The UK Health Security Agency (UKHSA) is launching a major expansion of its environmental surveillance capabilities, establishing an England-wide wastewater monitoring network designed to identify dangerous pathogens and antimicrobial resistance before they trigger hospital outbreaks.
Known as PRISM (Pathogen Risk Intelligence through Surveillance and Modelling), the initiative builds on pilot work begun in April 2025.
Supported by a two-year £3 million investment from the Cabinet Office’s UK Integrated Security Fund (ISF), the project moves environmental surveillance from municipal treatment works directly into high-risk settings, including targeted hospital wastewater outlets and major transport hubs.
A key technical departure from historical wastewater monitoring-such as the UK’s longstanding polio surveillance-is PRISM’s "pathogen-agnostic" design. Powered by advances in molecular genomics, high-throughput sequencing, and artificial intelligence, the platform operates on a "sample once, test many" framework. This allows scientists to screen a single environmental collection for emerging infectious diseases, bioterror threats, and resistance genes concurrently.
While deadly haemorrhagic fevers such as Ebola, Marburg, Lassa fever, and Crimean-Congo haemorrhagic fever are not present in the UK, officials noted the system creates a resilient tripwire capable of intercepting introduced pathogens rapidly.
During development phases, PRISM successfully mapped seasonal circulation patterns of norovirus, using AI models to differentiate between circulating sub-lineages across various regions. The programme is now actively incorporating surveillance for antimicrobial resistance (AMR), tracking dangerous multidrug-resistant bacteria and fungi such as Candidozyma auris and hypervirulent Klebsiella pneumoniae to map where resistance is emerging.
Professor Robin May, Chief Scientific Officer at UKHSA, stated: "The diversity of biological threats we face is growing and we need to continue to innovate in order to stay ahead of that curve. PRISM is a great step in that direction, setting the foundations for a powerful early warning system that will help us respond swiftly in order to protect the public before problems reach our hospitals and communities.
"Though viruses such as Crimean-Congo Haemorrhagic Fever and Ebola are, happily, absent from the UK, this new surveillance means we would be better equipped to spot them early, should they ever arrive in this country. In addition, this powerful surveillance system is already being used to track more common pathogens such as norovirus, giving us a clearer picture of the behaviour of important pathogens that cause pressures for the NHS every winter."
