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Wastewater testing helps public health officials detect measles early

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Wastewater testing can alert public health officials to measles infections days to months before cases are confirmed by doctors, researchers said in two studies published Thursday by the Centers for Disease Control and Prevention.

Colorado health officials were able to get ahead of the highly contagious virus by tracking its presence in sewer systems, researchers wrote. And Oregon researchers found wastewater could have warned them of an outbreak more than two months before the first person tested positive.

The findings add to evidence that wastewater testing is a valuable weapon in tracking disease, including Covid-19, polio, mpox and bird flu.

But the national wastewater surveillance systemrun by CDC since 2020, is newly at risk, under a Trump administration budget plan would slash its funding from about $125 million a year to about $25 million.

Peggy Honein, director of the CDC’s division of infectious disease readiness and innovation, said the proposed funding level would “sustain some of the most critical activities” but “it would likely require some prioritization.”

The national system covers more than 1,300 wastewater treatment sites serving 147 million people. It includes six “centers for excellence” — Colorado among them — that innovate and support other states in expanding their testing.

States brace for cuts

The funding cut is still a proposal, and Congress has started pushing back against cuts to health care in general.

But state health departments say they are preparing for a potential loss of federal support regardless. Most state programs are entirely federally funded, Honein said.

Colorado started its wastewater surveillance program in 2020 with 68 utilities participating voluntarily. The program has since narrowed in its focus even as it grew to include more diseases, because it is 100% federally funded, said Allison Wheeler, manager of the Colorado’s wastewater surveillance unit.

The work is funded through 2029, Wheeler said, and the department is talking to state leaders about what to do after that.

“I know that there are other states that haven’t been as fortunate as us,” Wheeler said. “They need this funding in order to sustain their program for the next year.”

Measles found in wastewater before patients are diagnosed

In the Colorado studywhich Wheeler co-authored, officials started testing wastewater for measles in May, as outbreaks in Texas, New Mexico and Utah were growing and five cases had been confirmed in Colorado.

In August, wastewater in Mesa County tested positive about a week before two measles cases were confirmed by a doctor. Neither patient knew that they had been exposed to measles. As they traced 225 household and health care contacts of the first two patients, health officials found five more cases.

In Oregonresearchers used preserved sewage samples from late 2024 to determine if sewage testing could have discovered a burgeoning outbreak.

The 30-case outbreak spanned two counties and hit a close-knit community that does not readily seek health care, the study’s authors wrote. The first case was confirmed on July 11 and it ultimately took health officials 15 weeks to stop the outbreak.

The researchers found that wastewater samples from the area were positive for measles about 10 weeks before the first cases were reported. The virus concentration in the wastewater over the weeks also matched the known peak of the outbreak.

“We knew that we were missing cases, and I think that’s always the case in measles outbreaks,” said Dr. Melissa Sutton, of the Oregon Health Authority. “But this gave us an insight into how much silent transmission was occurring without us knowing about it and without our health care system knowing about it.”

State see value in sewage tracking

Other states, such as Utahhave integrated wastewater data into their public-facing measles dashboards, allowing anyone to track outbreaks in real time.

And in New Mexico, where 100 people got measles last year and one died, the testing helped state health officials shrink a vast rural expanse. The state’s system flagged cases in northwestern Sandoval County while officials were focused on a massive outbreak 300 miles (483 kilometers) away in the southeast, said Kelley Plymesser, of the state health department.

The early warning allowed the department to alert doctors and the public, lower thresholds for testing and refocus their resources. The outbreak ended in September. But because measles continues to spread across the Southwest, the state is still using the system to look for new cases.

Sutton, of Oregon, said she’s hopeful federal leaders will see the power of the system, its adaptability, affordability and reach.

“The widespread use of wastewater surveillance in the United States is one of the greatest advancements in communicable disease surveillance in a generation,” she said.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

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Congressional Black Caucus blasts Slotkin over her calls for new leadership in the House

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The CBC emphatically declared its support Friday for House Minority Leader Hakeem Jeffries…
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The weekend of Andy Burnham’s life

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Andy Burnham is set to become Labour leader on Friday, July 17 and British Prime Minister on Monday, July 20. In between, on Sunday, July 19, England could win the World Cup (no, really).

For Burnham, a lifelong soccer fan, it would be quite the weekend.

Some commentators — including IPSOS pollster Keiran Pedley — have even suggested that, in such circumstances, Burnham should call a snap election to ride a wave of national euphoria and secure his own political mandate.

Given Labour’s commanding majority in Parliament, that is unlikely to happen. But the suggestion hints at soccer’s extraordinary power to shape the national mood — something politicians, and especially new prime ministers, ignore at their peril.

Coming up next week on POLITICO’s Westminster Insider podcast, host Patrick Baker asks how soccer shapes our politics, and examines what politicians should — and should not — do in order to use soccer to their advantage.

Sometimes it is about timing. Former Labour Prime Minister Harold Wilson, buoyed by memories of watching England win in 1966, called an election four years later during the Mexico World Cup of 1970. He was banking on England’s dominance boosting the public mood and, in turn, his election chances. But England crashed out of the tournament to West Germany days before the poll and Wilson lost the election.

