Modifiable Risk Factors for West Nile Virus Infection during an Outbreak—Arizona, 2010

Katherine B. Gibney Division of Vector-borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado; Epidemic Intelligence Service Program, CDC, Atlanta, Georgia; Arizona Department of Health Services, Phoenix, Arizona; Maricopa County Department of Public Health, Phoenix, Arizona; Pinal County Division of Public Health, Florence, Arizona

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James Colborn Division of Vector-borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado; Epidemic Intelligence Service Program, CDC, Atlanta, Georgia; Arizona Department of Health Services, Phoenix, Arizona; Maricopa County Department of Public Health, Phoenix, Arizona; Pinal County Division of Public Health, Florence, Arizona

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Steven Baty Division of Vector-borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado; Epidemic Intelligence Service Program, CDC, Atlanta, Georgia; Arizona Department of Health Services, Phoenix, Arizona; Maricopa County Department of Public Health, Phoenix, Arizona; Pinal County Division of Public Health, Florence, Arizona

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Andrean M. Bunko Patterson Division of Vector-borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado; Epidemic Intelligence Service Program, CDC, Atlanta, Georgia; Arizona Department of Health Services, Phoenix, Arizona; Maricopa County Department of Public Health, Phoenix, Arizona; Pinal County Division of Public Health, Florence, Arizona

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Tammy Sylvester Division of Vector-borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado; Epidemic Intelligence Service Program, CDC, Atlanta, Georgia; Arizona Department of Health Services, Phoenix, Arizona; Maricopa County Department of Public Health, Phoenix, Arizona; Pinal County Division of Public Health, Florence, Arizona

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Graham Briggs Division of Vector-borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado; Epidemic Intelligence Service Program, CDC, Atlanta, Georgia; Arizona Department of Health Services, Phoenix, Arizona; Maricopa County Department of Public Health, Phoenix, Arizona; Pinal County Division of Public Health, Florence, Arizona

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Tasha Stewart Division of Vector-borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado; Epidemic Intelligence Service Program, CDC, Atlanta, Georgia; Arizona Department of Health Services, Phoenix, Arizona; Maricopa County Department of Public Health, Phoenix, Arizona; Pinal County Division of Public Health, Florence, Arizona

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Craig Levy Division of Vector-borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado; Epidemic Intelligence Service Program, CDC, Atlanta, Georgia; Arizona Department of Health Services, Phoenix, Arizona; Maricopa County Department of Public Health, Phoenix, Arizona; Pinal County Division of Public Health, Florence, Arizona

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Ken Komatsu Division of Vector-borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado; Epidemic Intelligence Service Program, CDC, Atlanta, Georgia; Arizona Department of Health Services, Phoenix, Arizona; Maricopa County Department of Public Health, Phoenix, Arizona; Pinal County Division of Public Health, Florence, Arizona

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Katherine MacMillan Division of Vector-borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado; Epidemic Intelligence Service Program, CDC, Atlanta, Georgia; Arizona Department of Health Services, Phoenix, Arizona; Maricopa County Department of Public Health, Phoenix, Arizona; Pinal County Division of Public Health, Florence, Arizona

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Mark J. Delorey Division of Vector-borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado; Epidemic Intelligence Service Program, CDC, Atlanta, Georgia; Arizona Department of Health Services, Phoenix, Arizona; Maricopa County Department of Public Health, Phoenix, Arizona; Pinal County Division of Public Health, Florence, Arizona

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John-Paul Mutebi Division of Vector-borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado; Epidemic Intelligence Service Program, CDC, Atlanta, Georgia; Arizona Department of Health Services, Phoenix, Arizona; Maricopa County Department of Public Health, Phoenix, Arizona; Pinal County Division of Public Health, Florence, Arizona

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Marc Fischer Division of Vector-borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado; Epidemic Intelligence Service Program, CDC, Atlanta, Georgia; Arizona Department of Health Services, Phoenix, Arizona; Maricopa County Department of Public Health, Phoenix, Arizona; Pinal County Division of Public Health, Florence, Arizona

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J. Erin Staples Division of Vector-borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado; Epidemic Intelligence Service Program, CDC, Atlanta, Georgia; Arizona Department of Health Services, Phoenix, Arizona; Maricopa County Department of Public Health, Phoenix, Arizona; Pinal County Division of Public Health, Florence, Arizona

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West Nile virus (WNV) is the leading cause of mosquito-borne disease in the United States; however, risk factors for infection are poorly defined. We performed a case-control study to identify modifiable risk factors for WNV infection. Case-patients (N = 49) had laboratory evidence of recent WNV infection, whereas control-subjects (N = 74) had negative WNV serology. We interviewed participants, surveyed households, and assessed environmental data. WNV infection was associated with living in or near Water District X within Gilbert Township (adjusted odds ratio [aOR] 5.2; 95% confidence interval [95% CI] = 1.5–18.1), having water-holding containers in their yard (aOR 5.0; 95% CI = 1.5–17.3), and not working or attending school outside the home (aOR 2.4; 95% CI = 1.1–5.5). During this outbreak, WNV infection was likely primarily acquired peri-domestically with increased risk associated with potential mosquito larval habitats around the home and neighborhood.

Author Notes

*Address correspondence to J. Erin Staples, Division of Vector Borne Disease, Centers for Disease Control and Prevention, 3150 Rampart Road, Fort Collins, CO 80521. E-mail: AUV1@cdc.gov

Authors' addresses: Katherine B. Gibney, Department of Epidemiology and Preventive Medicine, Monash University, The Alfred Centre, Melbourne, Australia, E-mail: Katherine.Gibney@monash.edu. James Colborn, Division Of Parasitic Diseases And Malaria, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: fue6@cdc.gov. Steven Baty, U.S. Army, Public Health Command and Region-Europe, Landstuhl, Germany, E-mail: steven.baty@us.army.mil. Andrean M. Bunko Patterson, Tammy Sylvester, and Craig Levy, Maricopa County Department of Public Health, Phoenix, AZ, E-mails: AndreanBunkoPatterson@mail.maricopa.gov, tammysylvester@mail.maricopa.gov, and CraigLevy@mail.maricopa.gov. Graham Briggs, Pinal County Division of Public Health, Florence, AZ, E-mail: grahambriggs@pinalcountyaz.gov. Tasha Stewart, Tempe Police Department, Tempe, AZ, E-mail: stewarttasha@gmail.com. Ken Komatsu, Arizona Department of Health Services, Phoenix, AZ, E-mail: Ken.Komatsu@azdhs.gov. Katherine MacMillan, Mark J. Delorey, John-Paul Mutebi, Marc Fischer, and J. Erin Staples, Division of Vector-borne Disease, Centers for Disease Control and Prevention, Fort Collins, CO, E-mails: iky4@cdc.gov, esy7@cdc.gov, grv0@cdc.gov, mxf2@cdc.gov, and auv1@cdc.gov.

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