Disease surveillance teams deploy wastewater monitoring for World Cup 2026

In the weeks before the World Cup kicks off across three countries, epidemiologists are preparing for a task that goes well beyond the usual scope of public health work. They will be watching sewage. They will be reading social media. They will be listening for the first whispers of disease outbreaks that could ripple through millions of people gathered in stadiums, streets, and hotels across the United States, Canada, and Mexico.

The scale of what they're trying to prevent is staggering. More than 6.5 million football fans from over 100 countries will descend on host cities for 104 matches over 39 days, beginning in June. That convergence of humanity—traveling from distant corners of the globe, moving between cities, breathing the same air in crowded venues—creates ideal conditions for infectious disease to spread fast and far. The American public health system, already stretched thin by outbreaks of measles, Ebola, and hantavirus, is not in a position to absorb a major crisis. Budget cuts and the Trump administration's withdrawal from the World Health Organization have further weakened the infrastructure meant to catch and contain such threats.

To meet this challenge, a team based at Georgetown University in Washington, DC, has converted a laboratory into an epidemiological command center. Rebecca Katz, who directs Georgetown's Center for Global Health Science and Security, leads the effort. She has assembled 20 core colleagues and secured pro bono support from roughly 30 additional organizations—academic institutions, nonprofits, private companies, and wastewater monitoring firms that will provide data at no cost. The MedStar Health hospital network, which operates one of the country's 13 biocontainment units, is a key partner. The center will produce daily situation reports flagging emerging risks and feeding information to hospital emergency managers, local and state health authorities, federal agencies, and FIFA itself.

The technical heart of the operation is wastewater analysis. Using DNA and RNA sequencing, the team can identify genetic signatures of disease-causing microorganisms without waiting for traditional laboratory cultures to grow. Samples collected from sites across the United States and Canada will flow into the Georgetown center, where they will be analyzed for signs of trouble. Katz calls the method "incredibly powerful." When pathogens appear in sewage before people show up at hospitals, health officials gain precious time—time to alert doctors about symptoms that might otherwise be misdiagnosed, time to warn the public to take precautions, time to mobilize response.

The team is also monitoring social media and anonymized electronic health records, looking for patterns that might signal an outbreak. Katz points to a previous case in which public health authorities spotted a gastrointestinal illness spreading through a city by noticing a sudden spike in social media posts about toilet paper sales. The same kind of digital listening will be happening during the World Cup, across platforms and in multiple languages.

Which diseases worry them most? Measles tops the list. Cases in the United States have climbed to around 2,000 this year and are resurging in parts of Mexico and Canada. Mosquito-borne illnesses like dengue and chikungunya pose another risk—tropical diseases that can travel with infected visitors and then spread through local mosquito populations. Ebola, by contrast, is considered a very low threat to the general North American public, though the team is taking precautions. The Democratic Republic of Congo's World Cup team, from the epicenter of the current Ebola outbreak, is undergoing preventive quarantine in Belgium before traveling to the United States.

This surveillance operation is not just about the World Cup. It is a test run for future mega-events, including the 2028 Summer Olympics in Los Angeles. If the system works—if it catches threats early, if it helps prevent outbreaks from becoming disasters—it will become a template for protecting public health at the world's largest gatherings. The funding came from a small family foundation and Georgetown University itself, supplemented by in-kind contributions from partners like the University of Nebraska. It is a modest investment in a massive undertaking, built on the premise that in an age of global travel and interconnected cities, the only way to keep disease from spreading is to see it coming before it arrives.