{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:26:05Z","timestamp":1791905165973,"version":"4.3.4"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2016,11,11]],"date-time":"2016-11-11T00:00:00Z","timestamp":1478822400000},"content-version":"vor","delay-in-days":680,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["KL2 TR001115"],"award-info":[{"award-number":["KL2 TR001115"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ken and Sherrilyn Fisher Center"},{"name":"for Environmental Infectious Diseases"},{"name":"National Institute for Allergy and Infectious Diseases"},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K24 AI093969"],"award-info":[{"award-number":["K24 AI093969"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Boston Children's Hospital Pilot"},{"DOI":"10.13039\/100006990","name":"Thomas F. and Kate Miller Jeffress Memorial Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006990","id-type":"DOI","asserted-by":"publisher"}]},{"name":"InterAmerican Institute for Global Change Research","award":["CRN 3036"],"award-info":[{"award-number":["CRN 3036"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Background. \u2003The majority of Lyme disease cases in the United States are acquired on the east coast between northern Virginia and New England. In recent years the geographic extent of Lyme disease has been expanding, raising the prospect of Lyme disease becoming endemic in the southeast.<\/jats:p>\n               <jats:p>Methods. \u2003We collected confirmed and probable cases of Lyme disease from 2000 through 2014 from the Virginia Department of Health and North Carolina Department of Public Health and entered them in a geographic information system. We performed spatial and spatiotemporal cluster analyses to characterize Lyme disease expansion.<\/jats:p>\n               <jats:p>Results. \u2003There was a marked increase in Lyme disease cases in Virginia, particularly from 2007 onwards. Northern Virginia experienced intensification and geographic expansion of Lyme disease cases. The most notable area of expansion was to the southwest along the Appalachian Mountains with development of a new disease cluster in the southern Virginia mountain region.<\/jats:p>\n               <jats:p>Conclusions. \u2003The geographic distribution of Lyme disease cases significantly expanded in Virginia between 2000 and 2014, particularly southward in the Virginia mountain ranges. If these trends continue, North Carolina can expect autochthonous Lyme disease transmission in its mountain region in the coming years.<\/jats:p>","DOI":"10.1093\/ofid\/ofv143","type":"journal-article","created":{"date-parts":[[2015,9,29]],"date-time":"2015-09-29T00:23:32Z","timestamp":1443486212000},"source":"Crossref","is-referenced-by-count":56,"title":["Geographic Expansion of Lyme Disease in the Southeastern United States, 2000\u20132014"],"prefix":"10.1093","volume":"2","author":[{"given":"Paul M.","family":"Lantos","sequence":"first","affiliation":[{"name":"Divisions of Pediatric Infectious Diseases"},{"name":"General Internal Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lise E.","family":"Nigrovic","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Boston Children's Hospital, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul G.","family":"Auwaerter","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Johns Hopkins Medical Institutions, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Vance G.","family":"Fowler","sequence":"additional","affiliation":[{"name":"Infectious Diseases, Duke University School of Medicine, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicia","family":"Ruffin","sequence":"additional","affiliation":[{"name":"Infectious Diseases, Duke University School of Medicine, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Jory","family":"Brinkerhoff","sequence":"additional","affiliation":[{"name":"Department of Biology, University of Richmond, Virginia"},{"name":"University of KwaZulu-Natal, Westville, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodi","family":"Reber","sequence":"additional","affiliation":[{"name":"North Carolina Department of Public Health, Raleigh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Williams","sequence":"additional","affiliation":[{"name":"North Carolina Department of Public Health, Raleigh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Broyhill","sequence":"additional","affiliation":[{"name":"Virginia Department of Health, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William K.","family":"Pan","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute"},{"name":"Nicholas School of the Environment, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David N.","family":"Gaines","sequence":"additional","affiliation":[{"name":"Virginia Department of Health, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2015,9,27]]},"reference":[{"key":"2020081009364621000_OFV143C1","article-title":"Reported cases of Lyme disease by state or locality, 2004-2013","author":"Centers for Disease Control and Prevention"},{"key":"2020081009364621000_OFV143C2","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1093\/cid\/ciu397","article-title":"Lyme disease testing by large commercial laboratories in the United States","volume":"59","author":"Hinckley","year":"2014","journal-title":"Clin Infect Dis"},{"key":"2020081009364621000_OFV143C3","doi-asserted-by":"crossref","first-page":"320","DOI":"10.4269\/ajtmh.2012.11-0395","article-title":"Human risk of infection with Borrelia burgdorferi, the Lyme disease agent, in eastern United States","volume":"86","author":"Diuk-Wasser","year":"2012","journal-title":"Am J Trop Med Hyg"},{"key":"2020081009364621000_OFV143C4","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.ttbdis.2010.08.003","article-title":"Borrelia species in Ixodes affinis and Ixodes scapularis ticks collected from the coastal plain of North Carolina","volume":"1","author":"Maggi","year":"2010","journal-title":"Ticks Tick Borne Dis"},{"key":"2020081009364621000_OFV143C5","article-title":"Annual update on surveillance for Lyme disease in North Carolina","author":"North Carolina Department of Health and Human Services: Division of Public Health"},{"key":"2020081009364621000_OFV143C6","article-title":"Lyme Disease (Borrelia burgdorferi): 1996 Case Definition","author":"Centers for Disease Control and Prevention"},{"key":"2020081009364621000_OFV143C7","article-title":"Lyme Disease (Borrelia burgdorferi): 2008 Case Definition","author":"Centers for Disease Control and 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