@article{c7ab84cc8fc14ee59439fa01a20df391,
title = "Geographic expansion of lyme disease in the Southeastern United States, 2000-2014",
abstract = "Background. The majority of Lyme disease cases in the United States are acquired on the east coast between northern Virginia and New England. In recent years the geographic extent of Lyme disease has been expanding, raising the prospect of Lyme disease becoming endemic in the southeast. Methods. We collected confirmed and probable cases of Lyme disease from 2000 through 2014 from the Virginia Department of Health and North Carolina Department of Public Health and entered them in a geographic information system. We performed spatial and spatiotemporal cluster analyses to characterize Lyme disease expansion. Results. There was a marked increase in Lyme disease cases in Virginia, particularly from 2007 onwards. Northern Virginia experienced intensification and geographic expansion of Lyme disease cases. The most notable area of expansion was to the southwest along the Appalachian Mountains with development of a new disease cluster in the southern Virginia mountain region. Conclusions. The geographic distribution of Lyme disease cases significantly expanded in Virginia between 2000 and 2014, particularly southward in the Virginia mountain ranges. If these trends continue, North Carolina can expect autochthonous Lyme disease transmission in its mountain region in the coming years.",
keywords = "Epidemiology, GIS, Lyme disease, North Carolina, Virginia",
author = "Lantos, {Paul M.} and Nigrovic, {Lise E.} and Auwaerter, {Paul G.} and G. Fowler and Felicia Ruffin and Brinkerhoff, {R. Jory} and Jodi Reber and Carl Williams and James Broyhill and Pan, {William K.} and Gaines, {David N.}",
note = "Funding Information: Financial support. P. M. L. was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number KL2 TR001115. P. G. A. was supported by the Ken and Sher-rilyn Fisher Center for Environmental Infectious Diseases. V. G. F. and F. R. were supported by the National Institute for Allergy and Infectious Diseases of the National Institutes of Health under award number K24 AI093969. L. E. N. was supported by a Boston Children{\textquoteright}s Hospital Pilot research grant. R. J. B. was supported by the Thomas F. and Kate Miller Jeffress Memorial Trust. W. K. P. was supported by the InterAmerican Institute for Global Change Research, CRN 3036. P. G. A. has served as an expert witness in malpractice cases related to Lyme disease. V. G. F. served as Chair of V710 Scientific Advisory Committee (Merck), has received grant support or has grants pending from Cerexa, Pfizer, Advanced Liquid Logic, MedImmune, and Cubist, has been a paid consultant for Merck, Astellas, Affinium, Theravance, Cubist, Cerexa, Debiopharm, Durata, Pfizer, NovaDigm, Novartis, Medicines Company, Biosynexus, MedImmune, and Inimex, Bayer, and has received honoraria from Merck, Astellas, Cubist, Pfizer, Theravance, and Novartis. Funding Information: P. M. L. was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number KL2 TR001115. P. G. A. was supported by the Ken and Sherrilyn Fisher Center for Environmental Infectious Diseases. V. G. F. and F. R. were supported by the National Institute for Allergy and Infectious Diseases of the National Institutes of Health under award number K24 AI093969. L. E. N. was supported by a Boston Children's Hospital Pilot research grant. R. J. B. was supported by the Thomas F. and KateMiller JeffressMemorial Trust. W. K. P. was supported by the InterAmerican Institute for Global Change Research, CRN 3036. P. G. A. has served as an expert witness in malpractice cases related to Lyme disease. V. G. F. served as Chair of V710 Scientific Advisory Committee (Merck), has received grant support or has grants pending from Cerexa, Pfizer, Advanced Liquid Logic, MedImmune, and Cubist, has been a paid consultant forMerck, Astellas, Affinium, Theravance, Cubist, Cerexa, Debiopharm, Durata, Pfizer, NovaDigm, Novartis, Medicines Company, Biosynexus, MedImmune, and Inimex, Bayer, and has received honoraria from Merck, Astellas, Cubist, Pfizer, Theravance, and Novartis. Publisher Copyright: {\textcopyright} The Author 2015.",
year = "2015",
month = dec,
day = "1",
doi = "10.1093/ofid/ofv143",
language = "English (US)",
volume = "2",
journal = "Open Forum Infectious Diseases",
issn = "2328-8957",
publisher = "Oxford University Press",
number = "4",
}