Each year, as schools break into full swing, viral infections also become part of the back-to-school environment. SARS-CoV-2, the virus that causes COVID-19, has been detected at increasing levels in school wastewater samples at the start of each school year for the past four years.
The ability to monitor for outbreaks of COVID-19, as well as influenza and respiratory syncytial virus (RSV) at 46 HISD schools, is part of a citywide program managed by Houston Wastewater Epidemiology – a team of collaborators with the Houston Health Department, Rice University, and Houston Public Works.
HISD schools for the pilot preK-12 wastewater monitoring program were selected early in the pandemic from zip codes with the highest COVID-19 incidence rate.
“There has been nationwide interest in facility-level surveillance to assess the presence of an outbreak and inform local communities and those with underlying health conditions,” said Loren Hopkins, chief environmental science officer for the City of Houston and bureau chief of the Houston Health Department’s Data Science Division.
“HISD is Texas’ largest school district. Through this pilot program, schools have proven to be an integral part of Houston’s overall wastewater program. Community stakeholders are interconnected and work to protect their schools and those around them,” said Hopkins.
Houston’s Virus Alert Program pairs school wastewater reporting with the individuals with the largest impact on student health – school nurses and student caregivers. Nurses and student caregivers can sign up for text- and email-based alerts using existing City of Houston resources.
People who sign up for the alerts receive time-sensitive messages when viruses are present in their school’s wastewater, as well as information on important actions to take to protect their school and community health. Wastewater monitoring reports from the Houston Health Department are also shared with school district officials and nurses.
Hopkins says, “Houston’s alert program is unique, and the framework encourages greater engagement between the health department and schools, educating people about infectious diseases and how to reduce their spread. In some schools, the program has triggered vaccination events.”
Hopkins and her data science division, along with Rice’s Lauren Stadler, associate professor of civil and environmental engineering, and Katherine Ensor, the Noah G. Harding Professor of Statistics, initially launched the school wastewater monitoring pilot program in December 2020 to monitor for SARS-CoV-2.
The program was expanded to include influenza and respiratory syncytial virus (RSV) in November 2021 and September 2022, respectively, with Stadler’s laboratory managing the laboratory analysis to generate essential wastewater monitoring data throughout the program.
A new case study by the collaborators details steps taken to implement the school wastewater alert program. The study, which can serve as a template for other public health departments, was published online on September 13, 2024, in the journal Public Health Reports.
“Over a six-month period from September 2023 through February 2024, a combined 5178 messages for 43 schools were sent following virus detections,” said Houston Health Department Analyst Rebecca Schneider, who is a Rice alumna of the university’s Professional Master of Statistics program and first author on the paper.
Schneider says funding for the program early in the pandemic allowed them to pilot the school wastewater monitoring program, making Houston a leader in working with schools and other locations in facility-level wastewater analysis.
In 2024, Stadler’s laboratory began using multiplexed digital PCR assays to target other vaccine-preventable diseases such as measles, mumps, and rubella (MMR). They have been screening school and citywide wastewater for these disease targets as an early warning system, given recent outbreaks of measles in the U.S. and globally.
Both Schneider and Ensor analyze wastewater surveillance data from weekly samples processed in Rice University and Houston Health Department laboratories. They also work with the Center for Research Computing’s Spatial Studies Lab at Rice to manage the data published on the public-facing dashboard, which has long served as an effective source of information for Houstonians.
“Dashboards are a useful tool for distributing public health data, but they rely on users to seek out the data,” said Schneider. “A main thrust of the Virus Alert Program is about engaging strategic direct communications for effective community outreach.”
The Houston Health Department and Rice solicited feedback over a two-month period from HISD administration, teachers, staff, and student caregivers, as well as a school health expert advisory board, on how to best communicate pilot program data to the schools’ communities.
The school wastewater monitoring program brought forth funding from the Centers for Disease Control and Prevention (CDC) and the National Wastewater Surveillance System that designated Houston as a Center of Excellence for wastewater epidemiology.
Additional contributors to the pilot program and published study include Senior Analyst Kaavya Domakonda, Analyst Sharmila Bhandari, and Analyst Anthony Mulenga, all with the Houston Health Department, and Catherine D. Johnson of the Houston Health Foundation.
Shawn Hutchins, Communications Specialist