1/ We're seeing a concerning rise in H5 wastewater positivity in Turlock CA.
Unlike previous H5 signals, @WastewaterSCAN is showing an exponential rise in H5 (and flu A) concentration that has persisted for almost a month!
2/ For those following #H5N1 in CA, there have been positive farms there since late Aug.
@globaldothealth we're working w/ @ThinkGlobalHlth and @CFR_org to maintain a timeline of key events. This tracking allows us to better piece together signals. thinkglobalhealth.org/article/timeli…
3/ I'm concerned about the H5 wastewater signal because it lags far behind the uptick in farms and is better correlated with the rapid rise in human infections. thinkglobalhealth.org/article/timeli…
4/ Looking regionally at flu A and H5 in the wastewater, there's also a signal in San Jose. However, what we're seeing is largely contained to Turlock, which means there is time to act. Data from @WastewaterSCAN
5/ We urgently need sequence data from the wastewater to confirm it's of human origin and modeling to translate concentrations into estimation of case burden.
You can find the @WastewaterSCAN here: data.wastewaterscan.org/tracker?charts…
6/ I want to stress that these data don't mean human-to-human transmission is happening. We also don't know whether milk byproducts are being dumped in municipal wastewater, as has been seen in Texas.
But, this is *exactly* the kind of early warning signal we must act on!
7/ It's worth noting that the City of Turlock Regional Water Quality Control Facility states, "Nearly half of the flow comes from food processing and dairy industries."
cityofturlock.org/aboutturlock/h…
8/ We know milk processors dumping byproducts into municipal has contributed to H5 signals in Texas, so it's worth taking that hypothesis very seriously in Turlock.
However, in Texas, we saw a *much* more rapid rise (like a step function) to concentrations 5x what we see in CA.
9/ Note that @WastewaterSCAN wasn't testing for H5 back in early 2024, but we can see from their publication that this influenza A signal was almost certainly H5. pubs.acs.org/doi/10.1021/ac…
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