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Am. J. Trop. Med. Hyg., 78(4), 2008, pp. 586-594
Copyright © 2008 by The American Society of Tropical Medicine and Hygiene

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Ecoepidemiology of Tularemia in the Southcentral United States

Rebecca J. Eisen*, Paul S. Mead, Andrew M. Meyer, Liza E. Pfaff, Kristy K. Bradley, AND Lars Eisen
Division of Vector-Borne Infectious Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado; Office of the State Epidemiologist, Oklahoma State Department of Health, Oklahoma City, Oklahoma

We combined county-based data for tularemia incidence from 1990 to 2003 for a nine-state region (Arkansas, Illinois, Indiana, Kansas, Kentucky, Missouri, Nebraska, Oklahoma, and Tennessee) in the southcentral United States with Geographic Information System (GIS)-based environmental data to determine associations between coverage by different habitats (especially dry forest representing suitable tick habitat) and tularemia incidence. High-risk counties (> 1 case per 100,000 person-years) clustered in Arkansas-Missouri and far eastern Oklahoma and Kansas. County tularemia incidence was positively associated with coverage by dry forested habitat suitable for vector ticks for Oklahoma-Kansas-Nebraska and Arkansas-Missouri but not for Illinois-Indiana-Kentucky-Tennessee. A multivariate logistic regression model predicting presence of areas with risk of tularemia based on GIS-derived environmental data was developed for the Arkansas-Missouri tularemia focus. The study shows the potential for research on tularemia ecoepidemiology and highlights the need for further modeling efforts based on acarologic data and more fine-scale point or zip code/census tract epidemiologic data.

Received August 17, 2007. Accepted for publication January 3, 2008.

Acknowledgments: The authors thank Karen Yates and Bao-Ping Zhu of the Missouri Department of Health and Senior Services for helpful comments on the manuscript.

Financial support: This study was funded by a grant from the Colorado State University College of Veterinary Medicine and Biomedical Sciences to L. Eisen.

* Address correspondence to Rebecca J. Eisen, PO Box 2087, Fort Collins, CO 80522. E-mail: dyn2{at}cdc.gov

Authors’ addresses: Rebecca J. Eisen, Paul S. Mead, Andrew M. Meyer, Liza E. Pfaff, Kristy K. Bradley, and Lars Eisen, Division of Vector-Borne Infectious Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, 3150 Rampart Road, Fort Collins, CO 80522, Tel: 970-221-6408, Fax: 970-221-6476, E-mail: dyn2{at}cdc.gov.

Reprint requests: Rebecca J. Eisen, Division of Vector-Borne Infectious Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, 3150 Rampart Road, Fort Collins, CO 80521, E-mail: dyn2{at}cdc.gov.






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Copyright © 2008 by the American Society of Tropical Medicine and Hygiene.