Public health actions in response to pathogen detection in sewage: a scoping review protocol

Background Infectious disease surveillance and outbreak investigations have significantly benefited from sewage monitoring as an indicator for pathogen circulation in human populations. The use of sewage surveillance accelerated during the COVID-19 pandemic with the quantification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in sewage providing predictions of SARS-CoV-2 infections and hospital admissions. A comprehensive overview how sewage monitoring can further inform local and regional public health actions proactively is needed to optimize its future use. By conducting a scoping review, we aim to provide an overview of reported public health actions as a response to sewage monitoring for pathogens. Methods This scoping review will include peer-reviewed published literature from the databases MEDLINE, EMBASE and Web of Science. Literature describing public health actions as a response to sewage monitoring in the field of human infectious diseases will be considered for inclusion. Literature not written in English, published prior to 1 January 2014, systematic reviews, editorials and letters to the editor will be excluded. Screening of literature against the inclusion criteria and the subsequent data extraction will be performed by two reviewers. The described public health actions, and corresponding sewage sampling methods and microbiological analytic tools and techniques that can be applied on sewage samples for detecting pathogens will also be extracted. The extracted data from included literature will be combined into a narrative synthesis.