Effects of season and weather on blastomycosis in dogs: Northern Wisconsin, USA.

Dogs and humans acquire Blastomyces dermatitidis infections from the same incompletely defined habitat. Studies of blastomycosis cases have not consistently demonstrated seasonality or significant antecedent climate effects. To determine the distribution of disease by season, we studied over 18 years 219 dogs with blastomycosis from a single veterinary practice in Northern Wisconsin. The 202 Vilas County dog addresses were compared to 200 random-number selected addresses from the practice registry. Street addresses were geocoded and mapped using ArcGIS, including ratio of cases/random addresses to construct a control chart. Stepwise and linear regression was used to model case counts by season and by 6 month warm (April-September) and cold periods, using lagged local weather data. The geographic distribution of cases was found to be similar regardless of season and time period, and no season exceeded control chart limits. Seasonal distribution of cases was; winter (n = 53, 24%), spring (39, 18%), summer (79, 36%), fall (48, 22%), p = 0.002. When cases were considered by 6-month warm/cold periods, 67% of variation is explained by the total precipitation which occurred two periods prior, and lower average temperature, but higher maximum temperature one period prior (p = 0.000). Weather parameters along with fixed and variable environmental factors likely determine the occurrence of B. dermatitidis, perhaps as part of a 'grow and tolerate change' model.

Alcohol-related motor vehicle accident fatality: Wisconsin rural-urban trends and observations.

BACKGROUND: Wisconsin leads the nation in binge-drinking and alcohol consumption rates, creating substantial costs for taxpayers and contributing to countless alcohol-related comorbidities and numerous fatalities each year. This study was designed to assess the nature and extent of the alcohol problem in Wisconsin and compare alcohol- and non-alcohol-related motor vehicle accident (MVA) fatality rates between the subcultures of rural and urban counties and assess access to alcohol by examining Wisconsin liquor licensing. METHODS: County-level alcohol- and non-alcohol-related MVA fatality data from 1999 to 2006 were obtained from the Wisconsin Department of Transportation and the Wisconsin Interactive Statistics on Health (WISH) database; urban and rural counties were compared. Liquor license per capita rates were determined; rural and urban counties were compared. Additionally, trends in alcohol-related fatalities between 1999 and 2002 and between 2003 and 2006 were computed for all Wisconsin counties. RESULTS: Alcohol-related MVA fatalities were significantly higher in rural counties than non-alcohol-related MVA fatalities as compared to those in urban counties, with an Odds Ratio (OR) of 2.17 (95% Confidence Interval [CI], 2.00-2.35) and 1.68 (95% CI, 1.58-1.79), respectively. More importantly, significant interaction was found to be present between the 2 odds ratios (P < 0.001). When comparing these fatalities using county-level vehicle miles of travel (VMT) as a denominator, similar results were found; rural counties are still at significantly increased risk of MVA fatality in both alcohol- and non-alcohol-related MVAs compared to urban, with an OR of 1.76 (95% CI, 1.62-1.91) 1.37 (95% CI, 1.28-1.45), respectively. CONCLUSION: Evidence characterizing the rural alcohol subculture in Wisconsin's notorious consumption predicament is partially elucidated here, indicating the potential for rural counties to be a cost-effective target of intervention and policy.

A comparison of Wisconsin's suicide rates by urbanization and sex.

BACKGROUND: This report compares suicide rates in Wisconsin and the United States by sex and degree of urbanization. METHODS: Suicide mortality rates for Wisconsin and the United States from 1999 to 2005 were compared by sex and degree of urbanization using data from the Centers for Disease Control and Prevention. Data were also analyzed using Beale Codes to determine the appropriateness of the definition of "rural". RESULTS: While both Wisconsin and US males residing in rural areas are at increased suicide risk compared to their urban counterparts, Wisconsin males are at a much lower risk than the national average (Odds Ratio [OR] = 1.14 [95% Confidence Interval (CI), 1.06-1.23] and OR = 1.33 [95% CI, 1.32-1.35], respectively). U.S. women in rural areas are also at increased risk of suicide compared to females in urban areas (OR = 1.09 [95% CI, 1.07-1.12]). In contrast, Wisconsin females in rural areas-verified by both classification system's definitions of "rural"--are not at increased risk of committing suicide compared to their urban counterparts (OR = 1.03 [95% CI, 0.89-1.20]). CONCLUSION: In Wisconsin's rural areas, suicide rates for males are lower than the national average, especially in Wisconsin's most rural counties. However, the suicide rate for Wisconsin's rural females was very similar to the national average. Additionally, suicide rates for males and females from Wisconsin's only large metro area (Milwaukee County) are significantly than the corresponding national urban rates.

Blastomycosis in urban southeastern Wisconsin.

PURPOSE: A previous study revealed a non-random distribution of blastomycosis cases by home site in urban Milwaukee County. This study was conducted to determine the proportion of cases with likely exposures solely in urban areas. METHODS: Records of 68 urban southeastern Wisconsin individuals, including 45 residents of Milwaukee, 19 from suburban Milwaukee County, and 4 from outside Milwaukee County, diagnosed with blastomycosis between January 2002 and July 2007 were studied using medical record reviews, case reports, and telephone interviews. Geographic Information Systems (GIS) proximity analysis was then used to compare the distance between case and control home sites to environmental risk factors. RESULTS: Of patients reporting their exposure history, 41 of 49 (84%) participated in outdoor work or leisure activities, and 12 of 47 (26%) engaged in fishing, hunting, camping, or hiking. Of the urban cases, 64 occurred among Milwaukee County residents; of those, 25 of 49 (51%) denied traveling, which suggests local urban exposure, and 8 of 11 (73%) specifically recalled urban waterway exposure prior to diagnosis. The 45 Milwaukee cases were concentrated on the north side of town and were closer to inland waterways than a random sample of 6528 controls (median 690 versus 1170 meters; P=0.003), but not closer to parks. CONCLUSION: Southeastern Wisconsin residents may acquire blastomycosis solely in their local urban area, sometimes without specific outdoor exposures. Proximity to inland waterways is associated with blastomycosis cases in urban areas, similar to rural areas of Wisconsin. Clinicians should include blastomycosis in appropriate differential diagnoses of symptomatic individuals, even in urban residents without travel history or history of significant outdoor exposures.