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Risk factors for encephalitis and death from West Nile virus infection

Published online by Cambridge University Press:  04 May 2006

K. MURRAY
Affiliation:
University of Texas, School of Public Health, Houston, TX, USA University of Texas Medical Branch, Galveston, TX, USA
S. BARANIUK
Affiliation:
University of Texas, School of Public Health, Houston, TX, USA
M. RESNICK
Affiliation:
University of Texas, School of Public Health, Houston, TX, USA
R. ARAFAT
Affiliation:
City of Houston Department of Health and Human Services, Houston, TX, USA
C. KILBORN
Affiliation:
Harris County Public Health and Environmental Services, Houston, TX, USA
K. CAIN
Affiliation:
University of Texas, School of Public Health, Houston, TX, USA
R. SHALLENBERGER
Affiliation:
City of Houston Department of Health and Human Services, Houston, TX, USA
T. L. YORK
Affiliation:
Harris County Public Health and Environmental Services, Houston, TX, USA
D. MARTINEZ
Affiliation:
Harris County Public Health and Environmental Services, Houston, TX, USA
J. S. HELLUMS
Affiliation:
University of Texas, School of Public Health, Houston, TX, USA University of Texas, School of Medicine, Houston, TX, USA
D. HELLUMS
Affiliation:
Baylor College of Medicine, Houston, TX, USA
M. MALKOFF
Affiliation:
University of Texas, School of Medicine, Houston, TX, USA
N. ELGAWLEY
Affiliation:
City of Houston Department of Health and Human Services, Houston, TX, USA
W. McNEELY
Affiliation:
City of Houston Department of Health and Human Services, Houston, TX, USA
S. A. KHUWAJA
Affiliation:
City of Houston Department of Health and Human Services, Houston, TX, USA
R. B. TESH
Affiliation:
University of Texas Medical Branch, Galveston, TX, USA
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Abstract

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We conducted a nested case-control study to determine potential risk factors for developing encephalitis from West Nile virus (WNV) infection. Retrospective medical chart reviews were completed for 172 confirmed WNV cases hospitalized in Houston between 2002 and 2004. Of these cases, 113 had encephalitis, including 17 deaths, 47 had meningitis, and 12 were fever cases; 67% were male. Homeless patients were more likely to be hospitalized from WNV compared to the general population. A multiple logistic regression model identified age [odds ratio (OR) 1·1, P<0·001], history of hypertension, including those cases taking hypertension-inducing drugs (OR 2·9, P=0·012), and history of cardiovascular disease (OR 3·5, P=0·061) as independent risk factors for developing encephalitis from WNV infection. After adjusting for age, race/ethnicity (being black) (OR 12·0, P<0·001), chronic renal disease (OR 10·6, P<0·001), hepatitis C virus (OR 23·1, P=0·0013), and immunosuppression (OR 3·9, P=0·033) were identified as risk factors for death from WNV infection.

Type
Research Article
Copyright
2006 Cambridge University Press