About

Sarah Rhea is the Director of Student Engagement at the College of Veterinary Medicine at NC State University. Her role involves fostering a lively campus community that enriches students' academic, personal, and professional growth. She is dedicated to creating a welcoming, collaborative environment where students can study, socialize, and develop lifelong friendships, while engaging in extracurricular activities, research projects, and study abroad opportunities. Her focus is on supporting student achievement and well-being, ensuring they are well-prepared to become future leaders in veterinary medicine.

Research topics

• Data Mining
• Medicine
• Computer Science
• Computer Security
• Artificial Intelligence
• Machine Learning
• Nursing
• Virology
• Engineering
• Statistics
• Econometrics
• Mathematics
• Family medicine

Selected publications

• Wild Freshwater Turtles as Bioindicators of Antimicrobial Resistance: An Exploratory Cross-sectional Study in Wake County, North Carolina

  Journal of Herpetological Medicine and Surgery · 2026-03-18

  articleSenior author

  Abstract Wildlife can harbor and facilitate the spread of antimicrobial resistance (AMR) genes and antimicrobial resistant bacteria, including bacteria of public health concern (e.g., carbapenem-resistant Enterobacterales). However, the occurrence of and factors influencing AMR in wildlife are not well-understood. With their relatively long life spans and limited migration from human-impacted habitats, wild freshwater turtles could serve as bioindicators, or sentinels, of environmental AMR. During May-June 2024, we collected cloacal swabs and morphologic data from wild freshwater turtles across eight wetland locations in Wake County, North Carolina, USA, to explore their potential use as bioindicators of local environmental AMR. Among the 100 turtles (46 females, 44 males, 10 juveniles) humanely captured and released, six freshwater turtle species were represented, including 39 painted turtles ( Chrysemys picta ) and 24 yellow-bellied sliders ( Trachemys scripta scripta ). The median number of turtles captured per site was 11 (interquartile range: 7–18). Each cloacal sample was plated on MacConkey agar. Three morphologically distinct lactose-fermenting colonies per turtle were replated for purity. Among the 260 isolates identified to - and unique per turtle at - the genus-level, 14 genera were represented, mainly Citrobacter (n = 73; 28%), Enterobacter (n = 61; 23%), and Klebsiella (n = 36; 14%). A subset of 102 Enterobacterales isolates, namely Enterobacter , Escherichia , and Klebsiella spp., underwent antimicrobial susceptibility testing using microbroth dilution; of these, four Enterobacter spp. isolates demonstrated phenotypic resistance. Specifically, three Enterobacter spp. isolates, obtained from unique turtles captured at a single wetland location, exhibited resistance to an aminoglycoside and two folate pathway inhibitors; one resistant Enterobacter spp. isolate, obtained from a different wetland location, was multidrug resistant. Routine surveillance of freshwater turtles could further inform their potential use as bioindicators of environmental AMR and provide insight into environmental dynamics of AMR spread in aquatic and surrounding ecosystems.

  PublisherDOI

• Veterinary prescription and owner use of topical aural products and antimicrobials for Golden Retriever Lifetime Study participants with otitis externa in the US (2012–2023)

