莱姆病是美国最常见的媒介传播疾病,大多数病例发生在东北部,上中西部,和大西洋中部地区。虽然历史上被认为是低发病率状态,北卡罗来纳州(NC)在过去十年中报告了越来越多的病例。因此,这项研究的目的是描述2010年至2020年NC莱姆病的时空演变。
■报告给NC公共卫生司的确诊和疑似病例,没有相关的旅行到高传播状态包括在分析中。研究期间分为四个子期间,数据按居住邮政编码汇总。绘制发病率的绝对变化图,并在每个子周期内进行空间自相关分析。
■我们确定了位于阿巴拉契亚山脉西北部的邮政编码发生率的最大绝对变化。在研究期间,病例的空间分布变得越来越聚集(Moran\sI为0.012,p=0.127,2010-2012年与0.403,2019-2020年p<0.0001)。识别出的集群包括2019-2020年子期的22个高发邮政编码,与疾病发病率绝对变化最大的相同地区在很大程度上重叠。
■莱姆病在北卡罗来纳州西北部迅速出现,一些邮政编码报告的发病率与美国东北部历史高发地区相似,大西洋中部,和上中西部。迫切需要努力提高医疗提供者的认识,以防止发病率过高。
■资金由UNC研究副校长办公室的“创造力中心”奖提供。东南卓越中心提供了额外的支持在病媒疾病(U01CK000662)。
UNASSIGNED: Lyme disease is the most common vector-borne disease in the United States with the majority of cases occurring in the Northeast, upper Midwest, and mid-Atlantic regions. While historically considered a low incidence state, North Carolina (NC) has reported an increasing number of cases over the past decade. Therefore, the aim of this study was to characterise the spatiotemporal evolution of Lyme disease in NC from 2010 to 2020.
UNASSIGNED: Confirmed and probable cases reported to the NC Division of Public Health without associated travel to high-transmission state were included in the analysis. The study period was divided into four sub-periods and data were aggregated by zip code of residence. The absolute change in incidence was mapped and spatial autocorrelation analyses were performed within each sub-period.
UNASSIGNED: We identified the largest absolute changes in incidence in zip codes located in northwestern NC along the Appalachian Mountains. The spatial distribution of cases became increasingly clustered over the study period (Moran\'s I of 0.012, p = 0.127 in 2010-2012 vs. 0.403, p < 0.0001 in 2019-2020). Identified clusters included 22 high-incidence zip codes in the 2019-2020 sub-period, largely overlapping with the same areas experiencing the greatest absolute changes in disease incidence.
UNASSIGNED: Lyme disease has rapidly emerged in northwestern NC with some zip codes reporting incidence rates similar to historically high incidence regions across the US Northeast, mid-Atlantic, and upper Midwest. Efforts are urgently needed to raise awareness among medical providers to prevent excess morbidity.
UNASSIGNED: Funding was provided by a \"Creativity Hub\" award from the UNC Office of the Vice Chancellor for Research. Additional support was provided by Southeastern Center of Excellence in Vector Borne Diseases (U01CK000662).