Volta

Traveler-based Genomic Surveillance: A Scalable Approach to Early Pathogen Detection and Global Biosecurity

Abstract Background In September 2021, the U.S. Centers for Disease Control and Prevention (CDC) implemented the Traveler-based Genomic Surveillance (TGS) program, a surveillance system that leverages genomic sequencing of samples from international air travelers and aviation wastewater for early detection of infectious threats. Methods During September 2021–August 2024, nasal samples were collected anonymously from volunteer international travelers arriving at eight U.S. airports. During February 2023– August 2024, aviation wastewater samples were collected from arriving flights. Nasal samples were pooled and sent to a laboratory for RT-PCR testing. Genomic sequencing was conducted for SARS-CoV-2 and respiratory, gastrointestinal (wastewater), and other pathogens of public health importance. Findings Nasal samples from 694,798 travelers were grouped into 67,308 pools and tested; 13,990 (20.8%) were …

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