Unveiling the enterovirus diversity in Barcelona, Spain (2020–2024) through wastewater and clinical surveillance
Emerging Microbes & Infections·
- DOI
- 10.1080/22221751.2025.2589547
- PMID
- 41220304
- PMCID
- PMC12667296
- OpenAlex
- W4416129951
- Study type
- Journal article
- Publisher
- Informa UK Limited
- Article type
- journal-article
- Integrity
- current
Why this research matters now
Wastewater surveillance uncovered greater enterovirus diversity than clinical reporting alone, detecting 56 types not identified through clinical channels. The authors suggest this integrated approach may enable early detection of emerging public health threats and reveal hidden viral diversity missed by routine clinical surveillance.
Structured evidence summary
Research question
The study assessed whether combining wastewater surveillance with clinical reporting could capture a more complete picture of enterovirus circulation in Barcelona over a five-year period spanning pandemic restrictions and their relaxation.
Study design
Five-year surveillance (2020–2024) in Barcelona combined biweekly wastewater sampling with clinical enterovirus reporting. Investigators quantified enterovirus genome copies by RT-qPCR and sequenced partial VP1 regions from wastewater concentrates and clinical specimens.
Population and setting
The study was conducted in Barcelona, Spain, during 2020–2024. Clinical surveillance captured enterovirus infections reported through routine channels, while wastewater sampling reflected the catchment population of the sewage network.
Main findings
Deep sequencing identified 122 distinct enterovirus types in wastewater versus 92 in clinical samples; 66 types appeared in both sources while 56 types were detected only in sewage. Wastewater viral loads generally paralleled reported case trends, with good correlations in most years except 2022. A monotonic relationship was observed for certain types (CVA6, CVB2, CVB3, E11, EV-D68), though predictive capacity for clinical cases showed low robustness. Sequences from wastewater and clinical sources demonstrated high genetic similarity.
Public-health relevance
Wastewater surveillance uncovered greater enterovirus diversity than clinical reporting alone, detecting 56 types not identified through clinical channels. The authors suggest this integrated approach may enable early detection of emerging public health threats and reveal hidden viral diversity missed by routine clinical surveillance.
Important limitations
This summary relies on the supplied single-article abstract and metadata. Assessment of methodological limitations, statistical power, generalizability beyond Barcelona, and interpretation of the low predictive robustness observed for certain enterovirus types requires access to the full published article.
GIDS interpretation
The article was classified under SARS/COVID-19 disease tags and surveillance topics, likely reflecting the study period (2020–2024) coinciding with pandemic-era wastewater monitoring infrastructure. The research focuses on enterovirus diversity rather than SARS-CoV-2 and demonstrates wastewater as a tool for detecting viral circulation beyond the index pathogen for which sampling was originally established.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 9 auditable classifier relationships to diseases, places, topics, and study design.