Throughout the coronavirus disease 2019 (COVID-19) pandemic, wastewater surveillance has been utilized to monitor the disease in the United States through routine national, statewide, and regional monitoring projects. Over this period, a significant canon of evidence was produced showing that wastewater surveillance is a credible and effective tool for disease monitoring. Hence, the application of wastewater surveillance can extend beyond monitoring SARS-CoV-2 to encompass a diverse range of emerging diseases, including those caused by viral, bacterial, parasitic, and fungal pathogens. This article proposed a ranking system for prioritizing reportable communicable diseases (termed CDs, hereafter) in the Tri-County Detroit Area (TCDA), Michigan, for future wastewater surveillance applications at the Great Lakes Water Authority’s Water Reclamation Plant (GLWA’s WRP). The comprehensive CD wastewater surveillance ranking system (termed “CDWSRank”, hereafter) was developed based on reported incidence data from 2014 to 2021. The CDWSRank system includes 6 binary and 6 quantitative parameters. The final ranking scores of CDs were computed by summing the multiplication products of weighting factors for each parameter, and then were sorted based on decreasing priority. Disease incidence data from 2014 to 2021 were collected for the TCDA, including City of Detroit, as well as Wayne, Macomb, and Oakland Counties, served by the GLWA’s WRP. Disease incidence trends in the TCDA were endowed with higher weights, creating overall ranking scores that prioritize the TCDA over the state of Michigan. The CDWSRank system can be easily adopted to geographical locations beyond the TCDA. The CDWSRank system is the first of its kind to provide an empirical approach to select CDs for wastewater surveillance, specifically in geographies served by centralized wastewater collection in the area of interest. treatment plant. Appropriate wastewater sample concentration methods are summarized for the application of wastewater surveillance to viral, bacterial, parasitic, and fungal pathogens of epidemiological importance, where the parasitic category is designated for pathogens caused by parasitic organisms, excluding fungal, bacterial, and viral pathogens.
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