title: A spatial model of shared risk for plague and hantavirus pulmonary syndrome in the southwestern United States.
abstract: Plague and hantavirus pulmonary syndrome (HPS) are severe, often fatal diseases in humans that share a broad epidemiologic focus in the southwestern United States. Prevention of these diseases relies heavily on education and reducing rodent abundance in peridomestic environments. Resources for these activities are limited. Therefore, identifying areas sharing elevated risk for these two relatively rare but severe diseases could be useful for targeting limited public health resources. Using logistic regression and geographic information system-based modeling, we identified environmental predictors of elevated risk for plague (distance to piñon-juniper ecotones and amount of precipitation) and HPS (elevation and amount of precipitation) in northeastern Arizona and northwestern New Mexico. Our models accurately identified case locations as suitable (producer accuracies of 93% for plague and 96% for HPS) and indicated that approximately half of the coverage area was classified as suitable risk for either plague or HPS. The probability of a site being classified as suitable for plague was strongly correlated with its probability of being classified as suitable for HPS (rhos = 0.88). Increased risk for both diseases occurred for approximately 37% of the coverage area.
authors.affiliation: Division of Vector-Borne Infectious Diseases, National Center for Vector-Borne, Zoonotic and Enteric Diseases, Centers for Disease Control and Prevention, Fort Collins, CO 80522, USA. dyn2@cdc.gov
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Eisen
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Glass
authors.forename: Lars
authors.initials: L
authors.lastname: Eisen
authors.forename: James
authors.initials: J
authors.lastname: Cheek
authors.forename: Russell E
authors.initials: RE
authors.lastname: Enscore
authors.forename: Paul
authors.initials: P
authors.lastname: Ettestad
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Gage
mesh_terms: D000818:Animals; D001130:Arizona / Q000453:epidemiology; D004777:Environment; D040362:Geographic Information Systems; D005843:Geography; D018804:Hantavirus Pulmonary Syndrome / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D006801:Humans; D007198:Indians, North American; D016015:Logistic Models; D008954:Models, Biological; D009516:New Mexico / Q000453:epidemiology; D010930:Plague / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D011634:Public Health / Q000379:methods*; D018570:Risk Assessment; D012307:Risk Factors; D012376:Rodent Diseases / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D015047:Zoonoses / Q000453:epidemiology