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This study implemented wastewater-based genomic surveillance of Respiratory Syncytial Virus (RSV) across six Swiss cities during the 2024-2025 season, combining digital PCR and amplicon sequencing to track RSV subtypes and mutations. Both RSV-A and RSV-B co-circulated simultaneously with comparable epidemiological dynamics, and no mutations known to reduce the effectiveness of recently approved immunoprophylactic interventions were detected in the F protein. Genetic diversity patterns observed in wastewater samples were consistent with clinical data, showing higher diversity in RSV-A than RSV-B and greater variability in the G gene compared to the F gene.
Why it matters
Since new RSV vaccines and monoclonal antibodies were approved in 2023, continuous surveillance for resistance-associated mutations is critical to protecting vulnerable populations, particularly infants and older adults. This work demonstrates that wastewater surveillance can serve as a cost-effective, population-level complement to clinical monitoring, providing an early-warning system for viral evolution.
⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
Respiratory Syncytial Virus (RSV) is responsible for a substantial health burden worldwide, particularly among children and older adults. In 2023, novel immunoprophylactic interventions for RSV were approved, underscoring the need to monitor circulating RSV lineages and detect mutations that could compromise intervention effectiveness. Here, we implemented wastewater-based genomic RSV surveillance by integrating digital PCR and amplicon-based sequencing within Switzerland’s national wastewater monitoring program. We tracked RSV subtypes and individual mutations across the 2024-2025 peak season in six Swiss cities. RSV-A and RSV-B co-circulated nationwide, and both exhibited similar epidemiological dynamics estimated from their subtype-specific effective reproduction numbers. No previously reported F protein mutations relevant to prophylaxis efficacy were identified. Genetic diversity analysis of wastewater-derived sequences reflected patterns previously reported in clinical data, with higher diversity in RSV-A than RSV-B and greater variability in the G compared to the F gene. These findings demonstrate the potential of wastewater-based RSV surveillance for monitoring RSV dynamics and diversity and establish a national baseline for RSV evolution during the first season following vaccine implementation in Switzerland.