Publications by authors named "Alexandria Boehm"

The effective reproduction number serves as a metric of population-wide, time-varying disease spread. During the early years of the COVID-19 pandemic, this metric was primarily derived from case data, which has varied in quality and representativeness due to changes in testing volume, test-seeking behavior, and resource constraints. Deriving nowcasting estimates from alternative data sources such as wastewater provides complementary information that could inform future public health responses.

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Subterranean estuaries (STEs) are critical ecosystems at the interface of meteoric groundwater and subsurface seawater that are threatened by sea level rise. To characterize the influence of tides and waves on the STE microbial community, we collected porewater samples from a high-energy beach STE at Stinson Beach, California, USA, over the two-week neap-spring tidal transition during both a wet and dry season. The microbial community, analyzed by 16S rRNA gene (V4) amplicon sequencing, clustered according to consistent physicochemical features found within STEs.

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Wastewater-Based Epidemiology (WBE) has become a powerful tool for assessing disease occurrence in communities. This study investigates the coronavirus disease 2019 (COVID-19) epidemic in the United States during 2023-2024 using wastewater data from 189 wastewater treatment plants in 40 states and the District of Columbia. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and pepper-mild mottle virus normalized SARS-CoV-2 RNA concentration data were compared with COVID-19 hospitalization admission data at both national and state levels.

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Unlabelled: Wastewater surveillance for infectious agents has proved useful in identifying the circulation of viruses within populations. We investigated the presence and concentration of human immunodeficiency virus (HIV)-1 total nucleic acids (including both viral RNA and proviral DNA) in wastewater solids. We retrospectively measured HIV-1 nucleic acids in two samples per week for 26 months at two wastewater treatment plants serving populations with different prevalences of HIV infections in San Francisco and Santa Clara County, California, USA.

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Article Synopsis
  • Wastewater-based epidemiology can be a useful method for tracking hepatitis A infections in communities by analyzing wastewater samples for the virus (HAV) RNA levels from 191 treatment plants across the U.S. over several months.
  • Results showed that about 13.76% of wastewater samples tested positive for HAV RNA, and these positivity rates correlated with reported hepatitis A cases and socio-economic vulnerabilities like homelessness and drug overdose deaths.
  • The study suggests that detecting HAV in wastewater could precede clinical cases, which might help public health officials to implement timely interventions such as vaccination campaigns, especially in at-risk populations.
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Norovirus is a leading cause of acute gastroenteritis and imposes a substantial disease burden. In California, USA, norovirus surveillance is limited. We evaluated correlations between wastewater norovirus concentrations and available public health surveillance data.

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Article Synopsis
  • The study measured various viral concentrations, including COVID-19, flu viruses, and other pathogens, in solid waste from 191 wastewater treatment plants across the U.S. and Washington DC.
  • These measurements were taken 2 to 7 times a week from January 2022 to June 2024, depending on staff availability.
  • The data gathered helps in understanding disease prevalence in communities by analyzing what’s found in their wastewater.
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  • Scientists study "fecal indicator organisms" to check for poop pollution in U.S. waters.
  • They looked at how different types of particles in the water affect the survival of these organisms over time.
  • Small particles, especially in salty waters, made it harder for the fecal indicators to survive, which is important for cleaning up polluted water.
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  • * From May 12 to July 13, 2024, 38 states participated in testing, with 11 sites showing high levels of influenza A virus and 24 sites detecting the H5 subtype.
  • * Investigations revealed that many high-level detections corresponded with human influenza activity and identified possible animal sources, providing valuable data for future respiratory illness monitoring.
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Unlabelled: is an emerging, multidrug-resistant fungal pathogen that poses a significant public health threat in healthcare settings. Despite yearly clinical cases rapidly increasing from 77 to 8,131 in the last decade, surveillance data on its distribution and prevalence remain limited. We implemented a novel assay for detection on a nationwide scale prospectively from September 2023 to March 2024, analyzing a total of 13,842 samples from 190 wastewater treatment plants across 41 U.