  Journal of the American Veterinary Medical Association · 2025-08-21

  articleSenior author

  Objective: To describe topical aural products and antimicrobials prescribed or administered to Golden Retriever Lifetime Study (GRLS) participants with otitis externa (OE) and to characterize OE in this population. Methods: GRLS participants with ≥ 1 veterinarian-determined OE diagnosis during years 1 to 8 of enrollment (n = 1,755) were included. Reports of veterinary-prescribed or owner-administered topical aural products were identified in GLRS records by study year, classified (eg, prescription, nonprescription, antibiotic, antifungal), tallied, and stratified by presence of an OE diagnosis. Incidence rates (IRs) of first OE diagnosis were calculated. Results: Among included participants, 57% (n = 1,006) had OE in > 1 study year. The IR of first OE (per 100 dog-years [95% CI]) was greater for dogs 0 to 4 years of age (IR, 58.9 [56.3 to 61.4]) than dogs > 4 years of age (IR, 19.0 [15.0 to 23.0]). We identified 4,960 topical aural product reports (83% [n = 4,138] nonprescription; 17% [822] prescription). Combined antibiotic/antifungal products represented 72% (n = 590) of prescriptions; aminoglycosides and clotrimazole were the most common antibiotic and antifungal ingredients, respectively. Of all prescriptions, 47% (n = 388) were reported in a year with no OE diagnosis. Most study years (93% [3,617 of 3,888]) with nonprescription products reported had no reported prescription products. Among study years with prescription products reported, 57% (360 of 631) had no reported nonprescription products. Conclusions: Nonprescription product reports were 5 times greater than reports of prescription products used for OE. Nearly half of all prescription products were used in years without an OE diagnosis. Clinical Relevance: Results highlight the importance of educating owners on responsible antimicrobial use and obtaining a complete history of topical aural product use when managing canine OE.

  PublisherDOI

• A qualitative study exploring concepts and attitudes of guinea pig producers in rural parishes of Pichincha, Ecuador: The need for a one health-one welfare approach to enhance production practices

  One Health · 2025-11-17 · 1 citations

  articleOpen accessSenior authorCorresponding

  ) is a sustainable and high-quality protein option for people in resource restrictive areas of South America's Andean region. Each year in Ecuador, 47 million guinea pigs, destined for sale or household consumption, are produced. Despite the reported presence and anticipated growth of guinea pig production in the region, husbandry standards in this industry have not been fully documented. A qualitative study was conducted to explore the thoughts, attitudes, and practices of guinea pig producers in three rural parishes of Pichincha, Ecuador regarding guinea pig production, health, and welfare. During October-December 2024, a focus group was held in each parish with discussion including the basic principles of animal production and husbandry (i.e., breeding, feeding, treatment, preventative activities, euthanasia). Focus group transcripts underwent thematic analysis. Inductive codes were identified via an iterative open coding process with two independent coders, until a unifying theme was identified. Nineteen guinea pig producers participated across the three focus groups. A One Health approach was identified as the primary domain under which the identified themes fell. The main unifying theme mapped back to the concepts of traditional and modern medicine. The rural Ecuadorian guinea pig producers included in this study implement a combination of traditional and modern medicine and production practices to ensure the humane production of this species. When developing and implementing future studies and educational programs, researchers, veterinarians, and agricultural educators should consider blending these two strategies to ensure the industry can improve in a One Health-One Welfare way.

  PublisherDOI

• Geospatial forecasting of COVID-19 spread and risk of reaching hospital capacity

  Carolina Digital Repository (University of North Carolina at Chapel Hill) · 2024-08-30

  articleOpen accessSenior author

  Prompt surveillance and forecasting of COVID-19 spread are of critical importance for slowing down the pandemic and for the success of any public mitigation efforts. However, as with any infectious disease with rapid transmission and high virulence, lack of COVID-19 observations for near-real-time forecasting is still the key challenge obstructing operational disease prediction and control. In this context, we can follow the two approaches to forecasting COVID-19 dynamics: based on mechanistic models and based on machine learning. Mechanistic models are better in capturing an epidemiological curve, using a low amount of data, and describing the overall trajectory of the disease dynamics, hence, providing long-term insights into where the disease might go. Machine learning, in turn, can provide more precise data-driven forecasts especially in the short-term horizons, while suffering from limited interpretability and usually requiring backlog history on the infectious disease. We propose a unified reinforcement learning framework that combines the two approaches. That is, long-term trajectory forecasts are used in machine learning techniques to forecast local variability which is not captured by the mechanistic model.

