Addressing gaps in surveillance: Use of emergency department accessibility and social vulnerability to identify potential wastewater surveillance sites in North Carolina

Neha Shanker; Stacie Reckling; Nicole L. Snyder; Dianne Enright; Virginia T. Guidry; Ariel Christensen

doi:10.1371/journal.pone.0346668

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Open Access

Peer-reviewed

Research Article

Addressing gaps in surveillance: Use of emergency department accessibility and social vulnerability to identify potential wastewater surveillance sites in North Carolina

Neha Shanker ,

Contributed equally to this work with: Neha Shanker, Stacie Reckling

Roles Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Validation, Visualization, Writing – original draft, Writing – review & editing

Affiliation North Carolina Department of Health and Human Services, Division of Public Health, Raleigh, North Carolina, United States of America

https://orcid.org/0009-0008-6935-5199

⨯
Stacie Reckling ,

Contributed equally to this work with: Neha Shanker, Stacie Reckling

Roles Data curation, Formal analysis, Investigation, Methodology, Resources, Validation, Visualization, Writing – original draft, Writing – review & editing

Affiliation Center for Geospatial Analytics, North Carolina State University, Raleigh, North Carolina, United States of America
⨯
Nicole L. Snyder ,

Roles Data curation, Formal analysis, Investigation, Methodology, Resources, Validation, Visualization, Writing – original draft, Writing – review & editing

* E-mail: nicole.snyder@dhhs.nc.gov

Affiliation North Carolina Department of Health and Human Services, Division of Public Health, Raleigh, North Carolina, United States of America

https://orcid.org/0000-0002-2508-4090

⨯
Dianne Enright,

Roles Data curation, Formal analysis, Writing – original draft, Writing – review & editing

Affiliation North Carolina Department of Health and Human Services, Division of Public Health, Raleigh, North Carolina, United States of America
⨯
Virginia T. Guidry,

Roles Funding acquisition, Writing – review & editing

Affiliation North Carolina Department of Health and Human Services, Division of Public Health, Raleigh, North Carolina, United States of America
⨯
Ariel Christensen

Roles Conceptualization, Funding acquisition, Writing – review & editing

Affiliation North Carolina Department of Health and Human Services, Division of Public Health, Raleigh, North Carolina, United States of America
⨯

Addressing gaps in surveillance: Use of emergency department accessibility and social vulnerability to identify potential wastewater surveillance sites in North Carolina

Neha Shanker,
Stacie Reckling,
Nicole L. Snyder,
Dianne Enright,
Virginia T. Guidry,
Ariel Christensen

Published: August 17, 2026
https://doi.org/10.1371/journal.pone.0346668

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