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American Journal of Epidemiology Vol. 136, No. 5: 592-602
Copyright © 1992 by The Johns Hopkins University School of Hygiene and Public Health

other

The Geographic Structure of Measles Epidemics in the Northeastern United States

Andrew D. Cliff1,, Peter Haggett2 and Donna F. Stroup3

1Department of Geography, University of Cambridge Cambridge, England
2Department of Geography, University of Bristol Bristol, BS8 1SS, England
3Division of Surveillance and Epidemiology, Epidemiology Program Office, Centers for Disease Control Atlanta, GA

Reprint requests to Dr. Andrew D. Cliff, Department of Geography, University of Cambridge, Cambridge, CB2 3EN, England.

The incidence of disease across geographic space often produces distinctive regional patterns. In this paper, a modeling approach to the identification of the factors that shape the patterns is presented, and a procedure for fitting the model to observed data is given. The methodology is illustrated by an application to the geographic structure of measles epidemics among 22 states of the northeastern United States, New York City, and Washington, D. C., from 1962 to 1988. The patterns identified are interpreted in terms of the spatial behavior of measles epidemics in the region, and the implications of the methodology for surveillance and control are considered. Am J Epidemiol 1992; 136: 592–602

disease outbreaks; immunity, cellular; measles; space-time clustering


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