In the summer of 1996 Romania experienced a large outbreak of West Nile virus (WNV) meningoencephalitis with more than 500 clinical cases and high rates of death (up to 10%). It was the first epidemic recorded in Europe associated with urban/suburban infrastructural conditions that favoured an increase in the distribution and abundance of mosquito vectors. Careful monitoring of acute neurological human cases reported in previously affected districts, during a 10‐year period following the epidemic, revealed a gradual decrease of viral transmission and the absence of recurrent outbreaks. An additional benefit of WNV surveillance system has been the ability to pick up summer meningoencephalitis outbreaks or other causes of neurologic morbidity, like heatstroke, occurring in epidemic form during heat waves. This article provides a critical analysis of the post‐epidemic surveillance system together with a review of the intermediate‐term changes in ecological factors favouring viral transmission, by increasing interaction between mosquito vectors, avian hosts and susceptible human population.