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Holm RH, Rempala GA, Choi B, Brick JM, Amraotkar AR, Keith RJ, Rouchka EC, Chariker JH, Palmer KE, Smith T, Bhatnagar A. Dynamic SARS-CoV-2 surveillance model combining seroprevalence and wastewater concentrations for post-vaccine disease burden estimates. COMMUNICATIONS MEDICINE 2024; 4:70. [PMID: 38594350 PMCID: PMC11004132 DOI: 10.1038/s43856-024-00494-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 03/28/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Despite wide scale assessments, it remains unclear how large-scale severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination affected the wastewater concentration of the virus or the overall disease burden as measured by hospitalization rates. METHODS We used weekly SARS-CoV-2 wastewater concentration with a stratified random sampling of seroprevalence, and linked vaccination and hospitalization data, from April 2021-August 2021 in Jefferson County, Kentucky (USA). Our susceptible ( S ), vaccinated ( V ), variant-specific infected (I 1 andI 2 ), recovered ( R ), and seropositive ( T ) model ( S V I 2 R T ) tracked prevalence longitudinally. This was related to wastewater concentration. RESULTS Here we show the 64% county vaccination rate translate into about a 61% decrease in SARS-CoV-2 incidence. The estimated effect of SARS-CoV-2 Delta variant emergence is a 24-fold increase of infection counts, which correspond to an over 9-fold increase in wastewater concentration. Hospitalization burden and wastewater concentration have the strongest correlation (r = 0.95) at 1 week lag. CONCLUSIONS Our study underscores the importance of continuing environmental surveillance post-vaccine and provides a proof-of-concept for environmental epidemiology monitoring of infectious disease for future pandemic preparedness.
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Grants
- P20 GM103436 NIGMS NIH HHS
- P30 ES030283 NIEHS NIH HHS
- This study was supported by Centers for Disease Control and Prevention (75D30121C10273), Louisville Metro Government, James Graham Brown Foundation, Owsley Brown II Family Foundation, Welch Family, Jewish Heritage Fund for Excellence, the National Institutes of Health, (P20GM103436), the Rockefeller Foundation, the National Sciences Foundation (DMS-2027001), and the Basic Science Research Program National Research Foundation of Korea (NRF) (RS-2023-00245056).
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Affiliation(s)
- Rochelle H Holm
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, 40202, USA
| | - Grzegorz A Rempala
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, 43210, USA
| | - Boseung Choi
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, 43210, USA
- Division of Big Data Science, Korea University, Sejong, South Korea
- Biomedical Mathematics Group, Institute for Basic Science, Daejeon, South Korea
| | | | - Alok R Amraotkar
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, 40202, USA
| | - Rachel J Keith
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, 40202, USA
| | - Eric C Rouchka
- Department of Biochemistry and Molecular Genetics, School of Medicine, University of Louisville, Louisville, KY, 40202, USA
- KY INBRE Bioinformatics Core, University of Louisville, Louisville, KY, 40202, USA
| | - Julia H Chariker
- Department of Biochemistry and Molecular Genetics, School of Medicine, University of Louisville, Louisville, KY, 40202, USA
- KY INBRE Bioinformatics Core, University of Louisville, Louisville, KY, 40202, USA
| | - Kenneth E Palmer
- Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville, Louisville, KY, 40202, USA
- Department of Pharmacology and Toxicology, School of Medicine, University of Louisville, Louisville, KY, 40202, USA
| | - Ted Smith
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, 40202, USA
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, 40202, USA.
