Spatio-temporal patterns in county-level incidence and reporting of Lyme disease in the northeastern United States, 1990-2000

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 pla...

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Bibliographic Details
Published in:Environmental and ecological statistics 2007-03, Vol.14 (1), p.83-100
Main Authors: Waller, Lance A, Goodwin, Brett J, Wilson, Mark L, Ostfeld, Richard S, Marshall, Stacie L, Hayes, Edward B
Format: Article
Language:English
Subjects:
Conceptual context
Environmental risk
Health risks
Hierarchical linear model
Local precision
Local risk
Lyme disease
Risk map
Vector-borne diseases
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Summary: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.
ISSN:1352-8505
1573-3009
DOI:10.1007/s10651-006-0002-z