Spatio-temporal patterns in county-level incidence and reporting of Lyme disease in the northeastern United States, 1990–2000 |
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| Authors: | Lance A Waller Brett J Goodwin Mark L Wilson Richard S Ostfeld Stacie L Marshall Edward B Hayes |
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| Institution: | (1) Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA;(2) Department of Biology, University of North Dakota, Grand Forks, ND 58202, USA;(3) Departments of Biology and Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA;(4) Institute of Ecosystem Studies, Millbrook, NY 12545, USA;(5) US Centers for Disease Control and Prevention, Emory University, Atlanta, GA 30322, USA;(6) US Centers for Disease Control and Prevention, Colorado State University, Fort Collins, CO 80523, USA |
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| Abstract: | We present an exploratory analysis of reported county-specific incidence of Lyme disease in the northeastern United States
for the years 1990–2000. We briefly review the disease ecology of Lyme disease and the use of risk maps to describe local
incidence as estimates of local risk of disease. We place the relevant elements of local environmental and ecological variables,
local disease incidence, and (importantly) local disease reporting in a conceptual context to frame our analysis. We then
apply hierarchical linear models of increasing complexity to summarize observed patterns in reported incidence, borrowing
information across counties to improve local precision. We find areas of increasing incidence in the central northeastern
Atlantic coast counties, increasing incidence branching to the north and west, and an area of fairly stable and slightly decreasing
reported incidence in western New York. |
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| Keywords: | Hierarchical linear model Risk map Local risk Conceptual context Local precision |
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