@article{324bf0ff2e8c40bf965d24b0dc2e1f0d,
title = "Geographic expansion of Lyme disease in Michigan, 2000-2014",
abstract = "Background. Most Lyme disease cases in the Midwestern United States are reported in Minnesota and Wisconsin. In recent years, however, a widening geographic extent of Lyme disease has been noted with evidence of expansion eastwards into Michigan and neighboring states with historically low incidence rates. Methods. We collected confirmed and probable cases of Lyme disease from 2000 through 2014 from the Michigan Department of Health and Human Services, entering them in a geographic information system. We performed spatial focal cluster analyses to characterize Lyme disease expansion. We compared the distribution of human cases with recent Ixodes scapularis tick distribution studies. Results. Lyme disease cases in both the Upper and Lower Peninsulas of Michigan expanded more than 5-fold over the study period. Although increases were seen throughout the Upper Peninsula, the Lower Peninsula particularly expanded along the Indiana border north along the eastern shore of Lake Michigan. Human cases corresponded to a simultaneous expansion in established I scapularis tick populations. Conclusions. The geographic distribution of Lyme disease cases significantly expanded in Michigan between 2000 and 2014, particularly northward along the Lake Michigan shore. If such dynamic trends continue, Michigan-and possibly neighboring areas of Indiana, Ohio, and Ontario, Canada-can expect a continued increase in Lyme disease cases.",
keywords = "Borrelia burgdorferi, Geographic information systems, Ixodes scapularis, Lyme disease, Michigan",
author = "Lantos, {Paul M.} and Jean Tsao and Nigrovic, {Lise E.} and Auwaerter, {Paul G.} and Fowler, {Vance G.} and Felicia Ruffin and Erik Foster and Graham Hickling",
note = "Funding Information: P. M. L. was funded by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number KL2 TR001115. L. E. N. was funded by a Boston Children's Hospital Pilot research grant, Harvard Catalyst, and the Bay Area Lyme Foundation. P. G. A. was supported by the Ken and Sherrilyn Fisher Center for Environmental Infectious Diseases and has performed expert medical-legal reviews concerning Lyme disease. V. F. and F. R. were funded by the National Institute for Allergy and Infectious Diseases of the National Institutes of Health under award number K24 AI093969. G. H. and J. T. were funded by the Michigan Lyme Disease Association. In addition, G. H. was funded by cooperative agreement cI00171-01 from the Centers for Disease Control and Prevention. Funding Information: Financial support. P. M. L. was funded by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number KL2 TR001115. L. E. N. was funded by a Boston Children{\textquoteright}s Hospital Pilot research grant, Harvard Catalyst, and the Bay Area Lyme Foundation. P. G. A. was supported by the Ken and Sherrilyn Fisher Center for Environmental Infectious Diseases and has performed expert medical-legal reviews concerning Lyme disease. V. F. and F. R. were funded by the National Institute for Allergy and Infectious Diseases of the National Institutes of Health under award number K24 AI093969. G. H. and J. T. were funded by the Michigan Lyme Disease Association. In addition, G. H. was funded by cooperative agreement cI00171-01 from the Centers for Disease Control and Prevention. Potential conflicts of interest. All authors: No reported conflicts. Publisher Copyright: {\textcopyright} The Author 2017.",
year = "2017",
month = jan,
day = "1",
doi = "10.1093/ofid/ofw269",
language = "English (US)",
volume = "4",
journal = "Open Forum Infectious Diseases",
issn = "2328-8957",
publisher = "Oxford University Press",
number = "1",
}