An enhanced research paradigm is presented to address the spatial and temporal gaps in fine particulate matter (PM) measurements and generate realistic and representative concentration fields for use in epidemiological studies of human exposure to ambient air particulate concentrations. The general approach for research designed to analyze health impacts of exposure to PM is to use concentration data from the nearest ground-based air quality monitor(s), which typically have missing data on the temporal and spatial scales due to filter sampling schedules and monitor placement, respectively. To circumvent these data gaps, this research project uses a Hierarchical Bayesian Model (HBM) to generate estimates of PM in areas with and without air quality monitors by combining PM concentrations measured by monitors, PM concentration estimates derived from satellite aerosol optical depth (AOD) data, and Community-Multiscale Air Quality (CMAQ) model predictions of PM concentrations. This methodology represents a substantial step forward in the approach for developing representative PM concentration datasets to correlate with inpatient hospitalizations and emergency room visits data for asthma and inpatient hospitalizations for myocardial infarction (MI) and heart failure (HF) using case-crossover analysis. There were two key objective of this current study. First was to show that the inputs to the HBM could be expanded to include AOD data in addition to data from PM monitors and predictions from CMAQ. The second objective was to determine if inclusion of AOD surfaces in HBM model algorithms results in PM air pollutant concentration surfaces which more accurately predict hospital admittance and emergency room visits for MI, asthma, and HF. This study focuses on the New York City, NY metropolitan and surrounding areas during the 2004-2006 time period, in order to compare the health outcome impacts with those from previous studies and focus on any benefits derived from the changes in the HBM model surfaces. Consistent with previous studies, the results show high PM exposure is associated with increased risk of asthma, myocardial infarction and heart failure. The estimates derived from concentration surfaces that incorporate AOD had a similar model fit and estimate of risk as compared to those derived from combining monitor and CMAQ data alone. Thus, this study demonstrates that estimates of PM concentrations from satellite data can be used to supplement PM monitor data in the estimates of risk associated with three common health outcomes. Results from this study were inconclusive regarding the potential benefits derived from adding AOD data to the HBM, as the addition of the satellite data did not significantly increase model performance. However, this study was limited to one metropolitan area over a short two-year time period. The use of next-generation, high temporal and spatial resolution satellite AOD data from geostationary and polar-orbiting satellites is expected to improve predictions in epidemiological studies in are...

Wastewater surveillance of SARS-CoV-2 RNA is increasingly being incorporated into public health efforts to respond to the COVID-19 pandemic. In order to obtain the maximum benefit from these efforts, approaches to wastewater monitoring need to be rapid, sensitive, and relatable to relevant epidemiological parameters. In this study, we present an ultracentrifugation-based method for the concentration of SARS-CoV-2 wastewater RNA and use crAssphage, a bacteriophage specific to the human gut, to help account for RNA loss during transit in the wastewater system and sample processing. With these methods, we were able to detect, and sometimes quantify, SARS-CoV-2 RNA from 20 mL wastewater samples within as little as 4.5 hours. Using known concentrations of bovine coronavirus RNA and deactivated SARS-CoV-2, we estimate recovery rates of approximately 7-12% of viral RNA using our method. Results from 24 sewersheds across Upstate New York during the spring and summer of 2020 suggested that stronger signals of SARS-CoV-2 RNA from wastewater may be indicative of greater COVID-19 incidence in the represented service area approximately one week in advance. SARS-CoV-2 wastewater RNA was quantifiable in some service areas with daily positives tests of less than 1 per 10,000 people or when weekly positive test rates within a sewershed were as low as 1.7%. crAssphage DNA concentrations were significantly lower during periods of high flow in almost all areas studied. After accounting for flow rate and population served, crAssphage levels per capita were estimated to be about 1.35 × 10 11 and 2.42 × 10 8 genome copies per day for DNA and RNA, respectively. A negative relationship between per capita crAssphage RNA and service area size was also observed likely reflecting degradation of RNA over long transit times. Our results reinforce the potential for wastewater surveillance to be used as a tool to supplement understanding of infectious disease transmission obtained by traditional testing and highlight the potential for crAssphage co-detection to improve interpretations of wastewater surveillance data.

On August 16, 2022, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr).On July 18, 2022, the New York State Department of Health (NYSDOH) notified CDC of detection of poliovirus type 2 in stool specimens from an unvaccinated immunocompetent young adult from Rockland County, New York, who was experiencing acute flaccid weakness. The patient initially experienced fever, neck stiffness, gastrointestinal symptoms, and limb weakness. The patient was hospitalized with possible acute flaccid myelitis (AFM). Vaccine-derived poliovirus type 2 (VDPV2) was detected in stool specimens obtained on days 11 and 12 after initial symptom onset. To date, related Sabin-like type 2 polioviruses have been detected in wastewater* in the patient's county of residence and in neighboring Orange County up to 25 days before (from samples originally collected for SARS-CoV-2 wastewater monitoring) and 41 days after the patient's symptom onset. The last U.S. case of polio caused by wild poliovirus occurred in 1979, and the World Health Organization Region of the Americas was declared polio-free in 1994. This report describes the second identification of community transmission of poliovirus in the United States since 1979; the previous instance, in 2005, was a type 1 VDPV (1). The occurrence of this case, combined with the identification of poliovirus in wastewater in neighboring Orange County, underscores the importance of maintaining high vaccination coverage to prevent paralytic polio in persons of all ages.