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Dr. Sarah Chen
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Erika Austhof is an assistant research professor in Epidemiology at the University of Arizona Mel and Enid Zuckerman College of Public Health. Her research focuses on understanding how extreme weather and climate change influence the transmission dynamics of food-borne, water-borne, and enteric diseases. Prior to her current position, Dr. Austhof was an Epidemiologist with the college, coordinating public health research projects related to food-borne diseases and climate change and health. She holds a PhD in Epidemiology from the University of Arizona, earned in 2023, along with a Master of Public Health in Epidemiology and a Bachelor of Science in Microbiology from the same institution. Her work includes investigating the associations of precipitation events, drought, and animal operations on Salmonella and Campylobacter infections, as well as exploring the impact of weather variability on disease transmission. Dr. Austhof's research interests also encompass food-borne disease, climate change and health, and data science, contributing to the understanding of environmental factors affecting public health.
Risk of human exposure to wildfire is increasing, with detrimental effects on human health. Public health is uniquely placed to support community resilience during wildfire events, but the nature of public health's role remains unclear. Participants were recruited from government health entities in Southwestern counties that had previously experienced wildfires or significant smoke exposure. We used semi-structured interviews to understand perceptions and actions around wildfire response. To support public health practitioners' role in proactive and comprehensive wildfire outreach, evidence to support the interventions is summarized. In June 2024, 14 individuals from 12 organizations in Arizona and New Mexico were interviewed. Three themes emerged: (1) clear and consistent messaging, (2) connecting people to resources, and (3) flexibility supports capacity. There is evidence to support the need for clear and consistent messaging, but limited evidence on best practices for difficult to reach communities. More evidence is needed for which interventions work during a wildfire, adaptations for marginalized communities, and interventions when facing multiple hazards. Public health is shifting from passive education to proactive, comprehensive wildfire outreach. As part of a cross-sectoral response, public health is integral to disseminating consistent and clear messaging. Further, public health has an important role in facilitating access to resources, though there is a need for efficacy studies of what resources, under which circumstances, and for which populations. Finally, any successful response will require cooperation across sectors and community partners. Within the funding landscape for public health entities, flexibility in resource allocation is critical.
At-home blood collection kits have the potential to greatly increase the efficiency of blood collection for diagnostic or research purposes by reducing the cost and burden on participants, researchers, or physicians and eliminating the need for a phlebotomist, specialized equipment, and on-site processing. These kits have shown to be effective for studying specific blood metabolites and proteins, but for analyses targeting the entire proteome, their effectiveness is unknown. For this study, data on human serum proteome was compared when blood was capillary-collected with a Tasso+ device (Tasso Inc.) versus the gold-standard venous samples drawn by a trained phlebotomist. Analyses were conducted using the SomaScan 7K assay (SomaLogic Inc.), which assesses the levels of nearly 7,600 serum proteins. Additionally, duplicate Tasso+ blood samples were also subjected to a variety of pre-processing storage temperatures and times to mimic the effects of shipping samples from participants on the serum proteome compared to baseline samples. Minimal differences were seen between the serum proteome results of capillary and venous blood for all participants. Delays in processing of greater than 48 hours led to large changes in detected protein levels throughout the serum proteome, while lower holding temperatures (refrigeration at ≥4°C) pre-processing decreased the amount of change in the serum proteome. Overall, it was determined that when processed immediately, capillary blood gives similar results to venous blood, while minimizing the time (≤48 hrs) and temperature (≤4°C) can minimize the serum proteome changes in samples collected by at-home blood collection kits and detected by the 7K assay.
Ecotoxicology and Environmental Safety · 2025-08-01 · 2 citations
reviewOpen access1st authorCorresponding
The goal of this systematic review and meta-analysis is to understand cardiovascular health outcomes following wildfire and determine if fuel type clarifies variation in the association. The systematic review included English, peer-reviewed, primary data analysis studies that explored wildfire exposures with associated cardiovascular morbidity or mortality health outcomes published up to October 17, 2023 and identified through five databases (PROSPERO Protocol #CRD42024589994). We extracted article details, fire exposure metrics, cardiovascular health outcome metrics, study design, measures of association (risk ratio [RRs], incidence rate ratios [IRRs] and 95 % confidence intervals [CIs]), covariates, confounding factors, and stratified analyses from each article. Risk of bias was assessed using the Cochrane tool. Random effects meta-analyses, stratified by natural or structure/peat fuel types were conducted. Pooled estimates for all cardiovascular disease (pRR:1.04, 95 % CI: 1.01, 1.07), dysrhythmia (pRR:1.05, 95 % CI: 1.01, 1.09), and hypertensive disease (pRR:1.04, 95 % CI: 1.01, 1.07) were significantly associated with fire exposure. There were significant between group differences between wildfires with structure/peat sources compared to natural sources for all cardiovascular ED visits (RR structure/peat: 1.08, 95 % CI: 1.03, 1.12; RR natural: 1.03, 95 % CI: 1.00, 1.05) and dysrhythmia ED visits (RR structure/peat: 1.10, 95 % CI: 1.04, 1.09; RR natural: 1.02, 95 % CI: 0.98, 1.06). When exploring pooled estimates of risk for cardiovascular health, we find higher estimates and narrower CIs for structure/peat sources compared to natural wildfires with largely null estimates and wider CIs. Future detailed and consistent information about wildfire fuel types will help to inform better wildfire response.
