Human Risk of Infection with Borrelia burgdorferi, the Lyme Disease Agent, in Eastern United States

Authors

Maria A. Diuk-Wasser, Yale UniversityFollow
Anne Gatewood Hoen, Dartmouth Medical SchoolFollow
Paul Cislo, Yale University
Robert Brinkerhoff, University of RichmondFollow
Sarah A. Hamer, Michigan State UniversityFollow
Michelle Rowland, Magee Women's Hospital of UPMC
Roberto Cortinas, University of Nebraska-LincolnFollow
Gwenaël Vourc’h, Institut National de la Recherche Agronomique, Saint Genès ChampanelleFollow
Forrest S. Melton, California State University, Monterey BayFollow
Graham J. Hickling, University of TennesseeFollow
Jean I. Tsao, Michigan State UniversityFollow
Jonas Bunikis, University of California, IrvineFollow
Alan G. Barbour, University of California, IrvineFollow
Uriel Kitron, Emory UniversityFollow
Joseph Piesman, Centers for Disease Control and Prevention, Fort CollinsFollow
Durland Fish, Yale UniversityFollow

Document Type

Article

Date of this Version

2012

Citation

American Journal of Tropical Medicine and Hygiene 86:2 (2012), pp. 320–327.

doi:10.4269/ajtmh.2012.11-0395

Comments

This document is a US government work and is not subject to copyright in the United States.

Abstract

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.