Many of the EV detected in sewage have been related to severe symptomatology such as AFP or AFM (EV-A71, CVA6, CVA9, CVB3, CVB4, CVB5, E6, E9, E11, E25, CVA24, EV-D68, EV-C99) [8,31–35], myopericarditis (CVA16, CVB2, CVB3, CVB5, E9) [32,36,37], encephalitis (CVB3, CVB5, E9, E11) [32,38,39], meningitis (CVA9, CVA10, CVB3, CVB5, E9, E18, E30, CVA22, CVA24) [32,40–43] and other milder syndromes such as HFMD (CVA5, CVA6, CVA10, CVA16, CVB3, CVB5) [44–47]. Here, AFP is linked to viral encephalitis.