Title page 1

Contents 4

EDITORIAL - The Doomsday Clock is 85 Seconds to Midnight: Various Biosecurity Concerns Among Other Factors 5

CORRESPONDENCE - From signal to decision: Dutch experiences with local wastewater surveillance for infectious disease control 7

COMMENT 11

From the Golden Age of Antibiotics to an AI: Enabled Response to Antimicrobial Resistance 11

Advancing One Health Through EU Water Reuse: The role of EU regulation in driving uptake, safeguarding health, and strengthening water resilience 14

THE HUMAN SAMPLE - Work-in-Progress Spotlight: Environmental and Climate Drivers of Water Quality in Cox's Bazar Refugee Camps 16

BRIEF COMMUNICATIONS 20

MONTHLY BULLETIN: EU Wastewater Observatory for Public Health 23

Figures 5

Figure A. Bulletin President and CEO Alexandra Bell moves the minute hand on the Doomsday Clock 5

Figure B. Passive sampler deployed in a sewer manhole to capture local incidence of infectious diseases 8

Figure C. Roadmap for ethical considerations of local WES 9

Figure D. Water Laboratory - Joint Research Centre - European Commission 15

Figure E. The image is intended as an evocative visual: the collective action and solidarity to confront the challenges of the present 16

Figure 1. Overview of the European Wastewater Surveillance Dashboard: near real-time wastewater data on measured pathogens for connected... 25

Figure 2. Viral loads and trends of SARS-CoV-2 across EU countries 25

Figure 3. Temporal progression of viral load in wastewater (and Austria as a whole) 26

Figure 4. SARS-CoV-2 viral to faecal concentration at a national level 26

Figure 5. Presence of SARS-CoV-2 viral load in monitored wastewater 27

Figure 6. Concentration of SARS‐CoV‐2 in the wastewater, aggregate for all the sampling sites in Denmark 27

Figure 7. Total quantity of coronavirus in wastewater and laboratory-confirmed COVID-19 cases, in the areas of 8 treatment plants 28

Figure 8. Structure of the CSV file available containing Sars-Cov-2 wastewater surveillance of data 28

Figure 9. Mean viral load in wastewater 28

Figure 10. National index variation in viral load levels 29

Figure 11. National, population-weighted average of SARS-CoV-2 copy number measured in wastewater. The red dots show the raw data,... 29

Figure 12. Wastewater SARS-CoV-2 detections in Ireland. Week 50 2025 30

Figure 13. Spread of COVID-19 and detection of SARS-CoV-2 in wastewater 31

Figure 14. Vilnius City Wastewater Treatment Plant (copies/ 100,000 pop.) 31

Figure 15. SARS-CoV-2 national levels (RNA copies/day/100.000 inhab) 32

Figure 16. Malta Dashboard 32

Figure 17. The Netherlands. Average virus load (x100 billion) over time per 100,000 inhabitants 32

Figure 18. Mutation rates of the SARS-CoV-2 genome 33

Figure 19. PMMoV normalised levels of SARS-CoV-2 virus in multiple cities across Sweden 34

Figure 20. SARS-CoV-2 viral load distribution map, Istanbul city 36

Figure 21. Seven-day average national trend in COVID-19 wastewater 37

Figure 22. Relative viral load of SARS-CoV-2 at a selected location (Lugano) 37

Figure 23. National SARS-CoV-2 wastewater levels 38

Figure 24. Virus concentration in Komatsu City expressed in copies/liter 38

Figure 25. Average SARS-CoV-2 genome copies detected per person per day in wastewater for New Zealand, along with the reported case numbers 39

Figure 26. Trend graph of 7-day rolling average of COVID-19 viral load in wastewater 40

Figure 27. COVID-19 Wastewater Viral Activity Level Over 1 Year Time 40

Figure 28. Recent mpox detection in wastewater in cities across Canada 42

Figure 29. Mpox virus detection in wastewater in the past 4 weeks, United States 42

Figure 30. Site-level data for avian influenza A(H5) viral RNA detections in wastewater 44

Figure 31. Viral loads for Influenza and RSV across EU countries 46

Figure 32. Influenza virus load 47

Figure 33. Influenza virus load in Vienna 47

Figure 34. Ration between Influenza and PMMoV 47

Figure 35. Influenza A and B viral loads in wastewater (top and middle panels), Helsinki 48

Figure 36. National influenza viral load in wastewater (gene copies per liter) 48

Figure 37/Figure 39. National Influenza Type A Viral Load 48

Figure 38/Figure 37. National, population-weighted average of Influenza A copy number measured in wastewater 49

Figure 39/Figure 38. Influenza A/B national levels (RNA copies/day/100.00inhab) 49

Figure 40. PMMoV normalised Influenza A content 49

Figure 41. Development over time of influenza detections 50

Figure 42. National average of Flu A viral load (copies/ml) in wastewater 50

Figure 43. Influenza A virus concentration in Komatsu City expressed in copies/liter 50

Figure 44. National and Regional trends of wastewater viral activity levels of influenza A 51

Figure 45. RSV virus load 51

Figure 46. Ratio between RSV and PMMoV 51

Figure /Figure 46. Ratio between RSV and PMMoV 52

Figure 47. RSV viral load in wastewater (bottom panel), Helsinki (Number of residents within the network: 860,000) 52

Figure 48. National RSV viral load in the wastewater (no. of gene copies per litre) 52

Figure 49. National, population-weighted average of RSV copy number measured in wastewater 53

Figure 50. RSV national levels (RNA copies/day/100.00inhab) 53

Figure 51. RSV concentration in copies/liter 53

Figure 52. RSV relative viral load for a selected region (Lugano) 54

Figure 53. National average of RSV viral load (copies/ml) in wastewater 54

Figure 54. National and Regional trends of wastewater viral activity levels of RSV 54