Other times it is about authenticity. While there’s never been any doubt that Keir Starmer is a genuine Arsenal fan or that Andy Burnham is a devoted Everton supporter, the enthusiasm of some politicians for their club teams has appeared less convincing. Aston Villa fan David Cameron famously said he supported West Ham in a speech during the 2015 election campaign, which he won despite the flub.

For politicians seeking to speak for the whole U.K., remembering Scotland (on the brink of crashing out of the World Cup), Wales and Northern Ireland (neither made it to the tournament) matters too.

And in a sport capable of both uniting and dividing, ministers and prime ministers alike have often discovered that criticizing players, managers or fans can carry political risks of its own.

Politics and soccer: How to play the game. Listen to Westminster Insider next Friday, July 3.

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It’s getting real in a New Jersey parking lot

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EAST RUTHERFORD, New Jersey — Before the World Cup began, New York and New Jersey unveiled competing transportation plans.

After several matches, $20 shuttle buses subsidized by New York keep selling out, but $98 New Jersey Transit train trips don’t.

Now New Jersey Transit is poised to lose millions during the tournament, blaming the revenue shortfall on lower-than-expected demand caused in part by the cheaper options. New York Gov. Kathy Hochul has suggested maybe that is because of the sticker shock fans face to get on New Jersey trains and buses — an observation sure to rub salt in Jersey’s wounds.

The tensions are just the latest manifestation of a dysfunctional relationship between the two jurisdictions that comprise what FIFA calls “New York New Jersey,” where England and Panama will face off today in their final group-stage match.

After the tournament’s first game New Jersey’s MetLife Stadium — between Brazil and Morocco on June 13 — lines swelled in the parking lot for New York-run buses back to Manhattan. Worried about a crowd stuck at MetLife, the New Jersey State Police asked New Jersey’s state-run transit agency to carry some of the waiting fans instead.

New Jersey Transit had room for 40,000 people but only about 22,000 customers that night. It had spent months on a plan that was moving people quickly and did not want to suddenly upend it with an unexpected surge in passengers on its trains and buses. The agency fears a repeat of the 2014 Super Bowl, in which overcrowding left fans in the same stadium’s parking lot for hours and stained the agency’s reputation for years.

Kris Kolluri, the head of New Jersey Transit, said the bistate host committee, the New Jersey governor’s office and the State Police all decided that the transit agency would move thousands of people after 90 minutes, if needed. By then, however, the lines had calmed on their own.

The asphalt standoff stemmed in part from the cross-Hudson divide over pricing.

The border states separated by the Hudson River are symbiotic — New York companies depend on workers commuting from New Jersey suburbs — and also apt to squabble over everything from how to deal with the mob and fight wildfires to what state Ellis Island is in.

Perhaps over no issue do they bicker more than transportation. Unlike other regions that have a unified transit system, the New York City metropolitan area has three public transit agencies. The states have fought over tolls (a New Jersey governor once threatened a “nuclear option” when New York created new ones), how to split the check for big infrastructure projects and how to staff their bistate Port Authority.

“Transportation is too important for any mayor or governor to give up power to any other mayor or governor,” said Mitchell Moss, a longtime New York City urban planning adviser who is also a professor at New York University.

Things went more smoothly at MetLife following a French win over Senegal and despite a deluge before and after another Senegal loss at MetLife to Norway. After the Norway win, the first New Jersey Transit train got to Penn Station in 35 minutes. The average shuttle bus back to Manhattan took 45 minutes or less.

But there continued to be a behind-the-scenes back and forth over whether New Jersey Transit should lower its prices to get more people aboard.

For fans from the world who don’t immediately come to the region and begin following local politicians, transit planners or local gadflies on X, much of the back and forth is invisible. Yet consequences of two states that don’t see eye to eye are affecting how they come and go from the eight matches, including the July 19 final.

As soon as New Jersey Gov. Mikie Sherrill’s administration in April unveiled plans to charge fans $150 for a roundtrip ticket to the World Cup, Hochul worried it would throw “cold water” on the tournament and helped create a competing $20 shuttle bus.

Sherrill cut the price to $98, but that’s still higher than any other public transit system, and now New Jersey Transit trains are only two-thirds full. Her administration quietly blames the low-cost shuttle buses for siphoning away customers.

Allies of both governors have framed the opposite approaches as affordability-minded: Hochul wants a low price to signal that New York is welcoming the world. Sherrill wants the high price to cover the cost of providing a special service, and to prevent her voters from subsidizing trips for out-of-town fans to an event few locals can afford to attend.

In the real world, the cheaper bus tickets are selling out, while New York officials remain concerned New Jersey Transit’s high prices mean it isn’t carrying its load. New Jersey Transit, on the other hand, is proud of a smooth-running operation, which Sherrill has described as “the best option” for getting to matches.

Bistate tensions over transportation planning predate Sherrill and Hochul, but aren’t inevitable. Both Democrats only a few months ago worked together to restart construction on a new train tunnel between the states that President Donald Trump cut off funding for. But ongoing fighting could represent challenges for other bistate ventures, like a long-awaited overhaul of New York’s Penn Station on which the states will be asked to cooperate.

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