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Volume 32, Supplement –Summer 2026

SUPPLEMENT ISSUE
Supplement

Correlations between Wastewater Concentrations of Influenza A and Respiratory Syncytial Viruses and Clinical Laboratory Testing and Hospitalization Data, California, USA

Elisabeth BurnorComments to Author , Madhura S. Rane, Marisa A.P. Donnelly, Lauren A. White, Cora Hoover, Monica Sun, Caroline Collins, Andrew Abram, Mariah Otstot, Joel Rojas, Cody Berkobien, Seema Jain, Duc J. Vugia, Wayne T.A. Enanoria, Linlin Li, Chad Below, Marlene Wolfe, Alexandria B. Boehm, Tomás M. León, Erin L. Murray, and Alexander T. Yu
Author affiliation: California Department of Public Health, Richmond, California, USA (E. Burnor, M.S. Rane, M.A.P. Donnelly, L.A. White, C. Hoover, M. Sun, C. Collins, A. Abram, M. Otstot, J. Rojas, C. Berkobien, S. Jain, D.J. Vugia, T.M. León, E.L. Murray, A.T. Yu); County of Santa Clara Public Health Department, San Jose, California, USA (W.T.A. Enanoria, L. Li); San Mateo County Health, San Mateo, California, USA (C. Below); Rollins School of Public Health, Emory University, Atlanta, Georgia, USA (M. Wolfe); Stanford University, Stanford, California, USA (A.B. Boehm)

Main Article

Table 1

Descriptive characteristics for each county and sewershed included in a study of correlations between wastewater concentrations of influenza A and respiratory syncytial viruses and clinical laboratory testing and hospitalization data, California, USA*

County County-level
 Sewershed-level
Population No. influenza hospitalizations Sentinel laboratory, no. positive specimens
 Sewershed Estimated population No. ELR influenza A virus–positive specimens No. wastewater samples processed
Influenza A RSV
Alameda
 1,658,061
 991
 7,184
 5,999
East Bay
 740,000
 4,057
 261
Contra Costa 1,158,249 852 6,686 5,167 Central Contra Costa 484,800 3,460 223
Richmond
 100,000
 1,215
 207
Marin
 254,743
 144
 703
 1,544
Novato
 53,000
 618
 241
Sacramento
 1,596,281
 1,657
 6,692
 5,092
Sacramento
 1,480,000
 16,362
 548
San Francisco 845,355 574 2,706 2,847 Oceanside 250,000 1,133 524
Southeast†
 750,000
 3,607
 541
San Mateo 747,777 293 3,503 2,043 Half Moon Bay 28,000 151 224
San Mateo 150,000 1,149 232
Silicon Valley
 199,000
 1,900
 546
Santa Clara 1,921,406 3,066 11,336 8,278 Gilroy/Morgan Hill 110,338 1,631 550
Palo Alto† 236,000 1,225 549
San Jose 1,500,000 12,746 550
Sunnyvale
 153,000
 998
 536
Santa Cruz 263,454 NA‡ 113 NA‡ Santa Cruz City 70,000 272 238
Santa Cruz County
 94,000
 350
 239
Sonoma
 482,050
 448
 2,938
 1,957
Petaluma
 65,000
 641
 163
Yolo
 224,088
 NA‡
 115
 165
Davis
 70,717
 332
 343
Total 9,151,464 8,025 41,976 33,173 Total 6,689,855 51,847 6,715

*ELR, electronic laboratory reporting; NA, not applicable; RSV, respiratory syncytial virus. †The San Francisco Southeast sewershed and the Palo Alto sewershed both encompass small portions of neighboring San Mateo County. As a result, the total population coverage for the 2 San Francisco sewersheds is larger than the San Francisco County population, and the total population coverage for the 4 Santa Clara sewersheds is larger than the Santa Clara County population. ‡Numbers insufficient for inclusion in the analysis.

Main Article

Page created: July 16, 2026
Page updated: September 15, 2026
Page reviewed: September 15, 2026
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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