A statistical model of Rift Valley fever activity in Egypt.

Rift Valley fever (RVF) is a viral disease of animals and humans and a global public health concern due to its ecological plasticity, adaptivity, and potential for spread to countries with a temperate climate. In many places, outbreaks are episodic and linked to climatic, hydrologic, and socioeconomic factors. Although outbreaks of RVF have occurred in Egypt since 1977, attempts to identify risk factors have been limited. Using a statistical learning approach (lasso-regularized generalized linear model), we tested the hypotheses that outbreaks in Egypt are linked to (1) River Nile conditions that create a mosquito vector habitat, (2) entomologic conditions favorable to transmission, (3) socio-economic factors (Islamic festival of Greater Bairam), and (4) recent history of transmission activity. Evidence was found for effects of rainfall and river discharge and recent history of transmission activity. There was no evidence for an effect of Greater Bairam. The model predicted RVF activity correctly in 351 of 358 months (98.0%). This is the first study to statistically identify risk factors for RVF outbreaks in a region of unstable transmission.