Assessment of a SARS-CoV-2 wastewater monitoring program in El Paso, Texas, from November 2020 to June 2022

The border city of El Paso, Texas, and its water utility, El Paso Water, initiated a SARS-CoV-2 wastewater monitoring program to assess virus trends and the appropriateness of a wastewater monitoring program for the community. Nearly weekly sample collection at four wastewater treatment facilities (WWTFs), serving distinct regions of the city, was analyzed for SARS-CoV-2 genes using the CDC 2019-Novel coronavirus Real-Time RT-PCR diagnostic panel. Virus concentrations ranged from 86.7 to 268,000 gc/L, varying across time and at each WWTF. The lag time between virus concentrations in wastewater and reported COVID-19 case rates (per 100,00 population) ranged from 4-24 days for the four WWTFs, with the strongest trend occurring from November 2021 - June 2022. This study is an assessment of the utility of a geographically refined SARS-CoV-2 wastewater monitoring program to supplement public health efforts that will manage the virus as it becomes endemic in El Paso.

"Es Muy Tranquilo Aquí": Perceptions of Safety and Calm among Binationally Mobile Mexican Immigrants in a Rural Border Community

Perceptions of community can play an important role in determining health and well-being. We know little, however, about residents’ perceptions of community safety in the Southwestern borderlands, an area frequently portrayed as plagued by disorder. The qualitative aim of this community-based participatory research study was to explore the perceptions of Mexican-origin border residents about their communities in southern Yuma County, Arizona. Our team of University of Arizona researchers and staff from Campesinos Sin Fronteras, a grassroots farmworker support agency in Yuma County, Arizona, developed a bilingual interview guide and recruited participants through radio adds, flyers, and cold calls among existing agency clientele. Thirty individual interviews with participants of Mexican origin who live in and/or work in rural Yuma County were conducted remotely in 2021. Participants overwhelmingly perceived their communities as both calm and safe. While some participants mentioned safety concerns, the vast majority described high levels of personal security and credited both neighbors and police for ensuring local safety. These perceptions were stated in direct contrast to those across the border, where participants had positive familial and cultural ties but negative perceptions regarding widespread violence. In conclusion, we argue that to understand environmental factors affecting health and well-being in Mexican immigrant populations, it is critical to examine the role of binational external referents that color community perceptions.

Development of a Surveillance Definition for United States-Mexico Binational Cases of Tuberculosis

OBJECTIVES

Consistently collected binational surveillance data are important in advocating for resources to manage and treat binational cases of tuberculosis (TB). The objective of this study was to develop a surveillance definition for binational (United States-Mexico) cases of TB to assess the burden on US TB program resources.

METHODS

We collaborated with state and local TB program staff members in the United States to identify characteristics associated with binational cases of TB. We collected data on all cases of TB from 9 pilot sites in 5 states (Arizona, California, Colorado, New Mexico, and Texas) during January 1-June 30, 2014, that had at least 1 binational characteristic (eg, "crossed border while on TB treatment" and "received treatment in another country, coordinated by an established, US-funded, binational TB program"). A workgroup of US state, local, and federal partners reviewed results and used them to develop a practical surveillance definition.

RESULTS

The pilot sites reported 87 cases of TB with at least 1 binational characteristic during the project period. The workgroup drafted a proposed surveillance definition to include 2 binational characteristics: "crossed border while on TB treatment" (34 of 87 cases, 39%) and "received treatment in another country, coordinated by an established, US-funded, binational TB program" (26 of 87 cases, 30%). Applying the new proposed definition, 39 of 87 pilot cases of TB (45%) met the definition of binational.

CONCLUSION

Input from partners who were responsible for the care and treatment of patients who cross the United States-Mexico border was crucial in defining a binational case of TB.

A Binational Influenza Surveillance Network – California/Baja California

Objective

To enhance cross-border surveillance for Influenza-Like-Illness (ILI) in the California/Baja California (CA/BC) border region through the formation of a border binational surveillance network.

Introduction

In response to the 2009 H1N1 pandemic, the Early Warning Infectious Disease Surveillance Program (EWIDS) Office of Binational Border Health in the California Department of Public Health sought to strengthen outpatient ILI surveillance along the CA/BC border by creating the first binational influenza surveillance network in the region. The establishment of this network was crucial for enhancing cross-border situational awareness of influenza activity, especially in a region characterized by high levels of population mobility.

Methods

During summer of 2009, an assessment of current ILI surveillance activities in the CA/BC border region was conducted. Findings were utilized to guide recruitment efforts and build a cross-border surveillance network. In CA the assessment revealed that sentinel sites in the border region participating in CDC’s ILINet surveillance program were primarily pediatric or school-based clinics and that family practice patients were not equally represented. In BC the need to enhance surveillance among the private sector was identified, particularly among patients belonging to binational healthcare service plans. These plans offer care to US workforce individuals who seek medical care in BC. Other needs identified included the need to enhance surveillance among underserved populations such as farm workers and tribal communities which were not currently being represented. Working together with partners from both sides of the border EWIDS initiated efforts to address identified gaps. Over a three-year period EWIDS recruited private and public sector clinics to participate in the network.

Results

As a result of the assessment recruitment efforts were focused on inviting family practice clinics, private clinics, tribal health centers and clinics that provide care to underserved populations to participate in the network. These efforts led to the establishment of the California/Baja California Border Outpatient Provider ILI Surveillance Network, which monitors syndromic and virologic influenza activity. In total EWIDS recruited 22 (13 in CA, 9 in BC) sentinel sites to participate; of these, 17 are family practice sites and 5 are pediatric sites. Additionally, prior to the EWIDS enhancement local tribal health clinics were not represented in the surveillance system. EWIDS efforts resulted in the inclusion of 8 tribal sites in CA and 1 in BC.Figure 1 shows the geographical location of network sites, which includes sites recruited by EWIDS post-assessment as well as preexisting sites. Over the past three influenza seasons (2009–2012) EWIDS recruited sites have constituted 47% of all network sites. Since the 2009–2010 influenza season 483,772 individuals have been screened for ILI by participating sites; of these, 65.8% (n=318,295) were screened by EWIDS recruited sites. Since the establishment of the network EWIDS has focused on sentinel site retention, logistical support, data collection, and dissemination of surveillance results. A weekly report summarizing syndromic and virologic activity is distributed to public health officials throughout the influenza season.

Conclusions

The network serves as an example of a successful binational coordinated effort to establish an early warning system for enhancing situational awareness of influenza activity in a cross-border setting. Next steps include conducting a formal evaluation of the existing surveillance system, enhancing specimen collection for virologic testing, and continuing to foster and build public/private partnerships.