[Pathogen Surveillance in Wastewater from Airport and Port in the Chungcheong Region, Republic of Korea, in 2024].

Objectives: This study aimed to analyze the correlation between pathogen detection through wastewater-based infectious disease surveillance at airports and ports in the Chungcheong region and the incidence of corresponding infectious diseases in the local population. Methods: Between March and December 2024, 192 wastewater samples were collected from Gunsan Port, Pyeongtaek-Dangjin Port, and Cheongju International Airport. Eight infectious disease pathogens were analyzed using TaqMan Array Card-based multiplex detection. Next-generation sequencing was also conducted on selected samples positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to identify the Omicron sublineages. Results: Of the 192 samples, SARS-CoV-2 was detected in 101 (52.6%) and influenza virus in 38 (19.8%). The detection rates were higher at airports (SARS-CoV-2: 72.6%, influenza: 22.6%) than at ports (SARS-CoV-2: 37.0%, influenza: 17.6%). When comparing the monthly detection rates of SARS-CoV-2 and influenza with regional case counts, the SARS-CoV-2 detection rates increased in August and declined in September, showing a similar pattern to the trend in reported cases. In contrast, the influenza virus detection rates in wastewater increased in November, approximately one month earlier than the increase in reported influenza cases observed in December. Sequencing analysis of the SARS-CoV-2 samples identified variants KP.3, JN.1, and XEC, consistent with those reported in domestic patients. Conclusions: Wastewater-based surveillance at airports and ports can serve as an effective supplementary tool to symptom-based quarantine systems, enabling the earlier detection and prevention of the domestic spread of imported infectious diseases.