US data: Wastewater monitoring can boost flu preparedness, has public support

Morbidity and Mortality Weekly Report (MMWR) yesterday printed a examine suggesting that wastewater surveillance for detecting influenza viruses equivalent to H5N1 avian flu can help public well being preparedness and the outcomes of a survey discovering that 95% of US adults say they might take motion to guard themselves if wastewater information flagged illness transmission of their group.

Animal sources recognized at 15 websites

For the examine, researchers from the Facilities for Illness Management and Prevention (CDC) and different public well being companies reported on ranges of influenza A virus and the H5 subtype in wastewater from January to August 2024. The examine interval spans the primary 9 weeks of the continued H5N1 outbreak in US cattle and poultry, in addition to 13 associated human infections.

“As a part of the response to this outbreak, CDC and state and native well being departments are utilizing wastewater surveillance to observe influenza A virus and the H5 subtype; nonetheless, present testing methods can not distinguish between human and animal sources,” the examine authors wrote.

Public well being companies that conduct wastewater monitoring to enhance influenza surveillance methods ought to be ready so as to add influenza A virus subtype testing when wanted.

Amongst 309 websites in 38 states that generated enough information from monitoring wastewater for influenza A from Could 12 to July 13, 2024, 11 websites in 4 states (California, Illinois, Kansas, and Oregon) detected excessive concentrations of the virus. Three of the 4 states additionally had proof of human flu exercise from different surveillance methods. H5 subtype testing carried out at 203 websites in 41 states revealed H5 in wastewater at 24 websites in 9 states.

Seven of the 9 states with H5 in wastewater reported an H5N1-infected herd, and one other state reported an contaminated herd earlier than the examine interval. Two states, Colorado and Michigan, documented human H5N1 infections.

Every detection or excessive focus triggered the CDC to work with state and native well being departments to investigate information from different flu surveillance methods. The companies additionally labored with wastewater utilities and agriculture departments to establish potential sources of the virus.

Of the 24 websites with H5 detections, 15 pinpointed animal sources within the sewershed or neighboring county, together with eight milk-processing sources. Different sources had been meat-processing and dairy services, wild birds, home poultry farms, and livestock waste from, for instance, a truck wash.

“The present zoonotic outbreak of HPAI A(H5N1) virus highlights the significance of coordination throughout well being, agriculture, wildlife, meals security, and different companions,” the examine authors wrote. “Investigations into wastewater alerts additionally require coordination amongst public well being, educational, municipal water remedy, and group companions.”

“Public well being companies that conduct wastewater monitoring to enhance influenza surveillance methods ought to be ready so as to add influenza A virus subtype testing when wanted to enhance understanding of influenza A virus detections within the context of the present HPAI A(H5N1) outbreak,” they added. “CDC-funded Nationwide Wastewater Surveillance System’s Facilities of Excellence are increasing influenza A virus testing and subtyping, which might contribute to supply investigations and be deployed at strategic instances and locations.”

75% help public well being wastewater monitoring

From July 24 to 26, 2024, Porter Novelli Public Companies fielded a nine-question on-line survey developed with the CDC to 1,016 US adults to gauge their help for wastewater infectious-disease monitoring and protecting well being behaviors to assist form messaging about wastewater surveillance.

These findings point out robust help for wastewater monitoring for infectious ailments amongst U.S. adults throughout varied sociodemographic teams and intention to make use of reported wastewater information to information sure health-related behaviors.

In complete, 74.6% of respondents strongly or considerably supported public well being wastewater monitoring for infectious ailments. The outcomes had been related throughout races however different considerably by age, training, and marital standing.

Contributors strongly or considerably agreed (57.8%) that they wished entry to fast wastewater information, even when it contained inadequate data to find out public well being danger or inform particular protecting actions.

Black respondents (67.5%) had been almost definitely to say they wished fast wastewater information, adopted by Hispanic (64.2%) and non-Hispanic folks of different races (65.5%), and White folks (52.9%). Respondents most supportive of fast entry to wastewater information had been males, employed folks, and people dwelling in city or suburban communities.

Almost all members (95.3%) mentioned they might take into account taking at the very least one motion to guard their well being if wastewater information confirmed a virus equivalent to flu of their space. Probably the most-cited actions had been extra frequent handwashing (76.1%), avoidance of huge gatherings (61.1%), and avoidance of visiting folks at excessive danger for flu-related issues (59.1%).

“These findings point out robust help for wastewater monitoring for infectious ailments amongst U.S. adults throughout varied sociodemographic teams and intention to make use of reported wastewater information to information sure health-related behaviors,” the researchers wrote.

“As well as, most respondents indicated that they wished entry to fast wastewater information even when data obtainable to find out public well being danger or which actions ought to be taken is inadequate,” they added. “Wastewater information might help maintain the general public knowledgeable and ought to be accompanied by clear public well being interpretations.”