In article <t15045$2qd6s$106@news.freedyn.de>
<governor.swill@gmail.com> wrote:
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> Start putting CEO's in jail for abusing children.
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The same wastewater surveillance techniques that have emerged as
a critical tool in early detection of COVID-19 outbreaks are
being adapted for use in monitoring the startling spread of
monkeypox across the San Francisco Bay Area and some other U.S.
communities.

Before the COVID pandemic, wastewater sludge was thought to hold
promise as an early indicator of community health threats, in
part because people can excrete genetic evidence of infectious
diseases in their feces, often before they develop symptoms of
illness. Israel has for decades monitored wastewater for polio.
But before COVID, such risk monitoring in the U.S. was limited
largely to academic pursuits.

With the onset of the pandemic, a research collaboration that
involves scientists at Stanford University, the University of
Michigan, and Emory University pioneered efforts to recalibrate
the surveillance techniques for detection of the coronavirus,
marking the first time that wastewater has been used to track a
respiratory disease.

That same research team, the Sewer Coronavirus Alert Network, or
SCAN, is now a leader in expanding wastewater monitoring to
detect monkeypox, a once-obscure virus endemic to remote regions
of Africa that in a matter of months has infected more than
26,000 people globally and more than 7,000 across the U.S. The
Biden administration last week declared the monkeypox outbreak a
public health emergency, following similar decisions by health
officials in California, Illinois and New York.

And SCAN's scientists envision a future in which wastewater
sludge serves as a reservoir for tracking a slew of menacing
public health concerns. "We're looking at a whole range of
things that we might be able to test for," said Marlene Wolfe,
an assistant professor of environmental health at Emory.

Since expanding its surveillance in mid-June, the SCAN team has
detected monkeypox in several of the Northern California
sewersheds it is monitoring, including Palo Alto, San Jose,
Gilroy, Sacramento, and two locations in San Francisco. Funded
by grants from the National Science Foundation and the CDC
Foundation, SCAN is doing similar monitoring in Colorado,
Georgia, Michigan and four other states, and wants to scale up
to 300 U.S. sites.

It is one of a growing number of sewage surveillance projects
across the U.S. run jointly by universities, public health
agencies, and utilities departments that are feeding COVID
findings to state and federal agencies. How many of those
networks have expanded their search to monkeypox is unclear.
SCAN sites in California, Georgia, Michigan and Texas, and a
research team in Nevada are among the few that have reported
sludge samples that tested positive for the monkeypox virus.

Another public health tool
As with COVID, data on monkeypox can be used to compare trends
across regions, but there are limits to what this kind of
monitoring can accomplish. Wastewater monitoring doesn't
pinpoint who is infected; it reveals only the presence of a
virus in a given area. And it takes a specialist to analyze the
samples. Researchers consider wastewater surveillance a
complement to other public health tools, not a replacement.

"We're still really on the front end in terms of discovering the
potential here," said Heather Bischel, an assistant professor in
civil and environmental engineering at the University of
California Davis, which included wastewater monitoring as part
of its Healthy Davis Together COVID testing program for the
campus and surrounding community. "But what we've seen already
shows that this type of monitoring is adaptable to other public
health threats."

Some U.S. communities were sampling sewage before the pandemic
to figure out what kinds of opioids residents were using. More
recently, along with COVID and monkeypox, the technology has
shown promise for monitoring flu and respiratory syncytial
virus, or RSV. The federal Centers for Disease Control and
Prevention is planning pilot studies to see whether sewage can
reveal trends in antibiotic-resistant infections, foodborne
illnesses and candida auris, a fungal infection.

Much of the wastewater testing that ramped up during the
pandemic's first year was done in concert with universities or
county offices and reliant on funding provided through federal
COVID relief legislation. On Bischel's campus, those funds were
combined with university donor money to put together a
comprehensive testing and treatment program for the school and
the city of Davis that included wastewater surveillance. The
sewage testing is ongoing under a separate grant.

Currently, the CDC is reporting only COVID results on its
national wastewater surveillance system, a reflection of the
limited number of sewersheds that so far are testing for
monkeypox.

The global spread of monkeypox was first detected in the United
Kingdom in May and prompted conjecture that this virus, too,
might shed into wastewater, either through feces or when an
infected person with an open sore takes a shower. Sewersheds in
areas with infected people might then "light up" with evidence
of the disease � if the wastewater testing could pinpoint it.

"It did light up," said Brad Pollock, who chairs public health
sciences at UC Davis Health. "It acts as a warning system, and
you don't have to persuade people to take individual tests in
order to use the information; it's collected passively, so you
get a more broad community look."

A public health emergency
The virus is thought to be spreading primarily through intimate
skin-to-skin contact and exposure to symptomatic lesions,
although researchers are exploring other potential means of
transmission. For now, the U.S. outbreak is concentrated largely
in gay communities among men who have sex with men.

The discovery of monkeypox in San Francisco's wastewater system
in June, the first such finding in the nation, set off alarms in
a city with a thriving LGBTQ+ population. On July 28, San
Francisco declared monkeypox a public health emergency, urging
the federal government to step up its distribution of vaccines.

For its Northern California surveillance, SCAN partners with
local health officials and universities to collect samples and
then sends them to Verily Life Sciences � a health tech company
owned by Google's parent company, Alphabet � for analysis. In
the Atlanta area, SCAN is working with Emory and Fulton County
health officials.

Not all public health agencies are moving as fast. A wastewater
monitoring plan for the virus is only now being put together in
Los Angeles County, which had confirmed more than 300 cases of
monkeypox by the end of July.

And though California is collecting monkeypox data from its
surveillance partners, it's not available for all regions,
underscoring that wastewater monitoring for viruses is still an
emerging methodology.

"With every new thing that we add to the testing platform, we
are learning things," said SCAN's Wolfe. "The pandemic really
cracked open our imagination for a tool that already existed but
that hadn't been developed to its full capacity. That's changing
now."

KHN (Kaiser Health News) is a national newsroom that produces in-
depth journalism about health issues. It is an editorially
independent operating program of KFF (Kaiser Family Foundation).

https://www.npr.org/sections/health-
shots/2022/08/08/1115455190/covid-sewage-surveillance-labs-join-
the-hunt-for-monkeypox