Abstract
This study aims to examine the spatio-temporal dynamics of Rocky Mountain spotted fever (RMSF) prevalence in four contiguous states of Midwestern United States, and to determine the impact of environmental and socio–economic factors associated with this disease. Bayesian hierarchical models were used to quantify space and time only trends and spatio–temporal interaction effect in the case reports submitted to the state health departments in the region. Various socio–economic, environmental and climatic covariates screened a priori in a bivariate procedure were added to a main–effects Bayesian model in progressive steps to evaluate important drivers of RMSF space-time patterns in the region. Our results show a steady increase in RMSF incidence over the study period to newer geographic areas, and the posterior probabilities of county-specific trends indicate clustering of high risk counties in the central and southern parts of the study region. At the spatial scale of a county, the prevalence levels of RMSF is influenced by poverty status, average relative humidity, and average land surface temperature (>35°C) in the region, and the relevance of these factors in the context of climate–change impacts on tick–borne diseases are discussed.
Highlights
Rocky Mountain spotted fever (RMSF) is a life–threatening fulminant tick-borne infection caused by the obligate intercellular bacterium Rickettsia rickettsii (Family: Rickettisiaceae, Order: Rickettsiales) [1]
Missouri recorded the most number of cases (n = 3,766) followed by Arkansas (n = 3,271) and Oklahoma (n = 3,271), and Kansas recorded the least number of cases (n = 754) among the four states during this period
A general upward trend for cases can be observed for Arkansas and Oklahoma, while in Missouri the case numbers have fallen since 2007–2008 period with only a small increase in 2014, and Kansas is largely constant throughout the study period
Summary
Rocky Mountain spotted fever (RMSF) is a life–threatening fulminant tick-borne infection caused by the obligate intercellular bacterium Rickettsia rickettsii (Family: Rickettisiaceae, Order: Rickettsiales) [1]. This disease has been reported from most of the lower 48 states in the United States, with onsets typically occurring during the tick season (April through September). Spatial Analysis of Rocky Mountain Spotted Fever. Health (501 280-4433), and Oklahoma State Department of Health (405 271-5600) directly with data requests. The lead author requested data for this study from these departments using the telephone numbers provided
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