An academic and hospital system coalition is publishing daily wastewater dashboards for all 16 host cities, betting that the next outbreak is the one they catch before the clinics do.
When the 2026 FIFA World Cup kicks off this week, the first signal of a new outbreak will not come from a hospital or a clinic. It will come from a sewer.
Roughly five million fans from more than 100 countries will travel to 16 host cities across the United States, Mexico, and Canada over the next month, according to Scientific American. A pre-tournament estimate from Georgetown University had put the figure closer to 6.5 million. A network of academic researchers, hospital systems, and a Silicon Valley health-data company has spent the past year building what amounts to an early-warning system wrapped around the tournament. It samples wastewater from each host city, watches emergency-room data, tracks international health alerts, and publishes daily situation reports to the public. The goal is to catch the next outbreak before the next clinic visit, not after.
The coordinating body is the Health Security Operations Center (HSOC), which opened on June 1 under Georgetown University's National Center for Health Security and Resilience and MedStar Health. Rebecca Katz, a global health security professor at Georgetown and the center's director, told Scientific American the network was designed to fill gaps left by strained federal, state, and local health departments and a complicated U.S. relationship with the World Health Organization. Vindell Washington, a former national coordinator for health information technology and the center's clinical lead at Verily Health, runs the day-to-day data side.
What the network actually watches is a panel of pathogens tuned to both routine and high-consequence threats: SARS-CoV-2, influenza, measles, RSV, norovirus, mpox, and select sexually transmitted infections, plus mosquito-borne illnesses like dengue and chikungunya. The system is also configured to flag an Ebola detection, in the context of an ongoing outbreak in the Democratic Republic of the Congo. Ebola is not the leading threat modelers expect. It is one of the unexpected findings the net is built to catch.
Verily's public-facing dashboards, broken out by host city, are the visible layer. The company tracks five priority viruses in sewage: SARS-CoV-2, influenza, measles, RSV, and norovirus. PCR results turn around in roughly three days. Genomic sequencing of viral samples, run through a partnership with SecureBio, takes about five days, long enough to identify lineages and ask whether a strain detected in Miami also showed up in Kansas City.
The mechanism is the part epidemiologists say is genuinely new at this scale. Wastewater monitoring catches the genetic signature of a pathogen days to weeks before clinical cases spike, because infected people shed virus before they feel sick enough to visit a doctor. That lead time is what gives a public health department a chance to push testing, isolation, vaccination, or treatment into a specific neighborhood before a cluster becomes a wave. The CDC's National Wastewater Surveillance System has used the same logic for routine community tracking since the COVID-19 pandemic; the World Cup network is a deliberate extension of that idea to a transient, international crowd. As Marc Johnson, a University of Missouri virologist and SecureBio collaborator, told Scientific American, the wastewater data complements clinical surveillance rather than replacing it.
Mass gatherings have been an outbreak accelerant for decades. The 2022 World Cup in Qatar and the 2024 Paris Olympics both used wastewater surveillance, mostly after the fact, to reconstruct what had already spread. What is different in 2026 is the combination of a three-country footprint, daily public reporting for an entire month, and a named nongovernmental operator with academic credibility and hospital-system reach. Fans following their national teams will produce non-random movement between host cities, which means a pathogen imported by one fan base could land in a city that has not seen that strain before. The surveillance is built to track that pattern across borders in near-real-time.
The honest limit is that detection is not containment. A sewage signal tells public health officials that something is circulating, not that they have stopped it. Whether HSOC's daily reports translate into faster local action, or just faster awareness, will depend on staffing and political will in 16 different jurisdictions. The DRC Ebola context, the kind of high-consequence, low-probability event the system is configured to detect, is the one that depends on international cooperation that has gotten harder, not easier, in 2026.
For the next month, the dashboards will be the part the public can actually see. If a measles signal shows up in a host city three days before a clinical case, the system worked. If a dengue case clusters around a specific stadium district, the system worked. The question is whether the agencies, hospitals, and local health departments reading those reports can move fast enough to turn early warning into early action, and whether the template survives the tournament and gets used for the next one.