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Vasconcelos LDCM, Leony LM, Camelier AA, Meireles AC, Oliveira Júnior ALFD, Bandeira AC, Macedo YSF, Duarte AO, Van Voorhis W, Siqueira ICD, Santos FLN. Usefulness of receptor binding domain protein-based serodiagnosis of COVID-19. IJID REGIONS 2024; 10:1-8. [PMID: 38045864 PMCID: PMC10687696 DOI: 10.1016/j.ijregi.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 10/31/2023] [Accepted: 11/05/2023] [Indexed: 12/05/2023]
Abstract
Objectives This study evaluated the performance of recombinant receptor binding domain (RBD) protein-based enzyme-linked immunosorbent assays (RBD-ELISAs) for detecting anti-SARS-CoV-2 immunoglobulin (Ig) G and IgM antibodies. Methods In this study, 705 sera from SARS-CoV-2-infected individuals and 315 sera from healthy individuals were analyzed. Results The RBD-ELISA IgG exhibited high specificity (99.1%) and moderate sensitivity (48.0%), with an overall diagnostic accuracy of 73.5%. RBD-ELISA IgM demonstrated specificity at 94.6% and sensitivity at 51.1%, with an accuracy of 72.8%. Both assays displayed improved performance when analyzing samples collected 15-21 days post-symptom onset, achieving sensitivity and accuracy exceeding 88% and 90%, respectively. Combining RBD-ELISA IgG and IgM in parallel analysis enhanced sensitivity to 98.6% and accuracy to 96.2%. Comparing these RBD-ELISAs with commercially available tests, the study found overlapping sensitivity and similar specificity values. Notably, the combined RBD-ELISA IgG and IgM showed superior performance. Cross-reactivity analysis revealed low false-positive rates (4.4% for IgG, 3.7% for IgM), primarily with viral infections. Conclusion This research underscores the potential of RBD-based ELISAs for COVID-19 diagnosis, especially when assessing samples collected 15-21 days post-symptom onset and utilizing a parallel testing approach. The RBD protein's immunogenicity and specificity make it a valuable tool for serodiagnosis, offering an alternative to polymerase chain reaction-based methods, particularly in resource-limited settings.
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Affiliation(s)
| | - Leonardo Maia Leony
- Advanced Public Health Laboratory, Gonçalo Moniz Institute (IGM), Oswaldo Cruz Foundation (FIOCRUZ-RJ), Salvador, Brazil
| | - Aquiles Assunção Camelier
- Aliança D'Or Hospital, Salvador, Brazil
- Bahia School of Medicine and Public Health, Salvador, Brazil
- State University of Bahia, Salvador, Brazil
| | | | | | | | - Yasmin Santos Freitas Macedo
- Laboratory of Experimental Pathology, Institute Gonçalo Moniz, Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Brazil
| | - Alan Oliveira Duarte
- Laboratory of Experimental Pathology, Institute Gonçalo Moniz, Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Brazil
| | | | - Isadora Cristina de Siqueira
- Laboratory of Experimental Pathology, Institute Gonçalo Moniz, Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Brazil
- Integrated Translational Program in Chagas Disease from FIOCRUZ (Fio-Chagas), Oswaldo Cruz Foundation (FIOCRUZ-RJ), Rio de Janeiro, Brazil
| | - Fred Luciano Neves Santos
- Advanced Public Health Laboratory, Gonçalo Moniz Institute (IGM), Oswaldo Cruz Foundation (FIOCRUZ-RJ), Salvador, Brazil
- Integrated Translational Program in Chagas Disease from FIOCRUZ (Fio-Chagas), Oswaldo Cruz Foundation (FIOCRUZ-RJ), Rio de Janeiro, Brazil
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Holm RH, Rempala G, Choi B, Brick JM, Amraotkar A, Keith R, Rouchka EC, Chariker JH, Palmer K, Smith TR, Bhatnagar A. Wastewater and seroprevalence for pandemic preparedness: variant analysis, vaccination effect, and hospitalization forecasting for SARS-CoV-2, in Jefferson County, Kentucky. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.01.06.23284260. [PMID: 36656780 PMCID: PMC9844017 DOI: 10.1101/2023.01.06.23284260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Despite wide scale assessments, it remains unclear how large-scale SARS-CoV-2 vaccination affected the wastewater concentration of the virus or the overall disease burden as measured by hospitalization rates. We used weekly SARS-CoV-2 wastewater concentration with a stratified random sampling of seroprevalence, and linked vaccination and hospitalization data, from April 2021-August 2021 in Jefferson County, Kentucky (USA). Our susceptible (S), vaccinated (V), variant-specific infected (I_1 and I_2), recovered (R), and seropositive (T) model (SVI_2 RT) tracked prevalence longitudinally. This was related to wastewater concentration. The 64% county vaccination rate translated into about 61% decrease in SARS-CoV-2 incidence. The estimated effect of SARS-CoV-2 Delta variant emergence was a 24-fold increase of infection counts, which corresponded to an over 9-fold increase in wastewater concentration. Hospitalization burden and wastewater concentration had the strongest correlation (r = 0.95) at 1 week lag. Our study underscores the importance of continued environmental surveillance post-vaccine and provides a proof-of-concept for environmental epidemiology monitoring of infectious disease for future pandemic preparedness.
