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Plague and hantavirus pulmonary syndrome (HPS) are severe, often fatal diseases in humans that share a broad epidemiologic focus in the southwestern United States. Prevention of these diseases relies heavily on education and reducing rodent abundance in peridomestic environments. Resources for these activities are limited. Therefore, identifying areas sharing elevated risk for these two relatively rare but severe diseases could be useful for targeting limited public health resources. Using logistic regression and geographic information system–based modeling, we identified environmental predictors of elevated risk for plague (distance to piñon-juniper ecotones and amount of precipitation) and HPS (elevation and amount of precipitation) in northeastern Arizona and northwestern New Mexico. Our models accurately identified case locations as suitable (producer accuracies of 93% for plague and 96% for HPS) and indicated that approximately half of the coverage area was classified as suitable risk for either plague or HPS. The probability of a site being classified as suitable for plague was strongly correlated with its probability of being classified as suitable for HPS (
s = 0.88). Increased risk for both diseases occurred for approximately 37% of the coverage area.
Received June 20, 2007. Accepted for publication July 31, 2007.
Acknowledgments: We thank James N. Mills for helpful comments on the manuscript, the Diagnostics and Reference Laboratory (Bacterial Diseases Branch, Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO) for technical support, and the Special Pathogens Branch (Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA) for hantavirus serologic testing.
* Address correspondence to Rebecca J. Eisen, Division of Vector-Borne Infectious Diseases, National Center for Vector-Borne Zoonotic and Enteric Diseases, Centers for Disease Control and Prevention, 3150 Rampart Road, Fort Collins, CO 80522. E-mail: dyn2{at}cdc.gov
Authors’ addresses: Rebecca J. Eisen, Russell E. Enscore, and Kenneth L. Gage, Division of Vector-Borne Infectious Diseases, National Center for Vector-Borne, Zoonotic and Enteric Diseases, Centers for Disease Control and Prevention, 3150 Rampart Road, Fort Collins, CO 80522, Telephone: 970-266-3523, Fax: 970-225–4257, E-mail: dyn2{at}cdc.gov. Gregory E. Glass, The W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205. Lars Eisen, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO 80523. James Cheek, Division of Epidemiology and Disease Prevention, Indian Health Services, 5300 Homestead Rd., NE, Albuquerque, NM 87110. Paul Ettestad, Zoonoses Program, New Mexico Department of Health, Santa Fe, NM 87505.
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