Canadian Wastewater Watch Expands to New Public Health Threats: Tam

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Public Health Director Theresa Tam listens to a question during a news conference, Tuesday, Jan. 12, 2021, in Ottawa. Dr. Theresa Tam says Canada’s public health agency is looking to make the most of Canada’s waste and plans to screen wastewater to detect and measure new health threats such as monkeypox, polio, resistant organisms antimicrobials and more.Adrian Wyld/The Canadian Press

Plans are underway to screen Canadian sewage to detect and measure monkeypox, polio and other potential health threats, the country’s public health director said Friday.

Over the course of the COVID-19 pandemic, sewage screening has become a key way to track the spread of the virus, especially as free lab tests for people have been phased out for all but a select few in subsequent waves.

Dr. Theresa Tam said experts at the National Microbiology Laboratory have now discovered a promising approach to detecting monkeypox in wastewater and will use the infrastructure developed during the pandemic to search for it.

“In the future, it could be part of our monitoring of the activity of the disease that goes up and down throughout the country,” Tam said at a news conference.

Tam said the method is complicated, but they’ve come up with something that can “probably” be used more widely. It is not yet clear how such monitoring fits into the Public Health Agency of Canada’s monkeypox surveillance efforts.

Monkeypox disease comes from the same family of viruses that causes smallpox, which the World Health Organization declared eradicated worldwide in 1980.

Cases of monkeypox began appearing around the world in non-endemic countries in May.

This week alone, the number of Canadian cases topped 1,000, though there are early signs the virus may now be spreading at a slower rate, Tam said.

The Public Health Agency of Canada also intends to begin polio testing “as soon as possible” after US health officials found the polio virus in New York City sewage. York.

The devastating virus was eradicated from Canada in 1994 and until very recently had not been found in the United States since 1993. Cases have now recently emerged in Western nations with traditionally high rates of vaccinated people.

Last month a positive case was discovered in New York.

The presence of polio virus in the city’s sewage suggests the virus is likely to circulate locally, health officials from the city, New York state and the US federal government said Friday.

“We’re already starting to look at what the options are,” Tam said of polio monitoring in Canada.

Polio tests are only now available online in Ontario, said Eric Arts, a professor of microbiology and immunology at Western University.

The COVID-19 pandemic demonstrated how useful waste can be compared to individual tests, he said, especially when it comes to early detection.

“Instead of randomly testing hundreds of thousands of people to determine if they are infected with a specific pathogen, or one that we don’t even know is circulating, you can just get a sewage sample and test 100,000 people with a test,” he said.

Wastewater monitoring can also be adapted for other things, he said. Even before the pandemic, Tam said the public health agency was looking at ways to look for antimicrobial-resistant organisms, or superbugs, as they’re often called.

However, sewage detection is still imperfect, Tam cautioned.

“You’re dealing with a mix of a lot of things with a lot of DNA, RNA, all sorts of things,” Tam said politely.

That mix includes countless viruses and virus mutations. Some vaccines, such as the oral polio vaccine given in some countries and which includes a live attenuated virus, can also be confused with the real vaccine in a sewage sample.

“It’s not terribly easy,” he said.

Different countries use different methods, Tam said, and even within Canada many innovations are happening.

“I think one of the functions of our lab is to look for the best methods and try to standardize and guide those tests,” he said.

With Adina Bresge Archives in Toronto and the Associated Press

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