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IJE Advance Access published online on January 19, 2005
International Journal of Epidemiology, doi:10.1093/ije/dyh411
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IJE © International Epidemiological Association 2005; all rights reserved.
Accepted November 18, 2004

Original paper

Risks for Ross River virus disease in tropical Australia

David Harley 1*, Scott Ritchie 2, Chris Bain 3, and Adrian C. Sleigh 4

1 Queensland Centre for Intellectual and Developmental Disability, School of Population Health, University of Queensland, Mater Hospital, Brisbane, 4101, Queensland, Australia
2 Tropical Public Health Unit, Queensland Health, Cairns, 4870, Queensland, Australia; School of Public Health and Tropical Medicine, James Cook University, Cairns, 4870, Australia
3 School of Population Health, University of Queensland, Herston, 4006, Queensland, Australia; Queensland Institute of Medical Research, Herston, 4006, Queensland, Australia
4 National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, 0200, Australia

* To whom correspondence should be addressed.
David Harley, E-mail: D.Harley{at}uq.edu.au


  Abstract

Background There are no analytical studies of individual risks for Ross River virus (RRV) disease. Therefore, we set out to determine individual risk and protective factors for RRV disease in a high incidence area and to assess the utility of the case-control design applied for this purpose to an arbovirus disease.

Methods We used a prospective matched case-control study of new community cases of RRV disease in the local government areas of Cairns, Mareeba, Douglas, and Atherton, in tropical Queensland, from January 1 to May 31, 1998.

Results Protective measures against mosquitoes reduced the risk for disease. Mosquito coils, repellents, and citronella candles each decreased risk by at least 2-fold, with a dose-response for the number of protective measures used. Light-coloured clothing decreased risk 3-fold. Camping increased the risk 8-fold.

Conclusions These risks were substantial and statistically significant, and provide a basis for educational programs on individual protection against RRV disease in Australia. Our study demonstrates the utility of the case-control method for investigating arbovirus risks. Such a risk analysis has not been done before for RRV infection, and is infrequently reported for other arbovirus infections.

Keywords: Communicable diseases; emerging; arboviruses; Togaviridae; Alphavirus; Ross River virus; epidemiology; case-control studies; risk; behaviour; mosquito; Diptera; insect repellents; camping; Queensland; Australia.
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