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  1. Abstract Background

    Infections with nontyphoidalSalmonellacause an estimated 19,336 hospitalizations each year in the United States. Sources of infection can vary by state and include animal and plant-based foods, as well as environmental reservoirs. Several studies have recognized the importance of increased ambient temperature and precipitation in the spread and persistence ofSalmonellain soil and food. However, the impact of extreme weather events onSalmonellainfection rates among the most prevalent serovars, has not been fully evaluated across distinct U.S. regions.


    To address this knowledge gap, we obtainedSalmonellacase data forS.Enteriditis,S.Typhimurium,S.Newport, andS.Javiana (2004-2014; n = 32,951) from the Foodborne Diseases Active Surveillance Network (FoodNet), and weather data from the National Climatic Data Center (1960-2014). Extreme heat and precipitation events for the study period (2004-2014) were identified using location and calendar day specific 95thpercentile thresholds derived using a 30-year baseline (1960-1989). Negative binomial generalized estimating equations were used to evaluate the association between exposure to extreme events and salmonellosis rates.


    We observed that extreme heat exposure was associated with increased rates of infection withS.Newport in Maryland (Incidence Rate Ratio (IRR): 1.07, 95% Confidence Interval (CI): 1.01, 1.14), and Tennessee (IRR: 1.06, 95% CI: 1.04, 1.09), both FoodNet sites with high densities of animal feeding operations (e.g., broilermore »chickens and cattle). Extreme precipitation events were also associated with increased rates ofS.Javiana infections, by 22% in Connecticut (IRR: 1.22, 95% CI: 1.10, 1.35) and by 5% in Georgia (IRR: 1.05, 95% CI: 1.01, 1.08), respectively. In addition, there was an 11% (IRR: 1.11, 95% CI: 1.04-1.18) increased rate ofS. Newport infections in Maryland associated with extreme precipitation events.


    Overall, our study suggests a stronger association between extreme precipitation events, compared to extreme heat, and salmonellosis across multiple U.S. regions. In addition, the rates of infection withSalmonellaserovars that persist in environmental or plant-based reservoirs, such asS.Javiana andS.Newport, appear to be of particular significance regarding increased heat and rainfall events.

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  2. Abstract

    Nontraditional irrigation water sources (e.g., recycled water, brackish water) may harbor human pathogens, includingVibriospp., that could be present in a viable-but-nonculturable (VBNC) state, stymieing current culture-based detection methods. To overcome this challenge, we coupled 5-bromo-2′-deoxyuridine (BrdU) labeling, enrichment techniques, and 16S rRNA sequencing to identify nontraditional irrigation water (recycled water, pond water, non-tidal freshwater, and tidal brackish water). Our coupled BrdU-labeling and sequencing approach revealed the presence of metabolically-activeVibriospp. at all sampling sites. Whereas, the culture-based method only detected vibrios at three of the four sites. We observed the presence ofV. cholerae,V. vulnificus, andV. parahaemolyticususing both methods, whileV. aesturianusandV. shiloniiwere detected only through our labeling/sequencing approach. Multiple other pathogens of concern to human health were also identified through our labeling/sequencing approach includingP. shigelloides,B. cereusandE. cloacae. Most importantly, 16S rRNA sequencing of BrdU-labeled samples resulted inVibriospp. detection even when our culture-based methods resulted in negative detection. This suggests that our novel approach can effectively detect metabolically-activeVibriospp. that may have been present in a VBNC state, refining our understanding of the prevalence of vibrios in nontraditional irrigation waters.