INTRODUCTION: Postacute sequelae of SARS-CoV-2 infection (PASC) are extensive. Also known as long COVID, primary outcomes reported are neurologic, cardiac and respiratory in nature. However, several studies have also reported an increase in gastrointestinal (GI) symptoms and syndromes following COVID-19. This study of PASC will include extensive analyses of GI symptoms, determine if people with pre-existing irritable bowel syndrome (IBS) are at higher risk of developing PASC generally or PASC-GI, and which biomarkers are impacted and to what degree. This R01 study is being funded by the National Institute of Diabetes and Digestive and Kidney Diseases (1R01DK135483-01) from 2023 to 2028. METHODS AND ANALYSES: This study combines a longitudinal epidemiologic cohort study and in-depth, novel biologic analyses. In collaboration with a pre-existing study, the Arizona CoVID-19 Cohort (CoVHORT)-GI will recruit participants based on the history of COVID infection(s), new or ongoing GI symptoms 3-6 months postinfection, and pre-existing or incident IBS diagnosis to represent five study groups for comparison and analyses. A subset (n=1000) of those recruited will submit both stool and blood samples. Both samples will undergo a novel method to quantitate humoral and mucosal immune responses to host-derived faecal communities in conjunction with magnetic bead-based separation and high-depth shotgun microbial sequencing. Stool samples will also undergo traditional microbiome analyses (diversity and abundance) and faecal calprotectin assays. Additional serum analyses will aim to determine if a proteomics-based signature exists that differentiates a unique biomarker compositional signature discriminating PASC-GI versus no PASC. All laboratory data will be linked with in-depth epidemiologic data on demographics, symptoms and chronic conditions. ETHICS AND DISSEMINATION: This study involves human participants and was approved by the University of Arizona Institutional Review Board (IRB (#00002332) and has been deemed minimal risk. Participants gave informed consent to participate in the study before taking part. All publications from the study will be shared back to participants along with alternative lay summaries and webinars to communicate key findings. The data management plan has been published and is publicly available online, including protocols for data requests.
Foodborne Pathogens and Disease · 2025-10-10 · 1 citations
article
Introduction: Toxoplasma gondii ( T. gondii ) infections affect approximately 30% of the population worldwide. This systematic review of ocular sequelae from toxoplasmosis explores in greater depth the outcomes found in our previous scoping review. Uveitis and ocular lesions can be acute or recurrent following infection and result in long-term and often irreversible effects. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and used the Cochrane risk-of-bias tool to evaluate articles for inclusion. Data extraction included the frequency and proportion of participants who developed uveitis or chorioretinal lesions, the type, anatomical locations affected, and disease burden. Results: Utilizing an inclusion criterion that included a physical examination combined with laboratory confirmation, 63 articles from 27 countries spanning a publication period from 2000 to 2023 were included. Most reported outcomes in these articles included uveitis ( n = 61), chorioretinal lesions ( n = 42), or both ( n = 40). Meta analysis results indicate that the proportion of ocular toxoplasmosis (OT) cases resulting in lesions was lower than uveitis, with the highest estimates reported in Asia. Discussion: Uniform diagnostic methodology was only found in articles describing congenital case populations arising from toxoplasmosis monitoring programs. Consistent use of nomenclature, consistent diagnostic testing, and standardized reporting of patient demographics by researchers would greatly aid in understanding the burden of disease experienced.
Environmental Health Perspectives · 2024-09-01 · 4 citations
articleOpen access1st authorCorresponding
BACKGROUND: infections have been previously associated with precipitation and temperature, the association between precipitation and drought on campylobacteriosis has not been studied. OBJECTIVE: Using data from Arizona, Colorado, New Mexico, and counties in Utah, this ecological study aimed to assess the association between precipitation and the incidence of campylobacteriosis by county from 2009 to 2021 and to determine how this association is modified by prior drought level and animal operations. METHODS: We merged 38,782 cases of campylobacteriosis reported in 127 counties with total precipitation (in inches), temperature (in average degrees Fahrenheit), Palmer Drought Severity Index (PDSI, category), and animal census data (presence, density per square mile) by week from 2009 to 2021. Negative binomial generalized estimating equations adjusted for temperature with a 3-wk lag were used to explore the association between precipitation on campylobacteriosis with resulting incidence rate ratios (IRRs). Stratified analyses explored the association with precipitation following antecedent drought, presence of farm operations, and animal density. RESULTS: 0.89; 95% CI: 0.85, 0.94) for antecedent extreme drought. Compared to counties with no animal operations, counties with animal operations had significantly more cases following precipitation for every PDSI category except extreme drought. Counties with a higher density of beef cattle, goats for meat, chicken broilers, and chicken layers had significantly higher rates of campylobacteriosis following precipitation than those with no such operations, whereas those with dairy cattle and goats for milk, did not. DISCUSSION: . https://doi.org/10.1289/EHP14693.
