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Risk Factors for Severe Rift Valley Fever Infection in Kenya, 2007

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  • Ministry of Public Health and Sanitation, Kenya; Centers for Disease Control and Prevention, Atlanta, Georgia; Walter Reed Programme (WRP) U.S. Army Medical Research Unit, Kenya; National Institute of Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; Global Disease Detection Division, Centers for Disease Control and Prevention, Nairobi, Kenya

A large Rift Valley fever (RVF) outbreak occurred in Kenya from December 2006 to March 2007. We conducted a study to define risk factors associated with infection and severe disease. A total of 861 individuals from 424 households were enrolled. Two hundred and two participants (23%) had serologic evidence of acute RVF infection. Of these, 52 (26%) had severe RVF disease characterized by hemorrhagic manifestations or death. Independent risk factors for acute RVF infection were consuming or handling products from sick animals (odds ratio [OR] = 2.53, 95% confidence interval [CI] = 1.78–3.61, population attributable risk percentage [PAR%] = 19%) and being a herdsperson (OR 1.77, 95% CI = 1.20–2.63, PAR% = 11%). Touching an aborted animal fetus was associated with severe RVF disease (OR = 3.83, 95% CI = 1.68–9.07, PAR% = 14%). Consuming or handling products from sick animals was associated with death (OR = 3.67, 95% CI = 1.07–12.64, PAR% = 47%). Exposures related to animal contact were associated with acute RVF infection, whereas exposures to mosquitoes were not independent risk factors.

Author Notes

*Address correspondence to Robert F. Breiman, Global Disease Detection Division, International Emerging Infections Program, CDC-Kenya, Nairobi, Kenya. E-mail: rbreiman@ke.cdc.gov

Financial support: This work was supported by the Ministry of Public Health and Sanitation, Kenya; Centers for Disease Control and Prevention, Atlanta, GA and Nairobi, Kenya; Walter Reed Programme (WRP) U.S. Army Medical Research Unit, Kenya; Kenya Medical Research Institute (KEMRI), Kenya.

Authors' addresses: Amwayi S. Anyangu, Ministry of Public Health and Sanitation, Kenya, Provincial Headquarters North Eastern Province, Garissa, Kenya, E-mail: amwayi2004@yahoo.com. L. Hannah Gould, Centers for Disease Control and Prevention, Atlanta GA, E-mail: lgould@cdc.gov. Shahnaaz K. Sharif, Ministry of Public Health and Sanitation, Nairobi, Kenya, E-mails: sksharif@africaonline.co.ke or pphs@health.go.ke. Patrick M. Nguku, Division of Communicable Disease Control, Ministry of Health, Nairobi-Kenya, E-mail: drnguku@yahoo.com. Jared O. Omolo and David Mutonga, Division of Disease Surveillance and Response, Ministry of Health, Kenya, Nairobi, E-mails: jaredom@gmail.com and davidmutonga@yahoo.com. Carol Y. Rao, Division of Healthcare Quality Promotion Centers for Disease Control and Prevention, Atlanta, GA, E-mail: cnr3@cdc.gov. Edith R. Lederman, Poxvirus and Rabies Branch, Division of Viral and Rickettisial Diseases, National Center for Zoonotic, Vector-borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: dvk9@cdc.gov, erlederman@yahoo.com, or Edith.Lederman@med.navy.mil. David Schnabel, U.S. Army, Medical Corps, Global Emerging Infections System (GEIS), U.S. Army Medical Research Unit – Kenya, E-mail: dschnabel@wrp-nbo.org. Janusz T. Paweska, Special Pathogens Unit, National Institute for Communicable Diseases, South Africa. Mark Katz, Global Disease Detection Division CDC-Kenya, Nairobi, Kenya, E-mail: mkatz@ke.cdc.gov. Allen Hightower, CDC, Kenya, E-mail: AHightower@ke.cdc.gov. M. Kariuki Njenga, GDD/IEIP-Kenya, Centers for Disease Control, E-mail: KNjenga@ke.cdc.gov. Daniel R. Feikin, International Emerging Infections Program – Kenya, Centers for Disease Control and Prevention, U.S. Public Health Service, E-mail: DFeikin@ke.cdc.gov. Robert F. Breiman, Global Disease Detection Division, International Emerging Infections Program, CDC-Kenya, Nairobi, Kenya, E-mail: RBreiman@ke.cdc.gov.

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