It emerged as a robust software for public well being officers through the COVID-19 pandemic, when it was used to gauge the prevalence of coronavirus in communities throughout the nation.
However wastewater surveillance — the testing of sewage for indicators of pathogens similar to SARS-CoV-2, poliovirus and mpox virus — has but to be employed within the monitoring of H5N1 fowl flu virus.
Now, as officers try to find out the extent of fowl flu outbreaks amongst dairy herds, some consultants are urging that wastewater surveillance start instantly. Others are faulting the U.S. Facilities for Illness Management and Prevention for reportedly discouraging its use.
“It has been constantly demonstrated that wastewater surveillance solely enhances conventional surveillance, and infrequently outperforms it on the subject of early/well timed outbreak or surge detection,” stated Denis Nash, distinguished professor of epidemiology and govt director of Metropolis College of New York’s Institute for Implementation Science in Inhabitants Well being.
“On this case, since conventional surveillance shouldn’t be actually systematically occurring, and wastewater surveillance is comparatively low-cost and simple to implement, it makes lots of sense to me to go forward and deploy it strategically,” stated Nash, whose workforce developed New York Metropolis’s community-based wastewater surveillance for SARS-CoV-2.
That has not been the view of the CDC, nonetheless.
Not too long ago, Marc Johnson, a professor of molecular microbiology and immunology on the College of Missouri, stated he was advised by the company to not use a virus assay he’d created for the aim of monitoring H5N1 outbreaks. The explanation? Johnson stated officers advised him it could simply add to the confusion.
Johnson stated that if the assay had been in widespread use earlier this yr, the unfold of fowl flu by way of the nation’s dairy herds might conceivably have been stopped, or at the least slowed down.
“I all the time suppose the extra data we’ve, the higher,” he stated.
Nevertheless, he stated he did perceive the federal government’s rationale.
“Public well being doesn’t like ambiguous data,” he stated. “You get a optimistic, you don’t know if that’s from a cow or a fowl. Or perhaps from milk poured down the drain.”
The CDC didn’t reply to questions from The Instances.
Concern over the virus escalated in March, when federal officers introduced the invention of avian flu in a Texas dairy herd. Over the following few weeks, stories of the virus in different states started to pop up. It additionally confirmed up in barn cats that drank uncooked milk, and in a single dairy employee.
H5N1 fowl flu has now been detected in 36 herds throughout 9 states, and well being and U.S. Division of Agriculture officers are scrambling to find out its attain. They consider the virus was launched by a wild fowl — both through contact or feed — at a Texas farm in December, giving the virus months to journey to different herds and animals.
The virus was additionally present in one in every of 5 grocery-shelf milk samples examined by federal researchers. These samples confirmed the virus had been inactivated by pasteurization, lowering the well being risk to folks.
In California, the place the virus has but to be detected in dairy cows, wildlife officers are protecting a cautious eye on migrating wild fowl populations in addition to home poultry and livestock.
Eric Topol, a professor of molecular drugs at Scripps Analysis Institute in La Jolla, stated the CDC is “off base” to say wastewater surveillance would trigger confusion.
“If something, we have to monitor the unfold of the virus and its evolution, which isn’t getting accomplished nicely by USDA and CDC,” he stated.
Michael Payne, a dairy educator and researcher on the College of California’s College of Veterinary Drugs, agreed with that sentiment. Though he was not conversant in the assay Johnson devised, he stated an correct check could be useful.
“Such a wastewater assay may very well be a great tool, even given the uncertainty of precisely the place the virus was coming from,” he stated. “There’s a rising physique of literature that’s utilizing PCR testing in wastewater to measure pathogens of public well being curiosity.”
Nash, of CUNY, stated he’d advocate for a “strategic deployment of community-based and facility-based wastewater surveillance.”
He stated testing wastewater at hospitals and well being clinics would offer clear alerts if an outbreak have been to happen. Beginning testing now, when a baseline for different “complicated” components similar to contaminated milk and fowl droppings may very well be established, would assist quell that noise.
He stated that within the present scenario, “we want dependable early warning as a result of if neighborhood unfold did occur, each further day of discover would matter an important deal by way of potential lives saved.”