  PublisherOA PDFDOI

• Subclinical bacteriuria is nonprogressive but persistent in dogs four years of age or older recruited from a small animal primary care setting

  Journal of the American Veterinary Medical Association · 2024-09-25 · 1 citations

  article

  OBJECTIVE: To evaluate clinical and microbial outcomes in dogs with untreated subclinical bacteriuria (SB) through longitudinal follow-up. METHODS: Between February 24, 2022, and July 7, 2023, healthy client-owned dogs ≥ 4 years old with no evidence of lower urinary tract signs (LUTS) were recruited for a longitudinal, prospective study. Phase 1 dogs with SB were followed for 28 days to document comorbidities and microbiological findings (ie, urinalysis, urine culture, and fimH gene in Escherichia coli isolates). Phase 1 participants enrolled in phase 2 were followed for at least an additional 120 days. RESULTS: The prevalence of SB was 11% (11 of 99), and all were female spayed. Of those with SB, 6 (55%) were followed for a median of 238 days; 91% (10 of 11) of phase 1 dogs and 67% (4 of 6) of phase 2 dogs had persistent bacteriuria, and 1 developed pyelonephritis 299 days after enrollment. Most dogs had E coli (8 of 11 [73%]), all of which contained the fimH gene. No change in antimicrobial susceptibility was noted during follow-up. CONCLUSIONS: SB is generally nonprogressive and can persist for months after diagnosis. Patients with SB were more likely to be female, but no difference related to age, weight, or life stage was found. The presence of fimH, previously associated with biofilm, was negatively correlated with antimicrobial resistance. CLINICAL RELEVANCE: For dogs with SB that are otherwise healthy, avoidance of systemic antimicrobials is warranted. For dogs with additional comorbidities, which might not be accompanied by, for example, pyelonephritis, or preclude the demonstration of LUTS, veterinarians should review the medical history and consider additional diagnostic testing.

  PublisherDOI

• Correction: Epidemiologic and clinical features of cyanobacteria harmful algal bloom exposures reported to the National Poison Data System, United States, 2010–2022: a descriptive analysis

  Environmental Health · 2024-12-16

  erratumOpen accessSenior author
  PublisherOA PDFDOI

• Geographic Variability, Seasonality, and Increase in ASPCA Animal Poison Control Center Harmful Blue-green Algae Calls 2010-2022

  Open MIND · 2024-01-01

  datasetOpen accessSenior author

  USEPA collaborated on a project conducted by scientists at the North Carolina State College of Veterinary Medicine. Scientist used data to summarize: ASPCA Animal Poison Control Center Harmful Blue-green Algae Calls - United States and Canada during 2010 - 2022. This analysis resulted in the report: Geographic Variability, Seasonality, and Increase in ASPCA Animal Poison Control Center Harmful Blue-green Algae Calls - United States and Canada, 2010 - 2022. Data characteristics include: day of animal poisoning report; state of call origination; and species. Key words include: blue-green algae; poisoning; animal. Data are owned by the American Society for the Prevention of Cruelty to Animals Poison Control Center. Data are available from Nicole Martin at: Nicole.Martin@aspca.org

  Publisher

• Epidemiologic and clinical features of cyanobacteria harmful algal bloom exposures reported to the National Poison Data System, United States, 2010–2022: a descriptive analysis