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Keith RJ, Holm RH, Amraotkar AR, Bezold MM, Brick JM, Bushau-Sprinkle AM, Hamorsky KT, Kitterman KT, Palmer KE, Smith T, Yeager R, Bhatnagar A. Stratified Simple Random Sampling Versus Volunteer Community-Wide Sampling for Estimates of COVID-19 Prevalence. Am J Public Health 2023; 113:768-777. [PMID: 37200600 PMCID: PMC10262242 DOI: 10.2105/ajph.2023.307303] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 05/20/2023]
Abstract
Objectives. To evaluate community-wide prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection using stratified simple random sampling. Methods. We obtained data for the prevalence of SARS-CoV-2 in Jefferson County, Kentucky, from adult random (n = 7296) and volunteer (n = 7919) sampling over 8 waves from June 2020 through August 2021. We compared results with administratively reported rates of COVID-19. Results. Randomized and volunteer samples produced equivalent prevalence estimates (P < .001), which exceeded the administratively reported rates of prevalence. Differences between them decreased as time passed, likely because of seroprevalence temporal detection limitations. Conclusions. Structured targeted sampling for seropositivity against SARS-CoV-2, randomized or voluntary, provided better estimates of prevalence than administrative estimates based on incident disease. A low response rate to stratified simple random sampling may produce quantified disease prevalence estimates similar to a volunteer sample. Public Health Implications. Randomized targeted and invited sampling approaches provided better estimates of disease prevalence than administratively reported data. Cost and time permitting, targeted sampling is a superior modality for estimating community-wide prevalence of infectious disease, especially among Black individuals and those living in disadvantaged neighborhoods. (Am J Public Health. 2023;113(7):768-777. https://doi.org/10.2105/AJPH.2023.307303).
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Affiliation(s)
- Rachel J Keith
- Rachel J. Keith, Rochelle H. Holm, Alok R. Amraotkar, Ted Smith, Ray Yeager, and Aruni Bhatnagar are with the Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY. Megan M. Bezold, Adrienne M. Bushau-Sprinkle, Krystal T. Hamorsky, Kathleen T. Kitterman, and Kenneth E. Palmer are with the Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville. J. Michael Brick is with Westat Inc, Rockville, MD
| | - Rochelle H Holm
- Rachel J. Keith, Rochelle H. Holm, Alok R. Amraotkar, Ted Smith, Ray Yeager, and Aruni Bhatnagar are with the Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY. Megan M. Bezold, Adrienne M. Bushau-Sprinkle, Krystal T. Hamorsky, Kathleen T. Kitterman, and Kenneth E. Palmer are with the Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville. J. Michael Brick is with Westat Inc, Rockville, MD
| | - Alok R Amraotkar
- Rachel J. Keith, Rochelle H. Holm, Alok R. Amraotkar, Ted Smith, Ray Yeager, and Aruni Bhatnagar are with the Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY. Megan M. Bezold, Adrienne M. Bushau-Sprinkle, Krystal T. Hamorsky, Kathleen T. Kitterman, and Kenneth E. Palmer are with the Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville. J. Michael Brick is with Westat Inc, Rockville, MD
| | - Megan M Bezold
- Rachel J. Keith, Rochelle H. Holm, Alok R. Amraotkar, Ted Smith, Ray Yeager, and Aruni Bhatnagar are with the Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY. Megan M. Bezold, Adrienne M. Bushau-Sprinkle, Krystal T. Hamorsky, Kathleen T. Kitterman, and Kenneth E. Palmer are with the Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville. J. Michael Brick is with Westat Inc, Rockville, MD
| | - J Michael Brick
