Eisen Rebecca J, Enscore Russell E, Biggerstaff Brad J, Reynolds Pamela J, Ettestad Paul, Brown Ted, Pape John, Tanda Dale, Levy Craig E, Engelthaler David M, Cheek James, Bueno Rudy, Targhetta Joseph, Montenieri John A, Gage Kenneth L
Division of Vector-Borne Infectious Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, P.O. Box 2087, Fort Collins, CO 80522, USA.
J Med Entomol. 2007 May;44(3):530-7. doi: 10.1603/0022-2585(2007)44[530:hpitsu]2.0.co;2.
Plague is a rare but highly virulent flea-borne zoonotic disease caused by the Gram-negative bacterium Yersinia pestis Yersin. Identifying areas at high risk of human exposure to the etiological agent of plague could provide a useful tool for targeting limited public health resources and reduce the likelihood of misdiagnosis by raising awareness of the disease. We created logistic regression models to identify landscape features associated with areas where humans have acquired plague from 1957 to 2004 in the four-corners region of the United States (Arizona, Colorado, New Mexico, and Utah), and we extrapolated those models within a geographical information system to predict where plague cases are likely to occur within the southwestern United States disease focus. The probability of an area being classified as high-risk plague habitat increased with elevation up to approximately 2300 m and declined as elevation increased thereafter, and declined with distance from key habitat types (e.g., southern Rocky Mountain piñon--juniper [Pinus edulis Engelm. and Juniperus spp.], Colorado plateau piñon--juniper woodland, Rocky Mountain ponderosa pine (Pinus ponderosa P.& C. Lawson var. scopulorum), and southern Rocky Mountain juniper woodland and savanna). The overall accuracy of the model was >82%. Our most conservative model predicted that 14.4% of the four-corners region represented a high risk of peridomestic exposure to Y. pestis.
鼠疫是一种罕见但极具传染性的由跳蚤传播的人畜共患病，由革兰氏阴性细菌鼠疫耶尔森菌引起。识别出人类接触鼠疫病原体的高风险区域，可为合理分配有限的公共卫生资源提供有用工具，并通过提高对该疾病的认知来降低误诊的可能性。我们创建了逻辑回归模型，以识别美国四角地区（亚利桑那州、科罗拉多州、新墨西哥州和犹他州）1957年至2004年期间人类感染鼠疫的相关景观特征，并在地理信息系统中对这些模型进行外推，以预测美国西南部鼠疫疫源地可能出现鼠疫病例的地点。一个地区被归类为鼠疫高风险栖息地的概率随着海拔升高至约2300米而增加，此后随着海拔进一步升高而下降，并随着与关键栖息地类型（如落基山脉南部矮松-杜松林[矮松和杜松属植物]、科罗拉多高原矮松-杜松林地、落基山黄松[西黄松]以及落基山脉南部杜松林地和稀树草原）的距离增加而下降。该模型的总体准确率超过82%。我们最保守的模型预测，四角地区14.4%的区域存在家庭周边接触鼠疫耶尔森菌的高风险。
