Background:Most seasonally circulating enteroviruses result in asymptomatic or mildly symptomatic infections. In rare cases, however, infection with some subtypes can result in paralysis or death. Of the 300 subtypes known, only poliovirus is reportable, limiting our understanding of the distribution of other enteroviruses that can cause clinical disease.Objective:The overarching objectives of this study were to: 1) describe the distribution of enteroviruses in Arizona during the late summer and fall of 2022, the time of year when they are thought to be most abundant, and 2) demonstrate the utility of viral pan-assay approaches for semi-agnostic discovery that can be followed up by more targeted assays and phylogenomics.Methods:This study utilizes pooled nasal samples collected from school-aged children and long-term care facility residents, and wastewater from multiple locations in Arizona during July-October of 2022. We used PCR to amplify and sequence a region common to all enteroviruses, followed by species-level bioinformatic characterization using the QIIME 2 platform. For Enterovirus-D68 (EV-D68), detection was carried out using RT-qPCR, followed by confirmation using near-complete whole EV-D68 genome sequencing using a newly designed tiled amplicon approach.Results:In the late summer and early fall of 2022, multiple enterovirus species were identified in Arizona wastewater, with Coxsackievirus A6, EV-D68, and Coxsackievirus A19 composing 86% of the characterized reads sequenced. While EV-D68 was not identified in pooled human nasal samples, and the only reported acute flaccid myelitis case in Arizona did not test positive for the virus, an in-depth analysis of EV-D68 in wastewater revealed that the virus was circulating from August through mid-October. A phylogenetic analysis on this relatively limited dataset revealed just a few importations into the state, with a single clade indicating local circulation.Significance:This study further supports the utility of wastewater-based epidemiology to identify potential public health threats. Our further investigations into EV-D68 shows how these data might help inform healthcare diagnoses for children presenting with concerning neurological symptoms.

The Sub-Regional Operating Group (SROG), that is comprised of Glendale, Mesa, Phoenix, Scottsdale, and Tempe, is responsible for implementing and operating industrial wastewater control programs in those communities. SROG is considering the use of best management practices (BMPs) as an alternative to local limit for fluoride. The goals of the Valley-wide BMPs include reducing the industrial and other users' loadings, eliminating/minimizing violations at the wastewater treatment plants (WWTPs), and maintaining (or reducing) current influent loadings while allowing for industrial growth. The following survey includes questions regarding materials and product usage, type of operation, current pretreatment, etc., at industries that discharge fluoride to the collection system. The survey results will be used to provide SROG with more specific information on industrial discharges of fluoride-containing wastewater. We also apologize for the short time frame in which to complete this survey. SROG and the City of Tempe will appreciate your cooperation in providing this important information. Please contact either your assigned Investigators and/or the Pretreatment Section Supervisor if you have any questions or need assistance with completing the survey. The contact telephone numbers are: