Wastewater testing could help identify monkeypox spread

As sewage testing continues to prove useful in estimating the spread of the coronavirus, scientists are once again using sewage to track the latest public health emergency: monkeypox.

In late June — about a month after the first case was confirmed in California — monkeypox DNA was detected in San Francisco sewage, according to the WastewaterSCAN coalition, a group of scientists who have been testing sewage for the presence of the coronavirus since 2020.

The group recently confirmed the presence of the monkeypox virus in Los Angeles County litter.

“It helps to understand how widespread this is,” said Alexandria Boehm, professor of civil and environmental engineering at Stanford, one of the lead researchers on the WastewaterSCAN team.

She said COVID-19 sewage testing has been particularly useful during the “early stages” or immediately after a new variant has been identified, but the extent of their presence is unclear. Public health officials can use the information to theorize how big the spread could get.

“We’re kind of in there [phase] now for monkeypox,” Boehm said.

Monkeypox DNA was first detected in Los Angeles County sewage on July 31, about 20 days after the WastewaterSCAN group expanded its monkeypox testing beyond the Bay Area to nearly 40 other facilities across the country — including in LA, according to the data of the group.

Samples from LA’s Joint Water Pollution Plant in Carson, which serves approximately 4 million residents and businesses, showed low levels of monkeypox virus presence on July 31 and three days in the first week of August, according to WastewaterSCAN data. Since then, the virus has not been detected there, despite rising cases of monkeypox in Los Angeles County.

By comparison, since June 27, monkeypox DNA has been detected in two San Francisco sewage treatment plants almost every day — and at much higher levels than LA County.

However, Boehm said that doesn’t mean that monkeypox is gone in Los Angeles County; It’s just hard to tell from the massive sample size.

Because LA’s sewage treatment facility serves such a large number of people, “one has to think about the sensitivity of detecting monkeypox relative to the incident rate in the population,” Boehm said. “Just because you don’t find monkeypox doesn’t mean there isn’t anyone [in that waste watershed] with monkey pox.”

The two San Francisco facilities serve a much smaller population, approximately 100,000 residents each.

While both Los Angeles and San Francisco have both seen rapid increases in monkeypox cases in recent weeks, the totals still represent only a fraction of each county’s population: about 600 in San Francisco among fewer than 1 million residents and about 1,000 in LA County under 10 million inhabitants, according to the health departments of the individual districts.

“We do [wastewater] Monitoring for monkeypox, and it’s only just been identified,” the Los Angeles Department of Health said in a statement. “Identification has taken longer here than it most likely has in some places because we have a large population relative to the number of cases. Wastewater monitoring is relatively new and in some ways still experimental.”

It wasn’t immediately clear if the LA County Health Department planned to expand monkeypox testing in sewage or how it would use the data. The county has been monitoring wastewater for the coronavirus for months, including at the Joint Water Pollution Plant and Hyperion Water Reclamation Plant in Playa Del Rey and facilities near Lancaster and Malibu.

As at-home COVID-19 testing began to limit the ability to monitor case numbers, LA County public health officials often used sewage data to track transmission trends — a factor that played a role in the decision not to mandate another mask for the implement indoors.

“It’s helpful to have that extra lens into the epidemiology and dynamics of disease because it doesn’t rely on human behavior or testing,” Boehm said. “There’s kind of a health equity component.”

She said wastewater data can help inform public health decisions, such as B. where to find information, clinics or treatments.

WastewaterSCAN scientists call the virus data “invaluable” after finding monkeypox at 22 California wastewater facilities from San Diego to Sacramento and nine facilities in seven other states.

There isn’t yet a national database tracking monkeypox in trash like the CDC does for COVID-19, but Boehm said she’d like to see testing expand. Her team is also working to test wastewater for influenza A and respiratory syncytial virus (RSV), which she hopes can continue to help answer questions about virus transmission.

She said she wants the sewage tests, which have proven extremely accurate, to be used to inform care, treatment and even vaccine development of current virus outbreaks — as well as future ones.

“I’m a scientist, so I’m curious to see how far we can take this,” Boehm said. “It’s proving to be a really interesting and amazing resource for understanding public health.”

https://www.latimes.com/california/story/2022-08-18/wastewater-testing-could-help-identify-monkeypox-spread Wastewater testing could help identify monkeypox spread

Russell Falcon

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