Wastewater Target Pathogens of Public Health Importance for Expanded Sampling, Houston, Texas, USA.

Building on the success of initiatives put forth during the COVID-19 pandemic response, US health officials are expanding wastewater surveillance programs to track other target pathogens and diseases of public health interest. The Houston Health Department in Houston, Texas, USA, conducted a hypothesis-generating study whereby infectious disease subject matter experts suggested potential targets. This study addressed 2 criteria recommended by the National Academies of Sciences, Engineering, and Medicine for selecting wastewater targets. Results can be used as a basis of a questionnaire for a future population-based study to recommend targets of highest priority to include for expanded wastewater sampling.

Assessment of Public Health Agency and Utility Training Needs for CDC National Wastewater Surveillance System Jurisdictions in the United States.

Since the start of the COVID-19 pandemic, wastewater surveillance hasemerged as a critical tool for tracking the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus and other pathogens in communities throughout the United States. In 2020, the Centers for Disease Control and Prevention (CDC) launched the National Wastewater Surveillance System (NWSS), which partners with state, local, tribal, and territorial health departments to develop and implement wastewater collection and analysis systems and to share data. In 2022, the CDC established the first two NWSS Centers of Excellence to lead its implementation and coordination efforts-one in Colorado (Colorado CoE) and one in Houston (Houston CoE). As the NWSS expands, it is becoming more important to support the training needs of jurisdictions at different stages of developing their wastewater surveillance infrastructure. To evaluate these needs, the Colorado CoE and Houston CoE conducted a needs assessment study of NWSS-funded public health agencies and public utilities departments located in the United States using surveys developed by the Colorado CoE. The results of the surveys showed that although some training needs were universal, it will be most beneficial to develop training modules tailored to the needs of entities that operate wastewater surveillance programs of various sizes, workforce experience levels, and at different stages in the infrastructure development process.

A Novel Framework for Internal Responses to Detection of Pathogens in Wastewater by Public Health Agencies.

OBJECTIVES: To build on the success of wastewater surveillance during the COVID-19 pandemic, jurisdictions funded under the Centers for Disease Control and Prevention National Wastewater Surveillance System are looking to expand their wastewater programs to detect more pathogens. However, many public health agencies do not know how to use the collected wastewater data to formulate public health responses, underscoring a need for guidance. To address this knowledge gap, the Houston Health Department (HHD) developed a novel response framework that outlines an internal action plan that is tailored by pathogen type after detection of various pathogens in wastewater. MATERIALS AND METHODS: In July 2023, HHD met with subject matter experts (eg, bureau chiefs, program managers) in internal departments, including epidemiology, immunization, and health education, to discuss the general outline of the response framework and each department's anticipated role after pathogen detection. RESULTS: The internal framework established a flow for notifications and the actions to be taken by departments in HHD, with the goals of (1) ensuring timely and efficient responses to pathogen detections, (2) creating accountability within departments for taking their assigned actions, and (3) making certain that HHD was prepared for intervention implementation when a new pathogen was detected. PRACTICE IMPLICATIONS: As more public health agencies expand their wastewater surveillance programs to target additional pathogens, development of internal action plans tailored to departmental capacity and programs is an important step for public health agencies. The information compiled in this response framework can be a model for other public health agencies to adopt when expanding the scope of their wastewater monitoring systems.

Implementing an Alert System for Communicating Actionable Wastewater Surveillance Results to School Communities, Houston, Texas, 2023-2024.

In 2020, the Houston Health Department (HHD) in Texas launched a citywide wastewater surveillance program, including a pilot program that monitored manholes at schools in Houston's largest school district (prekindergarten-12th grade). By 2022, the pilot program monitored wastewater for SARS-CoV-2, influenza A and B, and respiratory syncytial virus. To ensure effective communication of wastewater surveillance results to school communities, HHD designed and implemented a text- and email-based alert system using existing City of Houston resources. This alert program informs recipients about the presence of a virus at their schools and actions to protect themselves and others against that virus. To promote alert program sign-ups, a dedicated bilingual community involvement coordinator conducted in-person outreach geared toward school nurses and student caregivers. From September 2023 through February 2024, a combined 5178 alerts for 43 schools were sent following virus detections. As a supplemental initiative, HHD offered vaccination events to pilot program schools with consistent virus detection. As wastewater surveillance becomes more common across the United States, this alert program presents a framework for other public health agencies to scale and adapt according to their resources.

