title: Seroprevalence of West Nile virus in Saskatchewan's Five Hills Health Region, 2003.
abstract: BACKGROUND
  The Five Hills Health Region of Saskatchewan reported the highest West Nile virus (WNV) case rates in the 2003 outbreak. A serologic and telephone survey was undertaken to assess the seroprevalence of the virus and the knowledge, attitudes and behaviours of the residents.
  
  
  METHODS
  Respondents had to be at least 18 years of age, and residents of the Five Hills Health Region between July 1st and September 15th, 2003. Blood samples of respondents were tested at the National Microbiology Laboratory for flavivirus immunoglobulin using a WNV IgG ELISA and plaque reduction neutralization test. Descriptive analyses performed related to respondents' demographics, knowledge, attitudes, behaviours, and seropositivity. WNV infection risk was assessed using odds ratio.
  
  
  RESULTS
  There were 619 questionnaire respondents, of whom 501 donated a blood sample. The seroprevalence of WNV in the Five Hills Health Region was 9.98% (95% CI 7.37-12.59%). Seropositivity of rural areas was 16.8% and urban was 3.2%. Most (97%) of participants thought WNV was an important health issue. Forty-eight percent of the participants used insect repellents containing DEET most of the time. There was good knowledge regarding WNV transmission and prevention of the spread of WNV. Rural compared to urban residents were six times more likely to be positive for WNV (OR=6.13, 95% CI 2.82-13.34).
  
  
  CONCLUSIONS
  This is the highest seroprevalence rate of West Nile virus recorded in North America thus far. Many factors could have influenced this outbreak, such as eco-region, early prolonged hot weather, level of mosquito control programs, urban and rural community differences, and personal protective behaviours.
authors.affiliation: Department of Public Health Services, Five Hills Health Region, Moose Jaw, SK. tschell@fhhr.ca
authors.forename: Tara L
authors.initials: TL
authors.lastname: Schellenberg
authors.forename: Maureen E
authors.initials: ME
authors.lastname: Anderson
authors.forename: Michael A
authors.initials: MA
authors.lastname: Drebot
authors.forename: Mark T R
authors.initials: MT
authors.lastname: Vooght
authors.forename: A Ross
authors.initials: AR
authors.lastname: Findlater
authors.forename: Phillip S
authors.initials: PS
authors.lastname: Curry
authors.forename: C Alexia
authors.initials: CA
authors.lastname: Campbell
authors.forename: William D
authors.initials: WD
authors.lastname: Osei
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D004196:Disease Outbreaks; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D012423:Rural Health; D012525:Saskatchewan / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014504:Urban Health; D014901:West Nile Fever / Q000097:blood / Q000453:epidemiology*; D014902:West Nile virus / Q000302:isolation & purification*