HOUSTON — The graph that popped up on Michael Tisza’s computer screen sent his eyebrows arching high across his forehead.
A bright red dot had surfaced where there once had been a flat black line.
That is not normal, thought Tisza, an assistant professor of molecular virology and microbiology at Baylor College of Medicine in Houston.
It was January, 2025. There hadn’t been a confirmed case of measles in Texas for two years.
Tisza tested it manually. Still measles.
So he reached out to Anthony Maresso, a professor in his same department and lead on Baylor’s wastewater surveillance program. They activated their notification protocol, alerting public health officials that the virus had arrived.
Maresso’s team’s work on measles detection shows the power of wastewater surveillance to spot emerging health threats before they become widespread.
Now, a new study by Maresso and his team shows the same technology can even track cancer-causing viruses such as Human Papillomavirus (HPV).
“We can look at where there are cancer-causing viruses spiking and then compare that to public health data,” said Justin Clark, an assistant professor at Baylor. “Where they are high, we can push outreach.”
‘Conscience of the City’
Tens of thousands of people had already died from COVID-19 in the U.S. when Maresso and his team began asking: How can we track where the virus is spreading?
It was still early days — April, 2020 — and Texas was shuttered in an attempt to curb its spread.
Cases continued to climb, and tests were not readily available for this sweeping disease affecting man, woman and child.
READ MORE: The demoralization of America’s doctors
Maresso’s team began looking for an alternative to individual testing — something faster, broader and less invasive.
They turned to an unlikely source: wastewater.
The idea was straightforward enough. People shed tiny amounts of genetic material in urine, stool and skin cells, Clark said, all of which flow into sewage systems.
If those people were sick, that genetic material would likely show up.
And if there was a way to detect that, researchers could see which viruses were circulating in a community without ever testing a human.
“The sewer is the conscience of the city,” Clark told Straight Arrow.
Wastewater surveillance itself wasn’t new — researchers at Baylor developed it in the mid-20th century to track polio — but the pandemic offered a chance to track COVID at community levels.
It worked, allowing researchers to anticipate outbreaks, predict hospitalizations and detect new variants early.
Building off the COVID-19 monitoring from early 2020, the Texas Wastewater Environmental and Biomonitoring program (TexWEB) was born in October 2021, bringing together researchers from Baylor, UTHealth Houston School of Public Health and public health departments around the state.
Initially piloted in Houston and El Paso, the program has since expanded to 16 cities — about 50 different collection sites — and tests for thousands of viruses, including COVID-19, influenza and West Nile virus.
It has even received funding from the Texas legislature since 2022.
Each week, participating municipalities collect wastewater samples and send them to researchers. In the lab, Clark and his colleague, Harihara Prakash, run the samples through custom-built computer scripts that sequence the genetic material and scan for spikes across dozens of viruses.
And much of that information is published on a public dashboard.
When levels rise, the system flags them — sometimes weeks or even months before anyone tests positive.
In February 2025, one of those alerts lit up for Lubbock.
Measles.
With vaccination rates falling nationwide,Lubbock public health officials had been preparing for this moment.
TexWEB gave them a headstart.
“Our mitigation plans were in place, but that communication helped us on our next steps,” said Tiffany Torres, an epidemiologist for the city of Lubbock. “This was before the peak of the outbreak in West Texas, and we worked … to add an additional collection site before the outbreak began to spread.”
Can we track cancer-causing viruses?
Six years of wastewater surveillance have passed, and researchers are still asking questions.
Their most recent: Can we track cancer-causing viruses?
READ MORE: Why are more young women dying from breast cancer?
It might seem like an unusual step in a world where cancer is often linked to smoking, chemicals and genetics. But in reality, about 20% of all cancers are caused by infectious microorganisms, Maresso said.
That question led them to their newest study, published in “Applied and Environmental Microbiology,” where they showed they could extend wastewater surveillance to these cancer-causing viruses as well.
With this capability, researchers can begin building long-term datasets that public health officials could one day use to identify environmental or biological patterns linked to cancer spikes.
It also opens the door to something more immediate: Identifying where HPV remains high despite vaccination efforts and detecting if strains not covered by the vaccine are increasing. This information could help develop more effective vaccines.
For Maresso, it has an even greater application.
Adding cancer-causing virus levels to the public dashboard could shift behavior in real time. A parent might see an HPV spike in their area, for example, and decide to vaccinate their child.
And if that doesn’t work, a more directed public health approach might.
If HPV levels spike locally, public health officials could direct their limited resources there first, expanding education campaigns, improving vaccine access and addressing gaps in awareness.
“When we do see an outbreak, we can focus on stopping its spread in that area,” Clark said. “We can give people the information they need.”
Round out your reading
- Plea bargains keep America’s courts running. Guilt or innocence barely matters.
- Trump says the media isn’t covering one of his biggest accomplishments. We checked.
- Mike Lindell denied MyPillow was hacked. Its private data is now online.
- Red meat allergy rises with ticks as HHS targets Lyme disease, alpha-gal syndrome.
- We’re building a new Straight Arrow. Help us shape our future by taking our survey.