- Rachel J. Keith, Rochelle H. Holm, Alok R. Amraotkar, Ted Smith, Ray Yeager, and Aruni Bhatnagar are with the Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY. Megan M. Bezold, Adrienne M. Bushau-Sprinkle, Krystal T. Hamorsky, Kathleen T. Kitterman, and Kenneth E. Palmer are with the Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville. J. Michael Brick is with Westat Inc, Rockville, MD
| | - Adrienne M Bushau-Sprinkle
- Rachel J. Keith, Rochelle H. Holm, Alok R. Amraotkar, Ted Smith, Ray Yeager, and Aruni Bhatnagar are with the Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY. Megan M. Bezold, Adrienne M. Bushau-Sprinkle, Krystal T. Hamorsky, Kathleen T. Kitterman, and Kenneth E. Palmer are with the Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville. J. Michael Brick is with Westat Inc, Rockville, MD
| | - Krystal T Hamorsky
- Rachel J. Keith, Rochelle H. Holm, Alok R. Amraotkar, Ted Smith, Ray Yeager, and Aruni Bhatnagar are with the Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY. Megan M. Bezold, Adrienne M. Bushau-Sprinkle, Krystal T. Hamorsky, Kathleen T. Kitterman, and Kenneth E. Palmer are with the Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville. J. Michael Brick is with Westat Inc, Rockville, MD
| | - Kathleen T Kitterman
- Rachel J. Keith, Rochelle H. Holm, Alok R. Amraotkar, Ted Smith, Ray Yeager, and Aruni Bhatnagar are with the Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY. Megan M. Bezold, Adrienne M. Bushau-Sprinkle, Krystal T. Hamorsky, Kathleen T. Kitterman, and Kenneth E. Palmer are with the Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville. J. Michael Brick is with Westat Inc, Rockville, MD
| | - Kenneth E Palmer
- Rachel J. Keith, Rochelle H. Holm, Alok R. Amraotkar, Ted Smith, Ray Yeager, and Aruni Bhatnagar are with the Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY. Megan M. Bezold, Adrienne M. Bushau-Sprinkle, Krystal T. Hamorsky, Kathleen T. Kitterman, and Kenneth E. Palmer are with the Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville. J. Michael Brick is with Westat Inc, Rockville, MD
| | - Ted Smith
- Rachel J. Keith, Rochelle H. Holm, Alok R. Amraotkar, Ted Smith, Ray Yeager, and Aruni Bhatnagar are with the Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY. Megan M. Bezold, Adrienne M. Bushau-Sprinkle, Krystal T. Hamorsky, Kathleen T. Kitterman, and Kenneth E. Palmer are with the Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville. J. Michael Brick is with Westat Inc, Rockville, MD
| | - Ray Yeager
- Rachel J. Keith, Rochelle H. Holm, Alok R. Amraotkar, Ted Smith, Ray Yeager, and Aruni Bhatnagar are with the Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY. Megan M. Bezold, Adrienne M. Bushau-Sprinkle, Krystal T. Hamorsky, Kathleen T. Kitterman, and Kenneth E. Palmer are with the Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville. J. Michael Brick is with Westat Inc, Rockville, MD
| | - Aruni Bhatnagar
- Rachel J. Keith, Rochelle H. Holm, Alok R. Amraotkar, Ted Smith, Ray Yeager, and Aruni Bhatnagar are with the Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY. Megan M. Bezold, Adrienne M. Bushau-Sprinkle, Krystal T. Hamorsky, Kathleen T. Kitterman, and Kenneth E. Palmer are with the Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville. J. Michael Brick is with Westat Inc, Rockville, MD
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5
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Amraotkar AR, Keith RJ, Palmer KE, Bhatnagar A. Using SARS-CoV-2 Antibody Testing in COVID-19 Research. Am J Med 2023; 136:501-503. [PMID: 36780969 PMCID: PMC9922202 DOI: 10.1016/j.amjmed.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/03/2023] [Indexed: 02/14/2023]
Affiliation(s)
- Alok R Amraotkar
- Division of Environmental Medicine, Christina Lee Brown Envirome Institute.
