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.
Type
Journal articlePermalink
https://hdl.handle.net/10161/12049Published Version (Please cite this version)
10.1093/ofid/ofv143Publication Info
Lantos, Paul M; Nigrovic, Lise E; Auwaerter, Paul G; Fowler, Vance G; Ruffin, Felicia;
Brinkerhoff, R Jory; ... Gaines, David N (2015). Geographic Expansion of Lyme Disease in the Southeastern United States, 2000-2014.
Open Forum Infect Dis, 2(4). pp. ofv143. 10.1093/ofid/ofv143. Retrieved from https://hdl.handle.net/10161/12049.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
Collections
More Info
Show full item recordScholars@Duke
Vance Garrison Fowler Jr.
Florence McAlister Distinguished Professor of Medicine
Determinants of Outcome in Patients with Staphylococcus aureus Bacteremia Antibacterial
ResistancePathogenesis of Bacterial Infections Tropical medicine/International Health
Paul Michael Lantos
Professor of Medicine
I am interested in the spatial epidemiology of infectious diseases. My research utilizes
geographic information systems (GIS) and geostatistical analyses to understand the
spatial and spatiotemporal distribution of diseases, and their relationship with environmental
and demographic factors. I currently have active studies evaluating the spatial distribution
of numerous domestic and international infectious diseases, including SARS-CoV-2 (COVID-19),
cytomegalovirus, influenza, and Lyme disease. A
William Kuang-Yao Pan
Elizabeth Brooks Reid and Whitelaw Reid Associate Professor
William Pan, PhD, Assistant Professor of Global Environmental Health, joined the faculty
at Duke in 2011. He holds a joint appointment at DGHI and the Nicholas School of Environment,
and is Adjunct Assistant Professor in the Department of International Health at Johns
Hopkins Bloomberg School of Public Health. Pan’s research interests focuses on Population,
Health, and Environmental interactions in developing countries, with particular interest
in translational research directed toward sus
Alphabetical list of authors with Scholars@Duke profiles.

Articles written by Duke faculty are made available through the campus open access policy. For more information see: Duke Open Access Policy
Rights for Collection: Scholarly Articles
Works are deposited here by their authors, and represent their research and opinions, not that of Duke University. Some materials and descriptions may include offensive content. More info