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The COVID-19 outbreak led governmental officials to close many businesses and schools, including colleges and universities. Thus, the ability to resume normal campus operation required adoption of safety measures to monitor and respond to COVID-19. The objective of this study was to determine the efficacy of wastewater-based epidemiology as a surveillance method in monitoring COVID-19 on a college campus. The use of wastewater monitoring as part of a surveillance program to control COVID-19 outbreaks at East Carolina University was evaluated. During the Spring and Fall 2021 semesters, wastewater samples (N = 830) were collected every Monday, Wednesday, and Friday from the sewer pipes exiting the dormitories on campus. Samples were analyzed for SARS-CoV-2 and viral quantification was determined using qRT-PCR. During the Spring 2021 semester, there was a significant difference in SARS-CoV-2 virus copies in wastewater when comparing dorms with the highest number student cases of COVID-19 and those with the lowest number of student cases, (p = 0.002). Additionally, during the Fall 2021 semester it was observed that when weekly virus concentrations exceeded 20 copies per ml, there were new confirmed COVID-19 cases 85% of the time during the following week. Increases in wastewater viral concentration spurred COVID-19 swab testing for students residing in dormitories, aiding university officials in effectively applying COVID testing policies. This study showed wastewater-based epidemiology can be a cost-effective surveillance tool to guide other surveilling methods (e.g., contact tracing, nasal/salvia testing, etc.) to identify and isolate afflicted individuals to reduce the spread of pathogens and potential outbreaks within a community.

A natural wetland receiving drainage from a 24-ha urbanized catchment in the Falls Lake Watershed of North Carolina was evaluated to determine if it was providing ecosystem services with regards to phosphate and Escherichia coli (E. coli) attenuation. Inflow and outflow characteristics including nutrient and bacteria concentrations along with physicochemical properties (discharge, pH, oxidation reduction potential, temperature, and specific conductance) were assessed approximately monthly for over 2 years. The median exports of phosphate (0.03 mg/s) and E. coli (5807 MPN/s) leaving the wetland were 85% and 57% lower, respectively, relative to inflow loadings, and the differences were statistically significant (p < 0.05). Hydraulic head readings from three piezometers installed at different depths revealed the wetland was a recharge area. Phosphate and E. coli concentrations were significantly greater in the shallowest piezometer relative to the deepest one, suggesting treatment occurred during infiltration. However, severe erosion of the outlets is threatening the stability of the wetland. Upstream drainageway modifications were implemented to slow runoff, and septic system repairs and maintenance activities were implemented to improve water quality reaching the wetland and Lick Creek. However, more work will be needed to conserve the ecosystem services provided by the wetland.

Abstract Objectives Substance abuse is common in patients with psychiatric emergencies. To further understand the connection between substance abuse and psychiatric disorders, a retrospective chart review was done that included positive drug screens among patients with psychiatric emergencies and to determine whether there was an association between substances used and the psychiatric diagnosis. Methods A retrospective chart review of patients seen in an emergency department with psychiatric emergencies was conducted. The review comprised 1000 charts with diagnoses of anxiety, depression, schizophrenia, attention‐deficit/hyperactivity disorder (ADHD), bipolar disorder, alcohol abuse, or schizoaffective disorder. Data collected included patient demographics, tobacco abuse, chief complaint, arrival mode, voluntary versus involuntary status, suicide attempt on presentation, psychiatric diagnoses, urine drug screen, and ethanol results. Chi‐square statistical analysis was conducted to examine the relationship between substances of abuse and psychiatric diagnoses. Results Approximately 58% of patients with a history of psychiatric illness had a positive urine drug screen. Of 245 patients with schizoaffective disorder, 69 (28%) were positive for tetrahydrocannabinol (THC) and 48 (20%) were positive for cocaine. Of 225 patients with depression, 59 (29%) were positive for THC and 33 (15%) were positive for cocaine. Cannabis was the most commonly reported substance used among patients with depression, schizophrenia, anxiety, schizoaffective disorder, and bipolar disorder, and ethanol was most common in patients with ADHD. No significant correlations were found between psychiatric diagnosis and positive drug screens. A statistically significant secondary end point was found that White people using cannabinoids were more likely to attempt suicide than were African American people (P = 0.02). Conclusions Positive drug screens were common among patients presenting to an ED with psychiatric emergencies. Cannabis was the most commonly reported substance used among patients independent of diagnosis. Ethanol was the most common in patients with ADHD. Urine drug screens are unlikely to provide insights into relationships between specific substance use and psychiatric emergencies.

Urban runoff from the Boat House Creek watershed was suspected as a main delivery mechanism for fecal indicator bacteria (FIB) to the lower White Oak River Estuary in coastal North Carolina, but the dominant source of waste (animal or human) was unknown. Water samples from eight locations within the watershed were collected approximately monthly for two years for enumeration of Escherichia coli (E. coli), enterococci, physicochemical characterization, and microbial source tracking analyses. Concentrations and loadings of E. coli and enterococci were typically elevated during stormflow relative to baseflow conditions, and most samples (66% of enterococci and 75% of E. coli) exceeded the US EPA statistical threshold values. Concentrations of FIB were significantly higher during warm relative to colder months. Human sources of FIB were not observed in the samples, and FIB concentrations increased in locations with wider buffers, thus wildlife was the suspected main FIB source. Stormwater control measures including a rain garden, water control structures, swale modifications, and check dams were implemented to reduce runoff and FIB loadings to the estuary. Stormflow reductions of >5700 m3 year−1 are estimated from the installation of the practices. More work will be needed to improve/maintain water quality as watershed development continues.

Abstract Background Vector-borne diseases are an important cause of morbidity and mortality in the USA. Effective, convenient prevention methods are needed. Long-lasting permethrin-impregnated (LLPI) clothing can prevent tick bites, however, additional information is needed on the real-world effectiveness and safety of this preventative measure. Methods In this pilot study, we recruited state and county park employees from North Carolina to wear LLPI uniforms for three months during the summer of 2016. We collected spot urine samples for biomonitoring of permethrin metabolites at one week, one month and three months after first use of the LLPI uniform. Following three months of wear, we collected pants and socks and analyzed them for permethrin content and mortality to ticks and mosquitoes. Results Thirteen park employees were included in the analysis. Bioactive amounts of permethrin remained in all clothing swatches tested, although there was great variability. Tick mortality was high, with 78% of pant and 88% of sock swatches having mean knockdown percentages ≥ 85%. In contrast, mosquito mortality was low. Over the study period, the absorbed dosage of permethrin averaged < 4 μg/kg/d of body weight based on measurements of three metabolites. Conclusions LLPI clothing retained permethrin and bioactivity against ticks after three months of use in real-world conditions. The estimated absorbed dosage of permethrin was well below the U.S. EPA level of concern, suggesting that LLPI clothing can be used safely by outdoor workers for tick bite prevention.