title: Risk factors for infection during a dengue-1 outbreak in Maui, Hawaii, 2001.
abstract: Autochthonous dengue virus transmission, last identified in the state of Hawaii in 1945, was detected again in 2001. A seroepidemiological survey in a high-incidence community (Nahiku) and a nearby low-incidence community (Hana Subdivision) was implemented. The two communities studied differed in median household size (two vs. four persons), median lot size (2.8 vs. 0.8acres), proportion of households with mosquito larvae (81 vs. 28%) and incidence of recent infection (39% [28/72] vs. 1% [1/131]). The average number of reported anti-mosquito actions by residents of both locations remained low, and approximately 50% (42/80) of the inspected houses had larvae, evidencing the need for more effective community mosquito control. Logistic regression analysis of risk factors for infection in Nahiku identified residing in properties with birds in the house or yard as significantly associated with infection (odds ratio 7.0, 95% CI 1.7-28.5), probably as an indicator of unspecified environmental characteristics that were attractive to the vector. We documented that nearly 40% of Nahiku residents had acquired dengue locally in 2001 and that undetected dengue outbreaks had occurred in Hawaii. Our data suggest that ecological characteristics may help Hawaii health officials identify communities at increased risk of dengue infection.
authors.affiliation: Dengue Branch, Division of Vector-Borne Infectious Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 1324 Calle Cañada, San Juan, PR 00920-3860. jmhayes@usetinc.org
authors.forename: John Mosely
authors.initials: JM
authors.lastname: Hayes
authors.forename: José G
authors.initials: JG
authors.lastname: Rigau-Pérez
authors.forename: Paul
authors.initials: P
authors.lastname: Reiter
authors.forename: Paul V
authors.initials: PV
authors.lastname: Effler
authors.forename: Lorrin
authors.initials: L
authors.lastname: Pang
authors.forename: Vance
authors.initials: V
authors.lastname: Vorndam
authors.forename: Steven R
authors.initials: SR
authors.lastname: Hinten
authors.forename: Karen E
authors.initials: KE
authors.lastname: Mark
authors.forename: Melanie F
authors.initials: MF
authors.lastname: Myers
authors.forename: Kathleen
authors.initials: K
authors.lastname: Street
authors.forename: Lolly
authors.initials: L
authors.lastname: Bergau
authors.forename: Chad
authors.initials: C
authors.lastname: Meyer
authors.forename: Manuel
authors.initials: M
authors.lastname: Amador
authors.forename: Mike
authors.initials: M
authors.lastname: Napier
authors.forename: Gary G
authors.initials: GG
authors.lastname: Clark
authors.forename: Brad J
authors.initials: BJ
authors.lastname: Biggerstaff
authors.forename: Duane J
authors.initials: DJ
authors.lastname: Gubler
mesh_terms: D000293:Adolescent; D000328:Adult; D000330:Aedes / Q000469:parasitology*; D000368:Aged; D000818:Animals; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000453:epidemiology*; D003715:Dengue / Q000453:epidemiology*; D004196:Disease Outbreaks; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007303:Insect Vectors / Q000469:parasitology*; D008297:Male; D008875:Middle Aged; D009032:Mosquito Control; D012307:Risk Factors