Abstract Increasing extreme heat poses challenges to metropolitan areas, such as those areas already experiencing extreme heat in Arizona. Using the US Centers for Disease Control and Prevention (CDC)'s Building Resilience Against Climate Effects (BRACE) Framework, state and local health departments have looked to expand cooling center networks as one option to build heat resilience. We present a method to pick new locations for cooling centers based on demand and current coverage. Using two locations in Arizona, we highlight differences in workflows and how the resulting information can be incorporated into separate but parallel efforts to reduce heat impacts. We used the Network Analyst Location‐Allocation tool in ArcGIS Pro to maximize coverage of cooling centers in each area, so that additional cooling centers are selected to reflect local needs. The input data and parameters of the workflow were co‐produced with input from two county health departments and a cooling center working group to better address the unique challenges related to cooling center access. To facilitate the application of this approach to other regions seeking to address heat health inequities, we provide a detailed protocol and a discussion of alternative selections.
Temperature and precipitation have previously been associated with Salmonella infections. The association between salmonellosis and precipitation might be explained by antecedent drought conditions; however, few studies have explored this effect. Using an ecological study design with public health surveillance, meteorological (total precipitation [inches], temperature [average °F], Palmer Drought Severity Index [PDSI, category]), and livestock data we explored the association between precipitation and Salmonella infections reported in 127/141 counties from 2009 to 2021 in the Southwest, US and determined how this association was modified by antecedent drought. To explore the acute effect of precipitation on Salmonella infections we used negative binomial generalized estimating equations adjusted for temperature with a 2-week lag resulting in Incidence Rate Ratios (IRR). Stratified analyses were used to explore the effect of antecedent drought and type of animal density on this association. A one inch increase in precipitation was associated with a 2 % increase in Salmonella infections reported two weeks later (IRR: 1.02, 95 % CI: 1.00, 1.04) after adjusting for average temperature and PDSI. Precipitation following moderate (IRR: 1.22, 95 % CI: 1.17, 1.28) and severe drought (IRR: 1.16, 95 % CI: 1.10, 1.22) was associated with a significant increase in cases, whereas in the most extreme drought conditions, cases were significantly decreased (IRR: 0.89, 95 % CI: 0.85, 0.94). Overall, more precipitation (above a 30-year normal, the 95th and 99th percentiles) were associated with greater increases in cases, with the highest increase following moderate and severe drought. Counties with a higher density of chicken and beef cattle were significantly associated with increased cases regardless of drought status, whereas dairy cattle, and cattle including calves had mixed results. Our study suggests precipitation following prior dry conditions is associated with an increase in salmonellosis in the Southwest, US. Public health is likely to see an increase in salmonellosis with extreme precipitation events, especially in counties with a high density of chicken and beef cattle. • Novel contribution exploring human, animal, and weather associations. • Precipitation was associated with increased risk of salmonellosis. • Precipitation following drought associated with highest risk of salmonellosis. • Counties with higher density of livestock associated with increased risk.
Archives of Clinical Infectious Diseases · 2024-06-16
reviewOpen access
: Vibriosis, non-cholera infection by marine bacteria of the genus Vibrio, is a relatively uncommon infection associated with high morbidity and mortality relative to other bacterial food and waterborne pathogens. The range and impact of these common marine organisms is likely to increase as global water temperatures rise in association with global warming. We have conducted a scoping review of available literature (2000 - 2020), including individual case studies, in order to provide the most current overview of reported sequelae and complications of this disease, including amputation, necrotizing fasciitis, organ failure, respiratory complications, and uncommon serious outcomes. Notably, we have found the available data indicate that route of exposure (contact with water, ingestion) may not be as reliably associated with disease presentation (soft tissue infection, gastroenteritis, sepsis) as has commonly been proposed. This information can be used to inform more accurate burden estimates for this disease, which have, to date, not included severe tissue sequelae including amputation as an outcome associated with foodborne exposure to non-cholera Vibrio. We have also identified knowledge gaps and priority research areas that may provide data allowing further refinement of cost and burden models.
