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

  • Lance A. Waller
  • Brett J. Goodwin
  • Mark L. Wilson
  • Richard S. Ostfeld
  • Stacie L. Marshall
  • Edward B. Hayes
Original Article


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.


Hierarchical linear model Risk map Local risk Conceptual context Local precision 


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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Lance A. Waller
    • 1
  • Brett J. Goodwin
    • 2
  • Mark L. Wilson
    • 3
  • Richard S. Ostfeld
    • 4
  • Stacie L. Marshall
    • 5
  • Edward B. Hayes
    • 6
  1. 1.Department of Biostatistics, Rollins School of Public HealthEmory UniversityAtlantaUSA
  2. 2.Department of BiologyUniversity of North DakotaGrand ForksUSA
  3. 3.Departments of Biology and EpidemiologyUniversity of MichiganAnn ArborUSA
  4. 4.Institute of Ecosystem StudiesMillbrookUSA
  5. 5.US Centers for Disease Control and PreventionEmory UniversityAtlantaUSA
  6. 6.US Centers for Disease Control and PreventionColorado State UniversityFort CollinsUSA

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