  3. Free, publicly-accessible full text available October 1, 2023
  4. Abstract Purpose of Review Environmental epidemiology has long considered socioeconomic position (SEP) to be an important confounder of pollution effects on health, given that, in the USA, lower-income and minority communities are often disproportionately exposed to pollution. In recent decades, a growing literature has revealed that lower-SEP communities may also be more susceptible to pollution. Given the vast number of material and psychosocial stressors that vary by SEP, however, it is unclear which specific aspects of SEP may underlie this susceptibility. As environmental epidemiology engages more rigorously with issues of differential susceptibility, it is pertinent to define SEP more clearly, to disentangle its many aspects, and to move towards identifying causal components. Myriad stressors and exposures vary with SEP, with effects accumulating and interacting over the lifecourse. Here, we ask: In the context of environmental epidemiology, how do we meaningfully characterize”SEP”? Recent Findings In answering this question, it is critical to acknowledge that SEP, stressors, and pollution are differentially distributed by race in US cities. These distributions have been shaped by neighborhood sorting and race-based residential segregation rooted in historical policies and processes (e.g., redlining), which have served to concentrate wealth and opportunities for education and employment in predominantly-white communities.more »As a result, it is now profoundly challenging to separate SEP from race in the urban US setting. Summary Here, we cohere evidence from our recent and on-going studies aimed at disentangling synergistic health effects among SEP-related stressors and pollutants. We consider an array of SEP-linked social stressors, and discuss persistent challenges in this epidemiology, many of which are related to spatial confounding among multiple pollutants and stressors. Combining quantitative results with insights from qualitative data on neighborhood perceptions and stress (including violence and police-community relations), we offer a lens towards unpacking the complex interplay among SEP, community stressors, race, and pollution in US cities.« less
    Free, publicly-accessible full text available September 1, 2023
  5. Villanueva, Laura (Ed.)
    ABSTRACT Phylogenetic distribution and extended spectrum β-lactamase (ESBL) activity of Escherichia coli recovered from surface and reclaimed water in the mid-Atlantic U.S. were evaluated. Among 488 isolates, phylogroups B1 and A were the most and least prevalent, respectively. Water type, but not season, affected phylogroup distribution. The likelihood of detecting group A isolates was higher in reclaimed than pond ( P <  0.01), freshwater river ( P <  0.01) or brackish river (P <  0.05) water. Homogeneity in group distribution was lowest in pond water, where group B1 comprised 50% of isolates. Only 16 (3.3%) isolates exhibited phenotypic resistance to one or more cephalosporins tested and only four had ESBL activity, representing groups B1, B2 isolates, and D. Phylogroup was a factor in antimicrobial resistance ( P <  0.05), with group A (8.7%) and D (1.6%) exhibiting the highest and lowest rates. Resistance to cefoxitin was the most prevalent. Multi- versus single drug resistance was affected by phylogroup ( P <  0.05) and more likely in groups D and B1 than A which carried resistance to cefoxitin only. The most detected β-lactam resistance genes were bla CMY-2 and bla TEM . Water type was a factor for bla CTX-M gene detection ( P <  0.05). Phenotypicmore »resistance to cefotaxime, ceftriaxone, cefuroxime and ceftazidime, and genetic determinants for ESBL-mediated resistance were found predominantly in B2 and D isolates from rivers and reclaimed water. Overall, ESBL activity and cephalosporin resistance in reclaimed and surface water isolates were low. Integrating data on ESBL activity and β-lactam resistance among E. coli populations can inform decisions on safety of irrigation water sources and One Health. IMPORTANCE Extended spectrum β-lactamase (ESBL) producing bacteria, that are resistant to a broad range of antimicrobial agents, are spreading in the environment but data remain scarce. ESBL-producing Escherichia coli infections in the community are on the rise. This work was conducted to assess presence of ESBL-producing E. coli in water that could be used for irrigation of fresh produce. The study provides the most extensive evaluation of ESBL-producing E. coli in surface and reclaimed water in the mid-Atlantic United States. The prevalence of ESBL producers was low and phenotypic resistance to cephalosporins (types of β-lactam antibiotics) was affected by season but not water type. Data on antimicrobial resistance among E. coli populations in water can inform decisions on safety of irrigation water sources and One Health.« less
    Free, publicly-accessible full text available August 9, 2023
  6. Free, publicly-accessible full text available August 1, 2023
  7. Free, publicly-accessible full text available July 19, 2023
  8. High COVID-19 mortality among Black communities heightened the pandemic’s devastation. In the state of Louisiana, the racial disparity associated with COVID-19 mortality was significant; Black Americans accounted for 50% of known COVID-19–related deaths while representing only 32% of the state’s population. In this paper, we argue that structural racism resulted in a synergistic framework of cumulatively negative determinants of health that ultimately affected COVID-19 deaths in Louisiana Black communities. We identify the spatial distribution of social, environmental, and economic stressors across Louisiana parishes using hot spot analysis to develop aggregate stressors. Further, we examine the correlation between stressors, cumulative health risks, COVID-19 mortality, and the size of Black populations throughout Louisiana. We hypothesized that parishes with larger Black populations (percentages) would have larger stressor values and higher cumulative health risks as well as increased COVID-19 mortality rates. Our results suggest two categories of parishes. The first group has moderate levels of aggregate stress, high population densities, predominately Black populations, and high COVID-19 mortality. The second group of parishes has high aggregate stress, lower population densities, predominantly Black populations, and initially low COVID-19 mortality that increased over time. Our results suggest that structural racism and inequities led to severe disparities inmore »initial COVID-19 effects among highly populated Black Louisiana communities and that as the virus moved into less densely populated Black communities, similar trends emerged.« less
    Free, publicly-accessible full text available July 5, 2023
  9. Free, publicly-accessible full text available June 28, 2023
  10. The emergence of low-cost air quality sensors as viable tools for the monitoring of air quality at population and individual levels necessitates the evaluation of these instruments. The Flow air quality tracker, a product of Plume Labs, is one such sensor. To evaluate these sensors, we assessed 34 of them in a controlled laboratory setting by exposing them to PM10 and PM2.5 and compared the response with Plantower A003 measurements. The overall coefficient of determination (R2) of measured PM2.5 was 0.76 and of PM10 it was 0.73, but the Flows’ accuracy improved after each introduction of incense. Overall, these findings suggest that the Flow can be a useful air quality monitoring tool in air pollution areas with higher concentrations, when incorporated into other monitoring frameworks and when used in aggregate. The broader environmental implications of this work are that it is possible for individuals and groups to monitor their individual exposure to particulate matter pollution.
    Free, publicly-accessible full text available June 1, 2023