Wastewater surveillance in the military: how deployed members of the armed forces can monitor outbreaks on military vessels

This perspective piece explores the potential to implement wastewater surveillance on military vessels to improve disease monitoring and prevention. We examine five key topics: (1) recent studies of wastewater surveillance on military bases and training centers; (2) best practices for confined populations (e.g., colleges, prisons, hospitals, and low-income and middle-income countries) and their transferability to military settings; (3) current technologies enabling deployed personnel to conduct wastewater surveillance without advanced microbiological training; (4) key questions the military should address to prevent future outbreaks on vessels; and (5) unique ethical considerations surrounding implementation. This work aims to inform military decision-makers considering the adoption of wastewater surveillance programs.