  Environmental Health · 2024-10-05 · 4 citations

  articleOpen accessSenior author

  BACKGROUND: Harmful algal bloom occurrences have been increasingly reported globally and over time. Exposure to the variety of toxins and co-contaminants that may be present in harmful algal blooms can cause illness and even death. Poison control data is a valuable public health information source that has been used to characterize many types of toxin exposures, including harmful algal blooms. Prior studies have been limited by location and time, and knowledge gaps remain regarding cyanobacteria harmful algal bloom (cyanoHAB) exposure circumstances, and the breadth and severity of associated clinical effect. METHODS: The objective of this study was to characterize epidemiologic and clinical features of cyanoHAB exposure cases reported to 55 US poison control centers and available in the National Poison Data System (NPDS). We identified 4260 NPDS cyanoHAB exposure cases reported from 2010 to 2022, including symptomatic exposure cases with and without clinical effects related to the exposure and asymptomatic exposure cases. We assessed demographics; exposure routes, locations, chronicity; clinical effects; and medical outcomes. We calculated case rates annually and 13-year case rates by US geographic division. RESULTS: Over half of cyanoHAB exposure cases were children < 20 years old (n = 2175). Most cyanoHABs exposures occurred in a "public area" (n = 2902, 68.1%); most were acute (≤ 8 h) (n = 3824, 89.8%). Dermal and ingestion routes and gastrointestinal effects predominated. 2% (n = 102) of cases experienced a moderate or major medical outcome; no deaths were reported. National rates increased from 0.4 cases/1 million (1 M) person-years in 2010 to 1.4 cases/1 M person-years in 2022. The Mountain division had the highest 13-year rate (7.8 cases/1 M person-years). CONCLUSIONS: CyanoHAB exposure case rates increased 2010-2022, despite a decrease in all-cause exposure cases during the same period. NPDS data provide valuable public health information for characterization of cyanoHAB exposures, an emerging public health challenge.

  PublisherOA PDFDOI

• Assessing the impact of the early COVID-19 era on antibiotic-resistant threats in inpatient settings: A mixed Poisson regression approach

  American Journal of Infection Control · 2023-04-19 · 1 citations

  articleOpen accessSenior authorCorresponding
  PublisherOA PDFDOI

• Geographic Variability, Seasonality, and Increase in ASPCA Animal Poison Control Center Harmful Blue-Green Algae Calls—United States and Canada, 2010–2022

  Toxins · 2023-08-15 · 4 citations

  articleOpen accessSenior authorCorresponding

  Harmful cyanobacteria (blue-green algae) exposures can cause illness or death in humans and animals. We characterized American Society for the Prevention of Cruelty to Animals (ASPCA) Animal Poison Control Center (APCC) harmful blue-green algae (HBGA) call data, compared it to a measure of harmful algal bloom public awareness, and considered its suitability as a public health information source. ASPCA APCC dog and cat “HBGA exposure” calls made 1 January 2010–31 December 2022 were included. We calculated annual HBGA call percentages and described calls (species, month, origin, exposure route). We characterized public awareness by quantifying Nexis Uni® (LexisNexis Academic; New York, NY, USA)-indexed news publications (2010–2022) pertaining to “harmful algal bloom(s)”. Call percentage increased annually, from 0.005% (2010) to 0.070% (2022). Of 999 HBGA calls, 99.4% (n = 993) were dog exposures. Over 65% (n = 655) of calls were made July–September, largely from the New England (n = 154 (15.4%)) and Pacific (n = 129 (12.9.%)) geographic divisions. Oral and dermal exposures predominated (n = 956 (95.7%)). Harmful algal bloom news publications increased overall, peaking in 2019 (n = 1834). Higher call volumes in summer and in the New England and Pacific geographic divisions drove HBGA call increases; public awareness might have contributed. Dogs and humans have similar exposure routes. ASPCA APCC HBGA call data could serve as a public health information source.

  PublisherOA PDFDOI

Frequent coauthors

• Kasey Jones

  Communities In Schools of Orange County

  51 shared

• Jennifer MacFarquhar

  41 shared

• Marie C. D. Stoner

  RTI International

  40 shared

• Emily Hadley

  38 shared

• Alexander Preiss

  RTI International

  34 shared

• Lauren DiBiase

  Lindsay Unified School District

  31 shared

• Emily Sickbert-Bennett

  Oregon Medical Research Center

  31 shared

• David J. Weber

  University of North Carolina at Chapel Hill

  28 shared

Education

• BS - Biology, Science

  Purdue University West Lafayette

• DVM

  Purdue University

• MPH

  University of North Carolina at Chapel Hill

• PhD

  University of North Carolina at Chapel Hill

Awards & honors

• Preventive Medicine Resident/Fellow, CDC, 2015-2016
• Epidemic Intelligence Service Officer, CDC, 2013-2015