9% of county population in two counties, Dane, and Milwaukee. There were no cases of Lyme disease in this study population (P.D.) The study sample was selected with a priority of persons with first-episode Lyme disease. The study also enrolled a larger sample of persons from five Wisconsin locations, selected to have a higher incidence of Lyme disease. These five sites had an all-white population and an all-male population, which is similar to the population in Wisconsin as a whole. After obtaining consent from all persons in the study, the questionnaire included measures to establish demographic information, including age at initial infection and the location of the index case in 1986 and 1987. Data are available for 6,967 Wisconsin residents and 2,857 from one of Madison or Madison County, Wis. For the Madison area, data include an age at first episode and location. For the Madison population, this includes only the first report. For Madison County, the first report included persons from four different sites and an age at first infection. All three of the Wisconsin study sites had higher Lyme disease case rates than the national average for the same two cities, Dane and Milwaukee. The case rates for Madison or Madison County were higher (P < .001) than the corresponding rates in the five other Wisconsin cities. To examine the difference in the incidence of Lyme disease between Madison and the other Wisconsin cities, a regression model was computed on the data that included site, period, and age at first incident. For Madison or Madison County in 1986, the slope for this model matched that observed for the comparison cities for that year for the same age group at first incident. Thus, for Madison, the Madison incidence of Lyme disease was similar to that for the other cities. In fact, for Madison, the incidence of Lyme disease was higher than the annual average for the five Wisconsin cities (2.7 cases per 100,000 population during 1991--1998). In the Madison study population (4,932 persons), the relative risk of Lyme disease was 1.5 (95% confidence interval 1.1--2.3, P < .001) for the first report in 1986. This relative risk decreased gradually with higher number of reports. The age-adjusted incidence rate was 2.3--2.9 cases per 100,000 (95% confidence interval 0.9--2.7, P
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Lyme Disease Incidence in Wisconsin: A Comparison of State Reported Rates with Rates from a Population-Based Cohort Allison Gateway, Edward Belong, Robert Green lee Marsh field Medical Research Foundation
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