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Disclaimer: Early release articles are not considered as final versions. Any changes will be reflected in the online version in the month the article is officially released.

Volume 32, Supplement –Summer 2026

SUPPLEMENT ISSUE
Supplement

Temporal Alignment of Wastewater Signals with Clinical Indicators of Respiratory Illness Postpandemic, Texas, USA

Kaiming BiComments to Author , Micaela Sandoval, Thuy Nguyen, Isrrael Perez, Lopita Ghosh, Trudy Krause, Cecilia Ganduglia Cazaban, Remy Pasco, Lauren Meyers, Fuqing Wu, Janelle Rios, Michael Tisza, Justin Clark, Anthony Maresso, Eric Boerwinkle, and Cici Bauer
Author affiliation: University of Texas Health Science Center at Houston, Houston, Texas, USA (K. Bi, M. Sandoval, T. Nguyen, I. Perez, L. Ghosh, T. Krause, C. Ganduglia Cazaban, F. Wu, J. Rios, E. Boerwinkle, C. Bauer); Texas Epidemiologic Public Health Institute, Houston (K. Bi, M. Sandoval, T. Nguyen, F. Wu, J. Rios, E. Boerwinkle, C. Bauer); University of Colorado Boulder, Boulder, Colorado, USA (R. Pasco); The University of Texas at Austin, Austin, Texas, USA (L. Meyers); Baylor College of Medicine, Houston, Texas, USA (M. Tisza, J. Clark, A. Maresso)

Main Article

Table 8

Pearson correlation coefficients between RPMF and 2 ED visits data sources for influenza during the 2023–24 season across 10 counties, daily NSSP ED visit rates and weekly TX-APCD ED claims rates, Texas, USA*

County RPMF versus NSSP ED visit
 RPMF versus TX-APCD ED claims
Original r Optimal lag, d rmax Original r Optimal lag, wk rmax
Cameron 0.86 0 0.86 0.25 2 0.46
Chambers 0.84 0 0.84 0.56 1 0.61
El Paso 0.9 0 0.9 0.88 0 0.88
Fort Bend 0.87 0 0.87 0.29 0 0.29
Harris 0.79 10 0.83 0.63 2 0.71
Hays 0.57 −15 0.66 0.45 −3 0.65
Lubbock 0.81 0 0.81 0.4 −2 0.47
Travis 0.53 −15 0.61 0.5 −3 0.54
Wichita 0.68 −14 0.9 0.76 0 0.76
Williamson 0.54 −15 0.63 0.4 −3 0.67

*Optimal lag is reported relative to the clinical indicator. A negative value indicates that the wastewater signal leads the clinical indicator; a positive value indicates that it lags. The table shows the correlation at 0 (original), the optimal shift required to maximize the association (lag), and the resulting rmax. ED, emergency department; NSSP, National Syndromic Surveillance Program; rmax, maximum correlation; RPMF, reads per million filtered;; TX-APCD, Texas All-Payer Claims Database.

Main Article

Page created: July 17, 2026
Page updated: August 18, 2026
Page reviewed: August 18, 2026
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