Public Health Interventions Guided by Houston's Wastewater Surveillance Program During the COVID-19 Pandemic.

Since the start of the COVID-19 pandemic, wastewater surveillance has emerged as a powerful tool used by public health authorities to track SARS-CoV-2 infections in communities. In May 2020, the Houston Health Department began working with a coalition of municipal and academic partners to develop a wastewater monitoring and reporting system for the city of Houston, Texas. Data collected from the system are integrated with other COVID-19 surveillance data and communicated through different channels to local authorities and the general public. This information is used to shape policies and inform actions to mitigate and prevent the spread of COVID-19 at municipal, institutional, and individual levels. Based on the success of this monitoring and reporting system to drive public health protection efforts, the wastewater surveillance program is likely to become a standard part of the public health toolkit for responding to infectious diseases and, potentially, other disease-causing outbreaks.

Addition of fructooligosaccharides and dried plum to soy-based diets reverses bone loss in the ovariectomized rat.

Dietary bioactive components that play a role in improving skeletal health have received considerable attention in complementary and alternative medicine practices as a result of their increased efficacy to combat chronic diseases. The objectives of this study were to evaluate the additive or synergistic effects of dried plum and fructooligosaccharides (FOS) and to determine whether dried plum and FOS or their combination in a soy protein-based diet can restore bone mass in ovarian hormone deficient rats. For this purpose, 72 3-month-old female Sprague-Dawley rats were divided into six groups (n = 12) and either ovariectomized (Ovx, five groups) or sham-operated (sham, one group). The rats were maintained on a semipurified standard diet for 45 days after surgery to establish bone loss. Thereafter, the rats were placed on one of the following dietary treatments for 60 days: casein-based diet (Sham and Ovx), soy-based diet (Ovx + soy) or soy-based diet with dried plum (Ovx + soy + plum), FOS (Ovx + soy + FOS) and combination of dried plum and FOS (Ovx + soy + plum + FOS). Soy protein in combination with the test compounds significantly improved whole-body bone mineral density (BMD). All test compounds in combination with soy protein significantly increased femoral BMD but the combination of soy protein, dried plum and FOS had the most pronounced effect in increasing lumbar BMD. Similarly, all of the test compounds increased ultimate load, indicating improved biomechanical properties. The positive effects of these test compounds on bone may be due to their ability to modulate bone resorption and formation, as shown by suppressed urinary deoxypyridinoline excretion and enhanced alkaline phosphatase activity.

Combining fructooligosaccharide and dried plum has the greatest effect on restoring bone mineral density among select functional foods and bioactive compounds.

Functional foods and/or their bioactive compounds playing a role in improving skeletal health have received considerable attention. The objective of the present study was to determine the extent to which certain functional foods as (1) whole, e.g., dried plum (DP), figs, dates, raisin, and blueberry, (2) fractionated, e.g., DP puree, DP juice, and DP pulp/skin, or (3) isolated, e.g., DP polyphenols, fructooligosaccharides (FOS), and beta-hydroxy-beta-methylbutyrate, forms reverse bone loss in an ovariectomized (Ovx) rat model of osteoporosis. Additionally, some of these components were tested in reversal of bone loss in combination. For this purpose, 180 3-month-old female Sprague-Dawley rats were divided into 15 groups (n = 12) and either Ovx (14 groups) or sham-operated (Sham, one group). Rats were maintained on a semipurified standard diet for 45 days after surgery to establish bone loss. Thereafter, rats were placed on one of the following dietary treatments for 60 days: casein-based diet (Sham and Ovx). The remaining 13 Ovx groups were placed on various treatment diets. Results showed that diets supplemented with 5% FOS + 7.5% DP was most effective in reversing both right femur and fourth lumbar bone mineral density and fourth lumbar calcium loss while significantly decreasing trabecular separation. There were no significant effects of treatment on serum or urine measures of bone turnover. Although other treatments were good at altering some bone parameters, none had the success in altering several bone health indicators as the diets supplemented with 5% FOS + 7.5% DP. The findings of this study suggest the combination of 5% FOS + 7.5% DP is capable of reversing Ovx-induced bone loss.