Modelling Spatiotemporal Patterns of Lyme Disease Emergence in Québec.

Lyme disease is a growing public health problem in Quebec. Its emergence over the last decade is caused by environmental and anthropological factors that favour the survival of Ixodes scapularis, the vector of Lyme disease transmission. The objective of this study was to estimate the speed and direction of human Lyme disease emergence in Quebec and to identify spatiotemporal risk patterns. A surface trend analysis was conducted to estimate the speed and direction of its emergence based upon the first detected case of Lyme disease in each municipality in Quebec since 2004. A cluster analysis was also conducted to identify at-risk regions across space and time. These analyses were reproduced for the date of disease onset and date of notification for each case of Lyme disease. It was estimated that Lyme disease is spreading northward in Quebec at a speed varying between 18 and 32 km/year according to the date of notification and the date of disease onset, respectively. A significantly high risk of disease was found in seven clusters identified in the south-west of Quebec in the sociosanitary regions of Monteregie and Estrie. The results obtained in this study improve our understanding of the spatiotemporal patterns of Lyme disease in Quebec, which can be used for proactive, targeted interventions by public and clinical health authorities.