| | - Rachel J Keith
- Division of Environmental Medicine, Christina Lee Brown Envirome Institute
| | - Kenneth E Palmer
- Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville School of Medicine, Ky
| | - Aruni Bhatnagar
- Division of Environmental Medicine, Christina Lee Brown Envirome Institute
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Smith T, Holm RH, Keith RJ, Amraotkar AR, Alvarado CR, Banecki K, Choi B, Santisteban IC, Bushau-Sprinkle AM, Kitterman KT, Fuqua J, Hamorsky KT, Palmer KE, Brick JM, Rempala GA, Bhatnagar A. Quantifying the relationship between sub-population wastewater samples and community-wide SARS-CoV-2 seroprevalence. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 853:158567. [PMID: 36084773 PMCID: PMC9444845 DOI: 10.1016/j.scitotenv.2022.158567] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/07/2022] [Accepted: 09/02/2022] [Indexed: 06/15/2023]
Abstract
Robust epidemiological models relating wastewater to community disease prevalence are lacking. Assessments of SARS-CoV-2 infection rates have relied primarily on convenience sampling, which does not provide reliable estimates of community disease prevalence due to inherent biases. This study conducted serial stratified randomized samplings to estimate the prevalence of SARS-CoV-2 antibodies in 3717 participants, and obtained weekly samples of community wastewater for SARS-CoV-2 concentrations in Jefferson County, KY (USA) from August 2020 to February 2021. Using an expanded Susceptible-Infected-Recovered model, the longitudinal estimates of the disease prevalence were obtained and compared with the wastewater concentrations using regression analysis. The model analysis revealed significant temporal differences in epidemic peaks. The results showed that in some areas, the average incidence rate, based on serological sampling, was 50 % higher than the health department rate, which was based on convenience sampling. The model-estimated average prevalence rates correlated well with the wastewater (correlation = 0.63, CI (0.31,0.83)). In the regression analysis, a one copy per ml-unit increase in weekly average wastewater concentration of SARS-CoV-2 corresponded to an average increase of 1-1.3 cases of SARS-CoV-2 infection per 100,000 residents. The analysis indicates that wastewater may provide robust estimates of community spread of infection, in line with the modeled prevalence estimates obtained from stratified randomized sampling, and is therefore superior to publicly available health data.
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Affiliation(s)
- Ted Smith
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY 40202, USA
| | - Rochelle H Holm
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY 40202, USA
| | - Rachel J Keith
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY 40202, USA
| | - Alok R Amraotkar
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY 40202, USA
| | - Chance R Alvarado
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
| | - Krzysztof Banecki
- Laboratory of Bioinformatics and Computational Genomics, Faculty of Mathematics and Information Science, Warsaw University of Technology, Warsaw, Poland
| | - Boseung Choi
- Division of Big Data Science, Korea University, Sejong, South Korea; Biomedical Mathematics Group, Institute for Basic Science, Daejeon, South Korea
| | - Ian C Santisteban
- Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville, Louisville, KY 40202, USA
| | - Adrienne M Bushau-Sprinkle
- Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville, Louisville, KY 40202, USA; Department of Medicine, School of Medicine, University of Louisville, Louisville, KY 40202, USA
| | - Kathleen T Kitterman
- Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville, Louisville, KY 40202, USA
| | - Joshua Fuqua
- Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville, Louisville, KY 40202, USA; Department of Pharmacology and Toxicology, School of Medicine, University of Louisville, Louisville, KY 40202, USA
| | - Krystal T Hamorsky
- Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville, Louisville, KY 40202, USA; Department of Medicine, School of Medicine, University of Louisville, Louisville, KY 40202, USA
| | - Kenneth E Palmer
- Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville, Louisville, KY 40202, USA; Department of Pharmacology and Toxicology, School of Medicine, University of Louisville, Louisville, KY 40202, USA
| | | | - Grzegorz A Rempala
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY 40202, USA.
