title: Medical risk factors for severe West Nile Virus disease, United States, 2008-2010.
abstract: We conducted enhanced surveillance to identify medical risk factors for severe illness (i.e., hospitalization or death) and neuroinvasive disease (i.e., encephalitis or meningitis) among all West Nile virus disease cases reported from selected states from 2008 to 2010. Of the 1,090 case-patients included in the analysis, 708 (65%) case-patients were hospitalized, 641 (59%) case-patients had neuroinvasive disease, and 55 (5%) case-patients died. Chronic renal disease (adjusted odds ratio [aOR] = 4.1; 95% confidence interval [CI] = 1.4-12.1), history of cancer (aOR = 3.7; 95% CI = 1.8-7.5), history of alcohol abuse (aOR = 3.0; 95% CI = 1.3-6.7), diabetes (aOR = 2.2; 95% CI = 1.4-3.4), and hypertension (aOR = 1.5; 95% CI = 1.1-2.1) were independently associated with severe illness on multivariable analysis. Although the same medical conditions were independently associated with encephalitis, only hypertension was associated with meningitis. The only condition independently associated with death was immune suppression. Prevention messages should be targeted to persons with these conditions.
authors: Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado 80521, USA. frd3@cdc.gov
authors: Nicole P
authors: NP
authors: Lindsey
authors: J Erin
authors: JE
authors: Staples
authors: Jennifer A
authors: JA
authors: Lehman
authors: Marc
authors: M
authors: Fischer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014901:West Nile Fever / Q000453:epidemiology*