American Journal of Epidemiology Vol. 147, No. 4: 391-397
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Emergence of Lyme Disease in Hunterdon County, New Jersey, 1993: A Case-Control Study of Risk Factors and Evaluation of Reporting Patterns
1 Bacterial Zoonoses Branch, Division of Vector-Bome Infectious Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention Fort Collins, CO
2 New Jersey State Department of Health Trenton, NJ
3 Hurrterdon County Department of Health Remington, NJ
4New York State Department Of Health Albany,Ny.
Reprint requests to Dr. Kathleen A. Orloski, Centers for Disease Control and Prevention, P. O. Box 2087, Fort Collins, CO 80522.
Reported cases of Lyme disease in Hunterdon County, New Jersey, increased almost 200% from 75 (67/100,000 population) in 1992 to 216 (193/100,000 population) in 1993. For evaluation of risk factors for Lyme disease and for determination of the cause of this increase, a case-control study was conducted, and the reporting practices of physicians' offices were evaluated. For cases reported in 1993, age and sex distribution, month of disease onset, and proportion of cases with erythema migrans rash were within expected limits. Analysis of age-matched case-control data showed that rural residence; clearing periresi-dential brush during spring and summer months; and the presence of rock walls, woods, deer, or a bird feeder on residential property were associated with incident Lyme disease. A review of physician reporting patterns suggested that the increase in reported cases in 1993 was due to improved reporting as well as to an increase in the numbers of patients diagnosed with Lyme disease. In addition, substantial underreporting of Lyme disease by physicians' offices was found. Am J Epidemiol 1998; 147: 391–7.
Borrelia burgdorferi; Lyme diseases; Spirochaeta; zoonoses
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