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Holm RH, Brick JM, Amraotkar AR, Hart JL, Mukherjee A, Zeigler J, Bushau-Sprinkle AM, Anderson LB, Walker KL, Talley D, Keith RJ, Rai SN, Palmer KE, Bhatnagar A, Smith T. Public Awareness of and Support for the Use of Wastewater for SARS-CoV-2 Monitoring: A Community Survey in Louisville, Kentucky. ACS ES&T WATER 2022; 2:1891-1898. [PMID: 37552721 PMCID: PMC9063986 DOI: 10.1021/acsestwater.1c00405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 04/12/2022] [Accepted: 04/12/2022] [Indexed: 05/16/2023]
Abstract
The majority of sewer systems in the United States and other countries are operated by public utilities. In the absence of any regulation, the public perception of wastewater monitoring for population health biomarkers is an important consideration for a public utility commission when allocating resources for this purpose. We conducted a survey in August 2021 as part of an ongoing COVID-19 community prevalence study in Louisville/Jefferson County, KY, US. The survey comprised seven questions about wastewater awareness and privacy concerns and was sent to approximately 35 000 households randomly distributed within the county. A total of 1220 adults were involved in the probability sample, and data from 981 respondents were used in the analysis. A total of 2444 adults additionally responded to the convenience sample, and data from 1751 respondents were used in the analysis. The samples were weighted to obtain estimates representative of all adults in the county. Public awareness of tracking the virus that causes COVID-19 in sewers was low. Opinions strongly support the public disclosure of monitoring results. Responses showed that people more strongly supported measurements in the largest areas (>50 000 households), typically representing population levels found in a large community wastewater treatment plant. Those with a history of COVID-19 infection were more likely to support highly localized monitoring. Understanding wastewater surveillance strategies and privacy concern thresholds requires an in-depth and comprehensive analysis of public opinion for continued success and effective public health monitoring.
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Affiliation(s)
- Rochelle H. Holm
- Christina Lee Brown Envirome Institute, School of
Medicine, University of Louisville, 302 East Muhammad Ali
Boulevard, Louisville, Kentucky 40202, United States
| | - J. Michael Brick
- Westat, Incorporated, 1600
Research Boulevard, Rockville, Maryland 20850, United States
| | - Alok R. Amraotkar
- Christina Lee Brown Envirome Institute, School of
Medicine, University of Louisville, 302 East Muhammad Ali
Boulevard, Louisville, Kentucky 40202, United States
| | - Joy L. Hart
- Christina Lee Brown Envirome Institute, School of
Medicine, University of Louisville, 302 East Muhammad Ali
Boulevard, Louisville, Kentucky 40202, United States
- Department of Communication, College of Arts and
Sciences, University of Louisville, 2010 South Avery Court
Walk, Louisville, Kentucky 40208, United States
| | - Anish Mukherjee
- Department of Bioinformatics and Biostatistics, School
of Public Health and Information Science, University of
Louisville, 505 South Hancock Street, Louisville, Kentucky 40202,
United States
| | - Jacob Zeigler
- Christina Lee Brown Envirome Institute, School of
Medicine, University of Louisville, 302 East Muhammad Ali
Boulevard, Louisville, Kentucky 40202, United States
| | - Adrienne M. Bushau-Sprinkle
- Center for Predictive Medicine for Biodefense and
Emerging Infectious Diseases, University of Louisville, 505
South Hancock Street, Louisville, Kentucky 40202, United States
| | - Lauren B. Anderson
- Christina Lee Brown Envirome Institute, School of
Medicine, University of Louisville, 302 East Muhammad Ali
Boulevard, Louisville, Kentucky 40202, United States
- Center for Healthy Air, Water and Soil,
