Multimodal genomic surveillance for respiratory pathogens at four U.S. international airports: A comparison of air, wastewater, clinical, and national surveillance data
5 affiliations
- 1Ginkgo Biosecurity, Boston, Massachusetts, United States of America
- 2Division of Global Migration Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- 3Friedman Global Health and Biosecurity, LLC, Atlanta, Georgia, United States of America
- 4Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- 5Department of Public Safety, Dallas/Fort Worth International Airport, Dallas, Texas, United States of America
Abstract
Early detection of outbreaks and emerging pathogens is critical for public health and global biosecurity. Airports, as major international travel hubs with dense, enclosed populations, are high-risk settings for disease transmission and potential pathogen introduction. The U.S. Centers for Disease Control and Prevention, in collaboration with Ginkgo Biosecurity and the University of Wisconsin–Madison, implemented air monitoring for pathogen surveillance in congregate areas at four U.S. international airports. From October 2023 to August 2024, SARS-CoV-2 was detected by PCR in 98.3% of air samples and influenza A in 17.2%. Influenza A positivity in air samples correlated with aviation wastewater (r = 0.48), traveler nasal swab positivity (r = 0.73), and national clinical surveillance (r = 0.86), whereas SARS-CoV-2 measurements did not correlate significantly across these modalities. Targeted amplicon sequencing of SARS-CoV-2 from air samples identified contemporaneous lineages also detected in wastewater collected from the same airports. Targeted enrichment sequencing detected 30 viral species and recovered high-quality genomes for SARS-CoV-2, influenza, bocavirus, and seasonal coronaviruses. Together, these findings demonstrate that air sampling can complement aviation wastewater surveillance at ports of entry, although performance and concordance vary by pathogen and sample type.
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BibTeX
@article{gratalo2026multimodal,
title = {{Multimodal genomic surveillance for respiratory pathogens at four U.S. international airports: A comparison of air, wastewater, clinical, and national surveillance data}},
author = {Dawn Gratalo and Cindy R. Friedman and Valerie J. Morley and Xueting Qiu and Ian Ruskey and Andrew P. Rothstein and Patrick B. Tiburcio and Casandra W. Philipson and Thomas W. S. Aichele and Stephen M. Bart and Dustin Jaynes and Birgitte B. Simen and Shelby L. O’Connor and David H. O’Connor},
journal = {PLOS Global Public Health},
year = {2026},
month = sep,
doi = {10.1371/journal.pgph.0006810},
url = {https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006810},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Multimodal genomic surveillance for respiratory pathogens at four U.S. international airports: A comparison of air, wastewater, clinical, and national surveillance data
AU - Dawn Gratalo
AU - Cindy R. Friedman
AU - Valerie J. Morley
AU - Xueting Qiu
AU - Ian Ruskey
AU - Andrew P. Rothstein
AU - Patrick B. Tiburcio
AU - Casandra W. Philipson
AU - Thomas W. S. Aichele
AU - Stephen M. Bart
AU - Dustin Jaynes
AU - Birgitte B. Simen
AU - Shelby L. O’Connor
AU - David H. O’Connor
PY - 2026
DA - 2026/09/09
JO - PLOS Global Public Health
DO - 10.1371/journal.pgph.0006810
UR - https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006810
AB - Early detection of outbreaks and emerging pathogens is critical for public health and global biosecurity. Airports, as major international travel hubs with dense, enclosed populations, are high-risk settings for disease transmission and potential pathogen introduction. The U.S. Centers for Disease Control and Prevention, in collaboration with Ginkgo Biosecurity and the University of Wisconsin–Madison, implemented air monitoring for pathogen surveillance in congregate areas at four U.S. international airports. From October 2023 to August 2024, SARS-CoV-2 was detected by PCR in 98.3% of air samples and influenza A in 17.2%. Influenza A positivity in air samples correlated with aviation wastewater (r = 0.48), traveler nasal swab positivity (r = 0.73), and national clinical surveillance (r = 0.86), whereas SARS-CoV-2 measurements did not correlate significantly across these modalities. Targeted amplicon sequencing of SARS-CoV-2 from air samples identified contemporaneous lineages also detected in wastewater collected from the same airports. Targeted enrichment sequencing detected 30 viral species and recovered high-quality genomes for SARS-CoV-2, influenza, bocavirus, and seasonal coronaviruses. Together, these findings demonstrate that air sampling can complement aviation wastewater surveillance at ports of entry, although performance and concordance vary by pathogen and sample type.
SN - 2767-3375
ER -