title: Human plague in the southwestern United States, 1957-2004: spatial models of elevated risk of human exposure to Yersinia pestis.
abstract: Plague is a rare but highly virulent flea-borne zoonotic disease caused by the Gram-negative bacterium Yersinia pestis Yersin. Identifying areas at high risk of human exposure to the etiological agent of plague could provide a useful tool for targeting limited public health resources and reduce the likelihood of misdiagnosis by raising awareness of the disease. We created logistic regression models to identify landscape features associated with areas where humans have acquired plague from 1957 to 2004 in the four-corners region of the United States (Arizona, Colorado, New Mexico, and Utah), and we extrapolated those models within a geographical information system to predict where plague cases are likely to occur within the southwestern United States disease focus. The probability of an area being classified as high-risk plague habitat increased with elevation up to approximately 2300 m and declined as elevation increased thereafter, and declined with distance from key habitat types (e.g., southern Rocky Mountain piñon--juniper [Pinus edulis Engelm. and Juniperus spp.], Colorado plateau piñon--juniper woodland, Rocky Mountain ponderosa pine (Pinus ponderosa P.& C. Lawson var. scopulorum), and southern Rocky Mountain juniper woodland and savanna). The overall accuracy of the model was >82%. Our most conservative model predicted that 14.4% of the four-corners region represented a high risk of peridomestic exposure to Y. pestis.
authors.affiliation: Division of Vector-Borne Infectious Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, P.O. Box 2087, Fort Collins, CO 80522, USA. dyn2@cdc.gov
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Eisen
authors.forename: Russell E
authors.initials: RE
authors.lastname: Enscore
authors.forename: Brad J
authors.initials: BJ
authors.lastname: Biggerstaff
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Reynolds
authors.forename: Paul
authors.initials: P
authors.lastname: Ettestad
authors.forename: Ted
authors.initials: T
authors.lastname: Brown
authors.forename: John
authors.initials: J
authors.lastname: Pape
authors.forename: Dale
authors.initials: D
authors.lastname: Tanda
authors.forename: Craig E
authors.initials: CE
authors.lastname: Levy
authors.forename: David M
authors.initials: DM
authors.lastname: Engelthaler
authors.forename: James
authors.initials: J
authors.lastname: Cheek
authors.forename: Rudy
authors.initials: R
authors.lastname: Bueno
authors.forename: Joseph
authors.initials: J
authors.lastname: Targhetta
authors.forename: John A
authors.initials: JA
authors.lastname: Montenieri
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Gage
mesh_terms: D000818:Animals; D017753:Ecosystem; D005843:Geography; D006801:Humans; D015233:Models, Statistical; D010930:Plague / Q000453:epidemiology*; D012307:Risk Factors; D012377:Rodentia / Q000382:microbiology; D005423:Siphonaptera / Q000382:microbiology; D015206:Southwestern United States / Q000453:epidemiology; D015010:Yersinia pestis / Q000502:physiology*