Spatio-temporal pattern of viral meningitis in Michigan, 1993-2001

To characterize Michigans high viral meningitis incidence rates, 8,803 cases from 1993–2001 were analyzed for standard epidemiological indices, geographic distribution, and spatio-temporal clusters. Blacks and infants were found to be high-risk groups. Annual seasonality and interannual variability in epidemic magnitude were apparent. Cases were concentrated in southern Michigan, and cumulative incidence was correlated with population density at the county level (r=0.45, p<0.001). Kulldorffs Scan test identified the occurrence of spatio-temporal clusters in Lower Michigan during July–October 1998 and 2001 (p=0.01). More extensive data on cases, laboratory isolates, sociodemographics, and environmental exposures should improve detection and enhance the effectiveness of a Space-Time Information System aimed at prevention.The authors gratefully acknowledge Dr. Duane Newton, former manager of the Virology Section, Michigan Department of Community Health Bureau of Laboratories, for his provision of data on viral isolates. We also appreciate the contributions of Drs. Leah Estberg and Dunrie Greiling for ClusterSeer support, Scott Swan for his assistance with ArcView GIS, and Dr. Edward L. Ionides for his advice on time series analysis. We are grateful to Dr. Pierre Goovaerts and two anonymous reviewers for their insightful comments on an earlier draft of this paper. This project was supported in part by a grant from the National Oceanic and Atmospheric Administrations Joint Program on Climate Variability and Human Health, a consortium including the EPA, NASA, NSF, and EPRI (NA16GP2361) to MLW.