Human risk of infection with Borrelia burgdorferi, the Lyme disease agent, in eastern United States.
The geographic pattern of human risk for infection with Borrelia burgdorferi sensu stricto, the tick-borne pathogen that causes Lyme disease, was mapped for the eastern United States. The map is based on standardized field sampling in 304 sites of the density of Ixodes scapularis host-seeking nymphs infected with B. burgdorferi, which is closely associated with human infection risk. Risk factors for the presence and density of infected nymphs were used to model a continuous 8 km×8 km resolution predictive surface of human risk, including confidence intervals for each pixel. Discontinuous Lyme disease risk foci were identified in the Northeast and upper Midwest, with a transitional zone including sites with uninfected I. scapularis populations. Given frequent under- and over-diagnoses of Lyme disease, this map could act as a tool to guide surveillance, control, and prevention efforts and act as a baseline for studies tracking the spread of infection.
Yale School of Public Health, New Haven, Connecticut, USA. maria.diuk@yale.edu
Maria A
MA
Diuk-Wasser
Anne Gatewood
AG
Hoen
Paul
P
Cislo
Robert
R
Brinkerhoff
Sarah A
SA
Hamer
Michelle
M
Rowland
Roberto
R
Cortinas
Gwenaël
G
Vourc'h
Forrest
F
Melton
Graham J
GJ
Hickling
Jean I
JI
Tsao
Jonas
J
Bunikis
Alan G
AG
Barbour
Uriel
U
Kitron
Joseph
J
Piesman
Durland
D
Fish
D000818:Animals; D025065:Borrelia burgdorferi / Q000302:isolation & purification / Q000472:pathogenicity*; D019353:Endemic Diseases; D006801:Humans; D018884:Ixodes / Q000254:growth & development / Q000382:microbiology; D016015:Logistic Models; D008193:Lyme Disease / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission*; D009758:Nymph / Q000254:growth & development; D015995:Prevalence; D012307:Risk Factors; D013984:Tick Infestations / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D014481:United States / Q000453:epidemiology