title: Risk factors and potential preventive measures for nephropatia epidemica in Sweden 2011-2012: a case-control study.
abstract: BACKGROUND
  Nephropatia epidemica (NE), a relatively mild form of hemorrhagic fever with renal syndrome caused by the Puumala virus (PUUV), is endemic in northern Sweden. We aim to study the risk factors associated with NE in this region.
  
  
  METHODS
  We conducted a matched case-control study between June 2011 and July 2012. We compared confirmed NE cases with randomly selected controls, matched by age, sex, and place of infection or residence. We analyzed the association between NE and several occupational, environmental, and behavioral exposures using conditional logistic regression.
  
  
  RESULTS
  We included in the final analysis 114 cases and 300 controls, forming 246 case-control pairs. Living in a house with an open space beneath, making house repairs, living less than 50 m from the forest, seeing rodents, and smoking were significantly associated with NE.
  
  
  CONCLUSIONS
  Our results could orient public health policies targeting these risk factors and subsequently reduce the NE burden in the region.
authors.affiliation: European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.|European Program for Intervention Epidemiology Training (EPIET), Stockholm, Sweden.|Swedish Institute for Communicable Disease Control (SMI), Solna, Sweden; amgherasim@externos.isciii.es.
authors.forename: Alin
authors.initials: A
authors.lastname: Gherasim
authors.affiliation: Swedish Institute for Communicable Disease Control (SMI), Solna, Sweden.
authors.forename: Marika
authors.initials: M
authors.lastname: Hjertqvist
authors.affiliation: Swedish Institute for Communicable Disease Control (SMI), Solna, Sweden.|Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden.|Department of Microbiology, Karolinska Institute, Stockholm, Sweden.
authors.forename: Åke
authors.initials: Å
authors.lastname: Lundkvist
authors.affiliation: Swedish Institute for Communicable Disease Control (SMI), Solna, Sweden.
authors.forename: Sharon
authors.initials: S
authors.lastname: Kühlmann-Berenzon
authors.affiliation: Swedish Institute for Communicable Disease Control (SMI), Solna, Sweden.
authors.forename: Jenny Verner
authors.initials: JV
authors.lastname: Carlson
authors.affiliation: Department of Clinical Microbiology, Umeå University, Umeå, Sweden.
authors.forename: Stephan
authors.initials: S
authors.lastname: Stenmark
authors.affiliation: Department of Clinical Microbiology, Umeå University, Umeå, Sweden.|Department of Communicable Disease Control and Prevention, Jämtland County Council, Östersund, Sweden.
authors.forename: Mikael
authors.initials: M
authors.lastname: Widerström
authors.affiliation: Department of Communicable Disease Control and Prevention, Norbotten County Council, Lulea, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Österlund
authors.affiliation: Department of Communicable Diseases Control and Prevention, Vasternorrland County Council, Matfors, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Boman
authors.affiliation: Division of Infectious Diseases, Department of Clinical Microbiology, Umeå University Hospital, Umeå, Sweden.
authors.forename: Clas
authors.initials: C
authors.lastname: Ahlm
authors.affiliation: Swedish Institute for Communicable Disease Control (SMI), Solna, Sweden.|Department of Medical Sciences, Infectious Diseases, Uppsala University, Uppsala, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Wallensten
keywords: Puumala virus; Sweden; risk factors