West Nile fever outbreak, Israel, 2000: epidemiologic aspects.

M Weinberger,R Lang,S D Pitlik,E Mendelson,N Pick,H Bin,Y Siegman-Igra,F Nassar,E Rubinstein,J Mishal,M Giladi,R Kitzes,D Gandacu,A Izthaki,D Ben David,T Shohat

doi:10.3201/eid0704.010416

Abstract

From August 1 to October 31, 2000, 417 cases of West Nile (WN) fever were serologically confirmed throughout Israel; 326 (78%) were hospitalized patients. Cases were distributed throughout the country; the highest incidence was in central Israel, the most populated part. Men and women were equally affected, and their mean age was 54+/-23.8 years (range 6 months to 95 years). Incidence per 1,000 population increased from 0.01 in the 1st decade of life to 0.87 in the 9th decade. There were 35 deaths (case-fatality rate 8.4%), all in patients >50 years of age. Age-specific case-fatality rate increased with age. Central nervous system involvement occurred in 170 (73%) of 233 hospitalized patients. The countrywide spread, number of hospitalizations, severity of the disease, and high death rate contrast with previously reported outbreaks in Israel.

Highlights

From August 1 to October 31, 2000, 417 cases of West Nile (WN) fever were serologically confirmed throughout Israel; 326 (78%) were hospitalized patients
Geographic Distribution From August 1 to October 31, 2000, 417 cases of WN fever were confirmed by the Central Virology Laboratory
No cases of WN virus fever were reported from the Judea, Samaria, and Gaza areas

Summary

Introduction

From August 1 to October 31, 2000, 417 cases of West Nile (WN) fever were serologically confirmed throughout Israel; 326 (78%) were hospitalized patients. There were 35 deaths (case-fatality rate 8.4%), all in patients >50 years of age. The countrywide spread, number of hospitalizations, severity of the disease, and high death rate contrast with previously reported outbreaks in Israel. In early August 2000, infectious disease specialists in hospitals in central Israel noted an increasing number of elderly patients admitted for encephalitis. This article outlines the epidemiologic aspects of this WN fever epidemic; Chowers et al [1] details the clinical characteristics. These are the first in-depth descriptions of an outbreak caused by WN virus involving an entire country

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Conclusion