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Respiratory syncytial virus (RSV) causes a large burden of respiratory illness globally. It has two subtypes, RSV A and RSV B, but little is known regarding the predominance of these subtypes during different seasons and their impact on morbidity and mortality. Using molecular methods, we quantified RSV A and RSV B RNA in wastewater solids across multiple seasons and metropolitan areas to gain insight into the predominance of RSV subtypes.

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Respiratory syncytial virus (RSV) is a leading cause of respiratory illness and hospitalization, but clinical surveillance detects only a minority of cases. Wastewater surveillance could determine the onset and extent of RSV circulation in the absence of sensitive case detection, but to date, studies of RSV in wastewater are few. We measured RSV RNA concentrations in wastewater solids from 176 sites during the 2022-2023 RSV season and compared those to publicly available RSV infection positivity and hospitalization rates.

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Unlabelled: The coronavirus disease 2019 pandemic illustrates the importance of understanding the behavior and control of human pathogenic viruses in the environment. Exposure via water (drinking, bathing, and recreation) is a known route of transmission of viruses to humans, but the literature is relatively void of studies on the persistence of many viruses, especially coronaviruses, in water and their susceptibility to chlorine disinfection. To fill that knowledge gap, we evaluated the persistence and free chlorine disinfection of human coronavirus OC43 (HCoV-OC43) and its surrogates, murine hepatitis virus (MHV) and porcine transmissible gastroenteritis virus (TGEV), in drinking water and laboratory buffer using cell culture methods.

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Wastewater-based epidemiology has emerged as a valuable tool for monitoring respiratory viral diseases within communities by analyzing concentrations of viral nucleic-acids in wastewater. However, little is known about the fate of respiratory virus nucleic-acids in wastewater. Two important fate processes that may modulate their concentrations in wastewater as they move from household drains to the point of collection include sorption or partitioning to wastewater solids and degradation.

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Enteric infections are important causes of morbidity and mortality, yet clinical surveillance is limited. Wastewater-based epidemiology (WBE) has been used to study community circulation of individual enteric viruses and panels of respiratory diseases, but there is limited work studying the concurrent circulation of a suite of important enteric viruses. A retrospective WBE study was carried out at two wastewater treatment plants located in California, United States.

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Background: Quantifying contributions of environmental faecal contamination to child diarrhoea and growth faltering can illuminate causal mechanisms behind modest health benefits in recent water, sanitation, and hygiene (WASH) trials. We aimed to assess associations between environmental detection of enteropathogens and human or animal microbial source tracking markers (MSTM) and subsequent child health outcomes.

Methods: In this individual participant data meta-analysis we searched we searched PubMed, Embase, CAB Direct Global Health, Agricultural and Environmental Science Database, Web of Science, and Scopus for WASH intervention studies with a prospective design and concurrent control that measured enteropathogens or MSTM in environmental samples, or both, and subsequently measured enteric infections, diarrhoea, or height-for-age Z-scores (HAZ) in children younger than 5 years.

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Article Synopsis
  • * A workshop held in April 2023, funded by the National Science Foundation, focused on identifying the current challenges and research gaps in bacterial wastewater surveillance, leading to discussions about methods, data standardization, and the importance of correlating wastewater data with human disease.
  • * To enhance bacterial monitoring in wastewater, experts suggested the need for better data reporting standards, method optimization, and a deeper understanding of bacterial shedding patterns to link wastewater findings to infection rates in communities.
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Modeling the fate and transport of viruses and their genetic material in surface water is necessary to assess risks associated with contaminated surface waters and to inform environmental surveillance efforts. Temperature has been identified as a key variable affecting virus persistence in surface waters, but the effects of the presence of biological and inert particles and of their interaction with temperature have not been well characterized. We assessed these effects on the persistence of human norovirus (HuNoV) genotype II.

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Enveloped virus fate in the environment is not well understood; there are no quantitative data on sunlight inactivation of enveloped viruses in water. Herein, we measured the sunlight inactivation of two enveloped viruses (Phi6 and murine hepatitis virus, MHV) and a nonenveloped virus (MS2) over time in clear water with simulated sunlight exposure. We attenuated UV sunlight wavelengths using long-pass 50% cutoff filters at 280, 305, and 320 nm.

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