Imagine a silent, invisible threat spreading through your community. Measles, a highly contagious disease, is making a comeback, and public health officials are turning to an unlikely ally: our own wastewater. But here's where it gets controversial: is this high-tech tracking system reaching everyone who needs it most, or are some communities being left behind?
FOX 13 News Utah (KSTU) reports that wastewater surveillance, a method that gained prominence during the COVID-19 pandemic, is now being deployed in Utah to monitor the spread of measles. Think of it like this: scientists are analyzing sewage for traces of the measles virus. This allows them to get a sense of how much disease activity is happening across entire communities, potentially even before people start showing symptoms and going to the doctor.
Nathan LaCross, the manager of Utah’s wastewater surveillance system, explains that what started with COVID-19 has evolved into a broader public health tool. "It started with COVID, and that’s how wastewater surveillance as a sort of long-term, broad-scale public health surveillance tool really got going," he says. "For us, and really nationwide, almost every state has a program like ours in some fashion." In essence, it provides an early warning system, supplementing traditional methods like reported cases and contact tracing, which can sometimes miss cases.
LaCross emphasizes that while traditional methods are still crucial, wastewater data can offer a more complete picture. "Just having additional data available is proving, in some ways, more reliable than some of the more traditional data streams," LaCross said. "The data we get from clinical case finding and contact tracing is extremely valuable, but we know it is also extremely incomplete." For example, some people with mild measles may not even realize they have it and therefore won't get tested. Wastewater surveillance can pick up these hidden cases. And this is the part most people miss: it’s not replacing traditional methods, but enhancing them.
Despite the potential benefits, the report reveals significant gaps in Utah's wastewater testing coverage. Large portions of central and southeastern Utah are currently not being monitored. Specifically, the Central Utah Health Department, serving six counties (Juab, Millard, Piute, Sanpete, Sevier, and Wayne), and San Juan County are not part of the state's active wastewater sampling network.
WATCH: Utah sees climbing measles count amid public exposure concerns
So, why the gaps? The primary reason, according to LaCross, is cost. "We don’t have any current sampling sites there, no," he said. "We had to scale back when we went from sampling once per week to twice per week because it is about twice as expensive to do." This raises a critical question: Is it ethical to prioritize wastewater surveillance in some communities while leaving others vulnerable due to budget constraints?
The Central Utah Health Department, in a statement provided to FOX 13 News, claims that the decision to discontinue wastewater testing in its district was made without their consultation by the Utah Department of Health and Human Services (UDHHS). Their full statement reads:
"Wastewater surveillance testing for diseases, including measles, is directed and conducted through the Utah Department of Health and Human Services (UDHHS) and the Utah Public Health Laboratory (UPHL), in cooperation with local sewer districts. The decision to not conduct wastewater testing in the central health district was made by UDHHS; the Central Utah Health Department (CUHD) was not consulted at any point. Upon inquiry regarding this decision, the CUHD was informed by UDHHS that previous wastewater surveillance testing was discontinued because it was not cost effective to test within the health district. When CUHD inquired about the possibility of measles wastewater testing, UDHHS indicated that a lack of funding would not allow for bringing on testing sites in central Utah at this time.
CUHD feels that regardless of whether wastewater surveillance is being conducted, the message around measles response in central Utah remains the same. Measles cases have been identified in the health district and throughout the state, and therefore, it is essential for individuals to be vigilant in protecting themselves from the virus. Vaccination has been, and continues to be, the best protection against contracting measles. CUHD encourages the public to be fully vaccinated in order to build herd immunity and limit further community spread of the virus.”
Even without wastewater data, measles cases have been identified in central Utah through traditional surveillance. Health officials consistently emphasize that vaccination remains the most effective way to prevent infection and curb the spread of measles. Think of vaccination as building a wall of immunity around yourself and your community. The more people vaccinated, the harder it is for the virus to spread.
"We study diseases in populations and how to make them less severe and ideally prevent them altogether," LaCross said. "That’s a tough ask, but that’s always our gold standard."
The Utah Department of Health and Human Services provides a public online dashboard where residents can track disease trends, including measles data, at the local health department level. This data is updated as it becomes available. You can view the dashboard HERE (https://avrpublic.dhhs.utah.gov/uwss/).
Ultimately, wastewater surveillance represents a powerful tool in the fight against infectious diseases. But the question remains: how do we ensure equitable access to this technology and protect all communities, regardless of their location or budget? What are your thoughts on wastewater surveillance? Is it a worthwhile investment, even if it means some areas are left out? Share your opinions in the comments below!
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