Correlation of wastewater surveillance data with traditional influenza surveillance measures in Cook County, Illinois, October 2022–April 2023

Emily A.G. Faherty*, Deniz Yuce, Colin Korban, Kelley Bemis, Rishi Kowalski, Stephanie Gretsch, Enrique Ramirez, Rachel Poretsky, Aaron Packman, Katelyn Plaisier Leisman, Melissa Pierce, Alyse Kittner, Richard Teran, Massimo Pacilli

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Influenza is a respiratory illness that can result in serious outcomes, particularly among persons who are immunocompromised, aged <5 years or aged >65 years. Traditional influenza surveillance approaches rely upon syndromic surveillance of emergency departments and public health reporting from clinicians and laboratories. Wastewater surveillance infrastructure developed to monitor SARS-CoV-2 is being used for influenza surveillance in the Chicago area. The goal was to evaluate timeliness and correlations between influenza virus detected through wastewater surveillance and traditional influenza surveillance measures to assess utility of wastewater surveillance for influenza at the county level. Specifically, we measured correlations between influenza virus gene copies in wastewater samples and 1) the number of intensive care unit admissions associated with a diagnosis of influenza, 2) the percentage emergency department (ED) visits for influenza-like-illness, and 3) the percentage of ED visits with influenza diagnosis at discharge in Cook County. Influenza concentrations in wastewater were strongly correlated with traditional influenza surveillance measures, particularly for catchment areas serving >100,000 residents. Wastewater indicators lagged traditional influenza surveillance measures by approximately one week when analyzed in cross-correlations. Although wastewater data lagged traditional influenza surveillance measures in this analysis, it can serve as a useful surveillance tool as a complement to syndromic surveillance; it is a form of influenza surveillance that does not rely on healthcare-seeking behavior or reporting by healthcare providers.

Original languageEnglish (US)
Article number169551
JournalScience of the Total Environment
StatePublished - Feb 20 2024


  • Influenza
  • Wastewater surveillance
  • Wastewater-based epidemiology

ASJC Scopus subject areas

  • Pollution
  • Waste Management and Disposal
  • Environmental Engineering
  • Environmental Chemistry


Dive into the research topics of 'Correlation of wastewater surveillance data with traditional influenza surveillance measures in Cook County, Illinois, October 2022–April 2023'. Together they form a unique fingerprint.

Cite this