University of Louisville, 302 East Muhammad Ali Boulevard,
Louisville, Kentucky 40202, United States
| | - Kandi L. Walker
- Christina Lee Brown Envirome Institute, School of
Medicine, University of Louisville, 302 East Muhammad Ali
Boulevard, Louisville, Kentucky 40202, United States
- Department of Communication, College of Arts and
Sciences, University of Louisville, 2010 South Avery Court
Walk, Louisville, Kentucky 40208, United States
| | - Daymond Talley
- Louisville/Jefferson County Metropolitan
Sewer District, Morris Forman Water Quality Treatment Center, 4522
Algonquin Parkway, Louisville, Kentucky 40211, United States
| | - Rachel J. Keith
- Christina Lee Brown Envirome Institute, School of
Medicine, University of Louisville, 302 East Muhammad Ali
Boulevard, Louisville, Kentucky 40202, United States
| | - Shesh N. Rai
- Christina Lee Brown Envirome Institute, School of
Medicine, University of Louisville, 302 East Muhammad Ali
Boulevard, Louisville, Kentucky 40202, United States
- Department of Bioinformatics and Biostatistics, School
of Public Health and Information Science, University of
Louisville, 505 South Hancock Street, Louisville, Kentucky 40202,
United States
- Brown Cancer Center, School of Medicine,
University of Louisville, 505 South Hancock Street,
Louisville, Kentucky 40202, United States
- Center for Integrative Environmental
Health Sciences, 500 South Preston Street, Louisville, Kentucky 40202,
United States
| | - Kenneth E. Palmer
- Center for Predictive Medicine for Biodefense and
Emerging Infectious Diseases, University of Louisville, 505
South Hancock Street, Louisville, Kentucky 40202, United States
- Department of Pharmacology and Toxicology, School of
Medicine, University of Louisville, 323 East Chestnut Street,
Louisville, Kentucky 40202, United States
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute, School of
Medicine, University of Louisville, 302 East Muhammad Ali
Boulevard, Louisville, Kentucky 40202, United States
| | - Ted Smith
- Christina Lee Brown Envirome Institute, School of
Medicine, University of Louisville, 302 East Muhammad Ali
Boulevard, Louisville, Kentucky 40202, United States
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Pre-Existing Comorbidities Diminish the Likelihood of Seropositivity after SARS-CoV-2 Vaccination. Vaccines (Basel) 2022; 10:vaccines10081363. [PMID: 36016250 PMCID: PMC9416221 DOI: 10.3390/vaccines10081363] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The impact of chronic health conditions (CHCs) on serostatus post-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is unknown. METHODS We assessed serostatus post-SARS-CoV-2 vaccination among fully vaccinated adult residents of Jefferson County, Kentucky, USA, from April 2021 to August 2021. Serostatus was determined by qualitative analysis of SARS-CoV-2-specific Spike IgG antibodies via enzyme-linked immunoassay (ELISA) in peripheral blood samples. RESULTS Of the 5178 fully vaccinated participants, 51 were seronegative and 5127 were seropositive. Chronic kidney disease (CKD) and autoimmune disease showed the highest association with negative serostatus in fully vaccinated individuals. The absence of any CHC was strongly associated with positive serostatus. The risk of negative serostatus increased as the total number of pre-existing CHCs increased. Similarly, the use of two or more CHC-related medications was associated with seronegative status. CONCLUSIONS The presence of any CHC, especially CKD or autoimmune disease, increased the likelihood of seronegative status among individuals who were fully vaccinated to SAR-CoV-2. This risk increased with a concurrent increase in number of comorbidities, especially with multiple medications. The absence of any CHC was protective and increased the likelihood of a positive serological response. These results will help develop appropriate guidelines for booster doses and targeted vaccination programs.
