Quantification of multiple respiratory viruses in wastewater in the Kathmandu Valley, Nepal — Potential implications of wastewater-based epidemiology for community disease surveillance in developing countries

Despite being the major cause of death, clinical surveillance of respiratory viruses at the community level remains challenging in developing countries due to limited healthcare infrastructure, diagnostic capacity, and reporting systems. Wastewater-based epidemiology provides a complementary tool for tracking the circulation of multiple respiratory viruses, including influenza, RSV, and SARS-CoV-2, by analyzing sewage samples from urban areas. This study demonstrates the potential of wastewater surveillance to strengthen community disease surveillance in resource-limited settings.