u00ed 78295, SLP, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7284-0194","authenticated-orcid":false,"given":"Juan Carlos","family":"Mu\u00f1oz-Escalante","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n en Ciencias de la Salud y Biomedicina, Universidad Aut\u00f3noma de San Luis Potos\u00ed, Av. Sierra Leona 550, Lomas de San Luis, San Luis Potos\u00ed 78210, SLP, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7762-2882","authenticated-orcid":false,"given":"Ana Mar\u00eda","family":"Gonz\u00e1lez-Ortiz","sequence":"additional","affiliation":[{"name":"Hospital de la Ni\u00f1ez y la Mujer \u201cDr. Alberto L\u00f3pez Hermosa\u201d, Blvd. Antonio Rocha Cordero 2510, San Juan de Guadalupe, San Luis Potos\u00ed 78364, SLP, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Torres-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n en Ciencias de la Salud y Biomedicina, Universidad Aut\u00f3noma de San Luis Potos\u00ed, Av. Sierra Leona 550, Lomas de San Luis, San Luis Potos\u00ed 78210, SLP, Mexico"},{"name":"Facultad de Medicina, Universidad Aut\u00f3noma de San Luis Potos\u00ed, Av. 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