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Risk factors for Nipah virus encephalitis in Bangladesh.

Montgomery JM, Hossain MJ, Gurley E, Carroll GD, Croisier A, Bertherat E, Asgari N, Formenty P, Keeler N, Comer J, Bell MR, Akram K, Molla AR, Zaman K, Islam MR, Wagoner K, Mills JN, Rollin PE, Ksiazek TG, Breiman RF - Emerging Infect. Dis. (2008)

Bottom Line: Exact odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by using a matched analysis.We did not identify an increased risk for NiV infection among persons who had contact with a potential intermediate host.Although we cannot rule out person-to-person transmission, case-patients were likely infected from contact with fruit bats or their secretions.

View Article: PubMed Central - PubMed

Affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA. jmontgomery@cdc.gov

ABSTRACT
Nipah virus (NiV) is a paramyxovirus that causes severe encephalitis in humans. During January 2004, twelve patients with NiV encephalitis (NiVE) were identified in west-central Bangladesh. A case-control study was conducted to identify factors associated with NiV infection. NiVE patients from the outbreak were enrolled in a matched case-control study. Exact odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by using a matched analysis. Climbing trees (83% of cases vs. 51% of controls, OR 8.2, 95% CI 1.25-infinity) and contact with another NiVE patient (67% of cases vs. 9% of controls, OR 21.4, 95% CI 2.78-966.1) were associated with infection. We did not identify an increased risk for NiV infection among persons who had contact with a potential intermediate host. Although we cannot rule out person-to-person transmission, case-patients were likely infected from contact with fruit bats or their secretions.

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Related in: MedlinePlus

Top: Distribution of Nipah virus case (n = 12) and control (n = 36) households within the outbreak/study site of Goalando township, Bangladesh, January 2004. Number in the yellow triangle corresponds to household no. in Figure 2. Map also shows extreme habitat disturbance; areas under cultivation (for rice, sugar cane) are highlighted with “C,” and remaining trees (fruit trees and bamboo stands) with “T.” Bottom: Location of outbreak village.
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Figure 1: Top: Distribution of Nipah virus case (n = 12) and control (n = 36) households within the outbreak/study site of Goalando township, Bangladesh, January 2004. Number in the yellow triangle corresponds to household no. in Figure 2. Map also shows extreme habitat disturbance; areas under cultivation (for rice, sugar cane) are highlighted with “C,” and remaining trees (fruit trees and bamboo stands) with “T.” Bottom: Location of outbreak village.

Mentions: An outbreak of encephalitis in Bangladesh was recognized on January 21, 2004; it affected 2 villages of Goalando township, Rajbari District, Dhaka Division, 70 km west of the city of Dhaka (Figure 1). Ten deaths were reported among 12 ill persons with symptoms compatible with NiVE, resulting in a case-fatality ratio of 83% (9,23). Although previous outbreaks of NiVE outside Bangladesh involved primarily men and women >25 years of age (5,16,17,19,26), most (75%) patients in this outbreak were boys <15 years of age. We describe a matched case-control study that was conducted to characterize the epidemiology of NiVE and, specifically, to determine if risk for NiVE was associated with contact with animals; an environmental exposure, activity, or behavior; or contact with other NiVE patients during the 2004 NiVE outbreak in Goalando township.


Risk factors for Nipah virus encephalitis in Bangladesh.

Montgomery JM, Hossain MJ, Gurley E, Carroll GD, Croisier A, Bertherat E, Asgari N, Formenty P, Keeler N, Comer J, Bell MR, Akram K, Molla AR, Zaman K, Islam MR, Wagoner K, Mills JN, Rollin PE, Ksiazek TG, Breiman RF - Emerging Infect. Dis. (2008)

Top: Distribution of Nipah virus case (n = 12) and control (n = 36) households within the outbreak/study site of Goalando township, Bangladesh, January 2004. Number in the yellow triangle corresponds to household no. in Figure 2. Map also shows extreme habitat disturbance; areas under cultivation (for rice, sugar cane) are highlighted with “C,” and remaining trees (fruit trees and bamboo stands) with “T.” Bottom: Location of outbreak village.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2609878&req=5

Figure 1: Top: Distribution of Nipah virus case (n = 12) and control (n = 36) households within the outbreak/study site of Goalando township, Bangladesh, January 2004. Number in the yellow triangle corresponds to household no. in Figure 2. Map also shows extreme habitat disturbance; areas under cultivation (for rice, sugar cane) are highlighted with “C,” and remaining trees (fruit trees and bamboo stands) with “T.” Bottom: Location of outbreak village.
Mentions: An outbreak of encephalitis in Bangladesh was recognized on January 21, 2004; it affected 2 villages of Goalando township, Rajbari District, Dhaka Division, 70 km west of the city of Dhaka (Figure 1). Ten deaths were reported among 12 ill persons with symptoms compatible with NiVE, resulting in a case-fatality ratio of 83% (9,23). Although previous outbreaks of NiVE outside Bangladesh involved primarily men and women >25 years of age (5,16,17,19,26), most (75%) patients in this outbreak were boys <15 years of age. We describe a matched case-control study that was conducted to characterize the epidemiology of NiVE and, specifically, to determine if risk for NiVE was associated with contact with animals; an environmental exposure, activity, or behavior; or contact with other NiVE patients during the 2004 NiVE outbreak in Goalando township.

Bottom Line: Exact odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by using a matched analysis.We did not identify an increased risk for NiV infection among persons who had contact with a potential intermediate host.Although we cannot rule out person-to-person transmission, case-patients were likely infected from contact with fruit bats or their secretions.

View Article: PubMed Central - PubMed

Affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA. jmontgomery@cdc.gov

ABSTRACT
Nipah virus (NiV) is a paramyxovirus that causes severe encephalitis in humans. During January 2004, twelve patients with NiV encephalitis (NiVE) were identified in west-central Bangladesh. A case-control study was conducted to identify factors associated with NiV infection. NiVE patients from the outbreak were enrolled in a matched case-control study. Exact odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by using a matched analysis. Climbing trees (83% of cases vs. 51% of controls, OR 8.2, 95% CI 1.25-infinity) and contact with another NiVE patient (67% of cases vs. 9% of controls, OR 21.4, 95% CI 2.78-966.1) were associated with infection. We did not identify an increased risk for NiV infection among persons who had contact with a potential intermediate host. Although we cannot rule out person-to-person transmission, case-patients were likely infected from contact with fruit bats or their secretions.

Show MeSH
Related in: MedlinePlus