A new wastewater monitoring program means Oklahoma doesn't have to rely solely on testing to find COVID and monkeypox
Researchers at the University of Oklahoma started developing a monitoring program in 2020. Now, they're working with state health officials to scan for about a dozen pathogens.
It’s the first week of school at OU. In a lab — up on the ninth floor of one of the university’s brick buildings — researchers are carrying out work that started back in 2020, when the coronavirus pandemic hit.
They’re decked out: lab coats, safety goggles. Their gloved hands are inside white metal boxes, full of pipettes and tiny tubes.
Dr. Kara de Leon is a microbiologist at OU. She’s overseeing part of an expanded wastewater monitoring program. It’s allowing academic researchers — like the ones in this lab — to work with public health agencies across the state to detect viral and bacterial outbreaks by testing sewage.
Samples come from about 20 cities across the state, taken at different sites — water treatment facilities, airports. De Leon says they’re trying to get that up to 30.
That team is working with another one headed by OU civil engineering professor Dr. Jason Vogel.
He says the practice isn’t new; it helped identify a polio outbreak in Israel in 2013. But it’s new to Oklahoma.
“In Oklahoma, we started in the summer of 2020 on the OU campus,” Vogel said.
The team collected samples from manholes outside of dorms to monitor spread among their residents. It’s been growing since, and now they’re developing a statewide program.
Of course, monitoring across a city looks a little different from monitoring a specific residence hall. They still test manhole-accessible water, but they go to city treatment facilities too.
“In a small community that has 10,000 people, the treatment plant is still pretty representative of a relatively small population, whereas the largest treatment plant in Oklahoma City that we monitor drains 440,000 people,” Vogel said. “When we’re looking at a dorm, we may have been looking at 300 people. And so you can look at different populations… So that’s collected in the field. It’s refrigerated and it’s brought in under controlled conditions. And then we hand it off to Dr. de Leon’s lab. “
There, step one is cleaning up the samples.
“If you think about things that people put down the drain, they vary substantially,” de Leon said.
That’s flushing the toilet, yes, but also dishwashers, laundry machines. And then there are industries contributing too. De Leon says the lab workers extract genetic materials from those samples, and then scan those genetic materials for about a dozen pathogens.
Right now, there is a lot of COVID in the water. That’s easy to find. Vogel says that’s not the case for all of the pathogens.
“Something that’s brand new, such as monkeypox — if there’s only a few cases in there, we may or may not be able to see it, depending on how many people are contributing to that,” he said. “If we have 100,000 people and there’s only one or two cases, that’s going to be hard for us to find that needle in a haystack. “
He and de Leon say there is still work to do to refine the process and make it as accurate as possible.
But State Epidemiologist Jolianne Stone says the program has already proven helpful, especially with COVID.
“One of the ways that COVID wastewater testing was used was to look at where do we need to target testing or vaccination pods or, you know, maybe messaging to let them know that they might have high cases of COVID in their area,” she said.
This monitoring has one major benefit that other sampling, like PCR tests at the county health department, lacks.
“It doesn’t necessarily rely on individuals seeking out testing at a health care provider,” she said. “And in the era of moving to home testing, especially with COVID, we may not always get positive lab results to our agency.”
COVID data is skewed by home testing, monkeypox by misleading symptoms — such as appearing like herpes or other STDs — and some of the infections are transmissible without symptoms. That means these health officials need another way to find infections.