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DeMarco JK, Royal JM, Severson WE, Gabbard JD, Hume S, Morton J, Swope K, Simpson CA, Shepherd JW, Bratcher B, Palmer KE, Pogue GP. CoV-RBD121-NP Vaccine Candidate Protects against Symptomatic Disease following SARS-CoV-2 Challenge in K18-hACE2 Mice and Induces Protective Responses That Prevent COVID-19-Associated Immunopathology. Vaccines (Basel) 2021; 9:1346. [PMID: 34835277 PMCID: PMC8618284 DOI: 10.3390/vaccines9111346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/01/2021] [Accepted: 11/05/2021] [Indexed: 01/08/2023] Open
Abstract
We developed a SARS-CoV-2 vaccine candidate (CoV-RBD121-NP) comprised of a tobacco mosaic virus-like nanoparticle conjugated to the receptor-binding domain of the spike glycoprotein of SARS-CoV-2 fused to a human IgG1 Fc domain. CoV-RBD121-NP elicits strong antibody responses in C57BL/6 mice and is stable for up to 12 months at 2-8 or 22-28 °C. Here, we showed that this vaccine induces a strong neutralizing antibody response in K18-hACE2 mice. Furthermore, we demonstrated that immunization protects mice from virus-associated mortality and symptomatic disease. Our data indicated that a sufficient pre-existing pool of neutralizing antibodies is required to restrict SARS-CoV-2 replication upon exposure and prevent induction of inflammatory mediators associated with severe disease. Finally, we identified a potential role for CXCL5 as a protective cytokine in SARS-CoV-2 infection. Our results suggested that disruption of the CXCL5 and CXCL1/2 axis may be important early components of the inflammatory dysregulation that is characteristic of severe cases of COVID-19.
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Affiliation(s)
- Jennifer K. DeMarco
- Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville, Louisville, KY 40202, USA; (J.K.D.); (W.E.S.); (J.D.G.); (K.E.P.)
- Department of Microbiology and Immunology, University of Louisville, Louisville, KY 40202, USA
| | - Joshua M. Royal
- Kentucky BioProcessing, Inc., Owensboro, KY 42301, USA; (S.H.); (J.M.); (K.S.); (C.A.S.); (J.W.S.); (B.B.); (G.P.P.)
| | - William E. Severson
- Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville, Louisville, KY 40202, USA; (J.K.D.); (W.E.S.); (J.D.G.); (K.E.P.)
| | - Jon D. Gabbard
- Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville, Louisville, KY 40202, USA; (J.K.D.); (W.E.S.); (J.D.G.); (K.E.P.)
| | - Steve Hume
- Kentucky BioProcessing, Inc., Owensboro, KY 42301, USA; (S.H.); (J.M.); (K.S.); (C.A.S.); (J.W.S.); (B.B.); (G.P.P.)
| | - Josh Morton
- Kentucky BioProcessing, Inc., Owensboro, KY 42301, USA; (S.H.); (J.M.); (K.S.); (C.A.S.); (J.W.S.); (B.B.); (G.P.P.)
| | - Kelsi Swope
- Kentucky BioProcessing, Inc., Owensboro, KY 42301, USA; (S.H.); (J.M.); (K.S.); (C.A.S.); (J.W.S.); (B.B.); (G.P.P.)
| | - Carrie A. Simpson
- Kentucky BioProcessing, Inc., Owensboro, KY 42301, USA; (S.H.); (J.M.); (K.S.); (C.A.S.); (J.W.S.); (B.B.); (G.P.P.)
| | - John W. Shepherd
- Kentucky BioProcessing, Inc., Owensboro, KY 42301, USA; (S.H.); (J.M.); (K.S.); (C.A.S.); (J.W.S.); (B.B.); (G.P.P.)
| | - Barry Bratcher
- Kentucky BioProcessing, Inc., Owensboro, KY 42301, USA; (S.H.); (J.M.); (K.S.); (C.A.S.); (J.W.S.); (B.B.); (G.P.P.)
| | - Kenneth E. Palmer
- Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville, Louisville, KY 40202, USA; (J.K.D.); (W.E.S.); (J.D.G.); (K.E.P.)
- James Brown Cancer Center, University of Louisville, Louisville, KY 40202, USA
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, KY 40202, USA
| | - Gregory P. Pogue
- Kentucky BioProcessing, Inc., Owensboro, KY 42301, USA; (S.H.); (J.M.); (K.S.); (C.A.S.); (J.W.S.); (B.B.); (G.P.P.)
- IC² Institute, University of Texas at Austin, Austin, TX 78805, USA
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